Retrospective Hair Cortisol Concentrations from Pretreatment to Early Recovery in Alcohol Use Disorder.

Abstract

Cortisol profiles are known to vary across phases of alcohol use disorder (AUD; e.g. chronic use, withdrawal and early/sustained recovery). These patterns have largely been established through between-subjects contrasts. Using a segmental hair cortisol concentrations (HCC) approach, retrospective longitudinal analyses are feasible. Here, we examine monthly cortisol secretion in treatment-seekers with AUD from alcohol use to abstinence. At ~6weeks of recovery we collected hair samples from individuals with moderate-to-severe AUD. We examined HCC from three consecutive segments; proximal to the scalp representing the most recent month (sustained abstinence from alcohol), the midsegment representing the previous month in which abstinence was attained, and the distal segment representing 2months prior during active drinking. Analyses examined main and interactive effects of segment and sex, controlling for monthly alcohol consumption. Best fit by a quadratic shape, within-subject change was significant (F1,15=5.27, P=0.04, ηpartial2=0.26). The distal and midsegments did not differ from one another (P=0.51). The proximal segment was significantly lower than both the distal (M∆=0.200, P=0.004) and mid (M∆=0.175, P<0.001) segments. An effect of sex approached significance suggesting women had modestly higher HCC than men (MWOMEN=1.37 vs. MMEN=1.02, P=0.10). Consistent with previous cross-sectional reports, these data confirm nonlinear patterns of cortisol accumulation with elevations apparent during periods of alcohol consumption and a decrease in abstinence. Capturing these within-subject patterns via HCC trajectories may serve as a valuable resource in identifying profiles associated with increased risk and post-treatment outcomes.