Abstract
RationaleChronic alcohol misuse can escalate into alcohol use disorder (AUD). The causal mechanisms through which recreational social drinking develops into compulsive uncontrolled alcohol misuse are multifaceted. For example, stress is an important risk factor that influences alcohol craving in both healthy and addicted individuals. In addition, those that are high in impulsivity/risk taking drink more and are at greater risk of developing addiction. At present, however, it is not possible accurately to predict those at risk of escalation in alcohol use, or of developing AUD.ObjectivesThe aim of this study was to investigate how underlying physiological and personality traits affect stress-induced craving for, and consumption of, alcohol, in a sample of social drinkers. The primary hypothesis was that impulsivity/risk-taking would modulate stress-induced alcohol craving and consumption.MethodsThirty-nine participants (22 male and 17 female; mean age = 23.92 years [SD = 4.90]) were randomly allocated to ‘stress’ and ‘no-stress’ groups; in the stress group, participants took part in the Trier Social Stress Test (TSST). Participants completed several questionnaires and computer tasks in order to assess prior alcohol use, impulsivity/risk-taking, stress-reactivity, craving and physiological biomarkers of stress. Finally, participants completed a voluntary drinking task, in which increasing numbers of presses on a computer keyboard were reinforced with 5-ml shots of 37% ABV vodka (plus mixer).ResultsParticipants exposed to the TSST showed an increase in craving following the stressor. Several factors predicted voluntary drinking, including risky decision making, slow HR recovery from stress, poor vagal tone during recovery from stress and greater stress reactivity. Surprisingly, we found no correlation between craving and consumption.ConclusionsOur data suggest that variation in physiological stress parameters and poor decision-making abilities increase risk of stress-induced alcohol consumption. This may provide a useful translational framework through which we can further study early predictive markers for the shift between controlled recreational drinking to uncontrolled alcohol misuse, including AUD.
Highlights
Alcohol misuse is one of the leading avoidable risk factors for morbidity and mortality, and presents a significant globalElectronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.health challenge (Rehm et al 2009)
inter-beat interval (IBI) data acquired from the Polar Heart Rate monitor were converted standard deviation of NN intervals (SDNN) using Kubios for Windows (Tarvainen et al 2014)
BIS Motor was greater in males (M = 24.32, SD = 3.85) than in females (M = 21.88, SD = 2.67), t (37) = 2.33, p = 0.02, Cohen’s d = 0.72 [95% CI of difference
Summary
Alcohol misuse is one of the leading avoidable risk factors for morbidity and mortality, and presents a significant global. Alcohol misuse can escalate into alcohol use disorder (AUD) (Skinner and Allen 1982). AUD and other substance use disorders (SUDs) have traditionally been described as diseases Regardless of which theory you subscribe to, the consequences of addiction are severe and often lead to adverse health outcomes. Despite the substantial current and projected prevalence of AUD, and decades of research into alcohol misuse and AUD, we are still unable to provide effective treatment programs for those affected, or put into place effective protective factors to predict and prevent AUD from developing in at-risk individuals (Harris and Koob 2017). Current treatments for AUD are inefficacious, and in order to find curative or preventative treatments or interventions we must identify and understand the risk factors which cause both the acquisition and maintenance of the disease
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