Subjective response to alcohol and associated craving in heavy drinkers vs. alcohol dependents: an examination of Koob's allostatic model in humans.
BACKGROUND
Koob's allostatic model of addiction emphasizes the transition from positive reinforcement to negative reinforcement as dependence develops. This study seeks to extend this well-established neurobiological model to humans by examining subjective response to alcohol (SR) as a biobehavioral marker of alcohol reinforcement. Specifically, this study examines (a) differential SR in heavy drinkers (HDs) vs. alcohol dependent individuals (ADs) and (b) whether HDs and ADs differ in terms of the association between SR and craving.


METHODS
Data was culled from two alcohol challenge studies, totalling 91 participants (oversampled on OPRM1 Asp40 carriers). Alcohol was administered intravenously and participants completed standard measures of SR and craving at BrAC's of 0.02, 0.04, and 0.06 g/dl. SR was modeled as a multi-dimensional construct consisting of stimulation, sedation, and tension relief.


RESULTS
ADs reported significantly higher sedation and craving initially and exhibited a blunted response to alcohol along escalating BrACs. ADs exhibited greater initial tension but did not differ from HDs in tension reduction across rising BrACs. Further, alcohol-induced stimulation was associated with alcohol craving to a significantly greater degree in HDs, as compared to ADs.


CONCLUSIONS
This study provides initial evidence that HDs and ADs differ in their subjective experience of alcohol and in the association between dimensions of SR and craving for alcohol. Hypotheses derived from the allostatic model were partially supported, such that, while ADs and HDs did not differ on stimulation response, there was a relative dissociation between positive reinforcement and craving in ADs as compared to HDs.
University of California Los Angeles, Department of Psychology, Los Angeles, CA, United States.
Spencer
S
Bujarski
University of California Los Angeles, Department of Psychology, Los Angeles, CA, United States; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, United States. Electronic address: lararay@psych.ucla.edu.
Lara A
LA
Ray
D000328:Adult; D000339:Affect; D000437:Alcoholism / Q000523:psychology*; D001290:Attitude; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
Alcohol challenge; Alcoholism; Latent growth modeling; Subjective response to alcohol