title: Stress- and cue-elicited craving and reactivity in marijuana-dependent individuals.
abstract: BACKGROUND
  Cue-elicited craving and stress responses have been identified as predictors of relapse in drug dependence, but little research exists on the contribution of these factors to marijuana use specifically.
  
  
  OBJECTIVE
  The aims of the present study were to evaluate (1) responses to a psychological stressor, (2) responses to marijuana-related cues, and (3) if an exposure to a psychological stressor augmented craving subsequently elicited by marijuana-related cue exposure in marijuana-dependent individuals.
  
  
  METHODS
  Subjective (craving, stress), neuroendocrine (adrenocorticotropic hormone (ACTH), cortisol), and physiologic responses to the presentation of neutral and marijuana cues were assessed after randomization to a stress (Trier Social Stress Task (TSST)) or non-stress control condition in marijuana-dependent individuals. Outcome measures were assessed at baseline, post-stressor/pre-neutral cue, post-neutral cue, and post-marijuana cue.
  
  
  RESULTS
  Eighty-seven participants completed procedures (stress group, n = 45; non-stress group, n = 42). The stress group had a significant increase over the non-stress group in stress rating (p < 0.001), craving (p = 0.028), cortisol (p < 0.001), and ACTH (p < 0.001) after the completion of the TSST. An increased craving response for all participants was seen following the presentation of the marijuana cues (p = 0.005). Following the TSST or non-stress condition, the non-stress group had an increase in craving to marijuana cues as compared to neutral cues (p = 0.002); an increase in craving was not observed in the stress group (p = 0.404).
  
  
  CONCLUSIONS
  Marijuana cue exposure and a social stressor increased craving in marijuana-dependent individuals. Completion of the TSST did not increase craving response to subsequent marijuana cue exposure.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. mcraeal@musc.edu
authors.forename: Aimee L
authors.initials: AL
authors.lastname: McRae-Clark
authors.forename: Rickey E
authors.initials: RE
authors.lastname: Carter
authors.forename: Kimber L
authors.initials: KL
authors.lastname: Price
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Baker
authors.forename: Suzanne
authors.initials: S
authors.lastname: Thomas
authors.forename: Michael E
authors.initials: ME
authors.lastname: Saladin
authors.forename: Kathleen
authors.initials: K
authors.lastname: Giarla
authors.forename: Katherine
authors.initials: K
authors.lastname: Nicholas
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D003463:Cues; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology*; D011581:Psychological Tests; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone