title: Self-reports of interoceptive responses during stress and drug cue-related experiences in cocaine- and alcohol-dependent individuals.
abstract: Cocaine dependence is associated with neuroadaptations in stress and reward pathways that could alter stress and drug-related experiences and associated interoceptive sensations and result in enhanced craving states. Subjective interoceptive emotional and physiological responses experienced in stressful and drug cue situations were examined in abstinent cocaine-dependent individuals. Fifty-six treatment engaged cocaine-dependent patients with comorbid alcohol abuse or dependence were interviewed to identify personal stressful, drug cue, and neutral situations using a scene construction questionnaire (SCQ) that includes an emotional and physiological response checklist. Using this checklist, subjects identified emotional and bodily sensations that they recently experienced in the stress- and drug-related scenarios. Kappa coefficients indicated fair to moderate but significant degree of concordance in heart (p < .01), perspiration (p < .05), stomach (p < .05), and blood flow (p < .01) sensations for both stress and drug cue scenarios, while the McNemar change test indicated differential endorsement of interoceptive responses in stress and drug cue situations for breathing (p < .05), stomach (p < .05), tension (p < .05), and chest (p < .05) sensations, and for sad (p < .01), anger (p < .01), and excitement (p < .01) responses. Increased heartbeat and tension, tears, and anger urges were most commonly endorsed in the stress scenarios (between 50% and 79%), whereas butterflies in stomach, increased heartbeat and tension, jittery, restless, and warm excitement (53%-73%) were the most frequently endorsed sensations in the drug cue-related experiences. These self-reported sensations comprise both general arousal and specific interoceptive responses pertaining to stress or drug cue-related experiences in cocaine dependence, with potential value in guiding treatments targeting craving reduction.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. keri.bergquist@yale.edu
authors.forename: Keri L
authors.initials: KL
authors.lastname: Bergquist
authors.forename: Helen C
authors.initials: HC
authors.lastname: Fox
authors.forename: Rajita
authors.initials: R
authors.lastname: Sinha
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D001341:Autonomic Nervous System / Q000503:physiopathology; D057189:Checklist; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012650:Self Disclosure; D012677:Sensation / Q000502:physiology*; D013315:Stress, Psychological / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D055815:Young Adult