Stress-related salivary alpha-amylase (sAA) activity in alcohol dependent patients with and without a history of childhood maltreatment.
BACKGROUND
Alcohol-dependent (AD) patients with a history of childhood maltreatment (CM) have shown a more severe clinical profile and a higher risk of relapse than those without CM. It was hypothesized that stress responsivity plays an important role in moderating the relationship between CM and AD. Surprisingly, systematic investigations about the stress responsivity in AD patients with CM are rare.


OBJECTIVE
This study compared physiological and subjective stress responses in AD patients with and without CM as well as in healthy controls with and without CM.


METHODS
A total of 130 participants performed the Trier Social Stress Test (TSST). Physiological stress reactivity related to the noradrenergic system was assessed by salivary alpha-amylase (sAA) activity. Subjective ratings of anxiety, nervousness, distress, and mood were rated on visual analogue scales.


RESULTS
AD patients showed significantly lower stress-related sAA activity than healthy controls (p ≤ 0.024; z ≥ 1.97). A different pattern was found in the subjective ratings. In particular, anticipatory anxiety revealed a clear effect of CM (p ≤ 0.005; z ≥ 2.43) but no difference between AD patients and healthy controls (p > 0.05). After the TSST, distress ratings differed between AD patients with CM and AD patients without CM (p ≤ 0.009; z ≥ 2.61).


CONCLUSIONS
The discrepancy between physiological responsivity and subjective stress experiences may account for an increased inability to cope with stressful situations, which in turn might explain the enhanced risk of relapse in AD patients with a history of CM during early abstinence.
Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany. markus.muehlhan@tu-dresden.de.|Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany. markus.muehlhan@tu-dresden.de.
Markus
M
Muehlhan
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany.
Anja
A
Höcker
Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
Michael
M
Höfler
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany.
Klaus
K
Wiedemann
Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
Sven
S
Barnow
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany.|Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany.
Ingo
I
Schäfer
D000328:Adult; D000339:Affect / Q000502:physiology; D000437:Alcoholism / Q000175:diagnosis / Q000201:enzymology* / Q000523:psychology*; D002649:Child Abuse / Q000523:psychology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055291:Salivary alpha-Amylases / Q000032:analysis / Q000378:metabolism*; D013312:Stress, Physiological / Q000502:physiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000201:enzymology* / Q000523:psychology*; D011795:Surveys and Questionnaires
D055291:Salivary alpha-Amylases
Alcohol dependence; Childhood maltreatment; Noradrenaline; Salivary alpha-amylase; Stress; Sympathetic nervous system