Enhanced Negative Emotion and Alcohol Craving, and Altered Physiological Responses Following Stress and Cue Exposure in Alcohol Dependent Individuals

Overview

Journal Neuropsychopharmacology

Date 2008 Jun 20

PMID 18563062

Citations 250

Authors

Rajita Sinha

Helen C Fox

Kwangik A Hong

Keri Bergquist

Zubin Bhagwagar

Kristen M Siedlarz

Affiliations

Soon will be listed here.

Abstract

Chronic alcohol abuse is associated with changes in stress and reward pathways that could alter vulnerability to emotional stress and alcohol craving. This study examines whether chronic alcohol abuse is associated with altered stress and alcohol craving responses. Treatment-engaged, 28-day abstinent alcohol-dependent individuals (ADs; 6F/22M), and social drinkers (SDs; 10F/18M) were exposed to a brief guided imagery of a personalized stressful, alcohol-related and neutral-relaxing situation, one imagery condition per session, presented in random order across 3 days. Alcohol craving, anxiety and emotion ratings, behavioral distress responses, heart rate, blood pressure, and salivary cortisol measures were assessed. Alcohol patients showed significantly elevated basal heart rate and salivary cortisol levels. Stress and alcohol cue exposure each produced a significantly enhanced and persistent craving state in alcohol patients that was marked by increased anxiety, negative emotion, systolic blood pressure responses, and, in the case of alcohol cue, behavioral distress responses, as compared to SDs. Blunted stress-induced cortisol responses were observed in the AD compared to the SD group. These data are the first to document that stress and cue exposure induce a persistent negative emotion-related alcohol craving state in abstinent alcoholics accompanied by dysregulated HPA and physiological arousal responses. As laboratory models of stress and negative mood-induced alcohol craving are predictive of relapse outcomes, one implication of the current data is that treatments targeting decreases in stress and alcohol cue-induced craving and regulation of stress responses could be of benefit in improving alcohol relapse outcomes.

Citing Articles

Synchrony between midbrain gene transcription and dopamine terminal regulation is modulated by chronic alcohol drinking.

Farahbakhsh Z, Holleran K, Sens J, Fordahl S, Mauterer M, Lopez A Nat Commun. 2025; 16(1):1944.

PMID: 39994195 PMC: 11850823. DOI: 10.1038/s41467-025-56715-y.

Influence of real-world cue exposure and mood states on drinking: testing neurobiological models of alcohol use disorder.

Meredith L, BaskervilleMann W, Baskerville W, Lee C, Grodin E, Wassum K Psychopharmacology (Berl). 2025; .

PMID: 39924613 DOI: 10.1007/s00213-025-06752-8.

Translation Effectiveness of Offset Heart Rate Biofeedback as a Mindless Intervention for Alcohol Craving Among Risky Drinkers: Controlled Experiment.

Zhao Y, Arora J, Tao Y, Miller D, Adams A, Choudhury T JMIR Form Res. 2024; 8:e54438.

PMID: 39740221 PMC: 11733521. DOI: 10.2196/54438.

Altered Physiological, Affective, and Functional Connectivity Responses to Acute Stress in Patients With Alcohol Use Disorder.

Schwarze Y, Voges J, Schroder A, Dreessen S, Voss O, Krach S Biol Psychiatry Glob Open Sci. 2024; 4(5):100358.

PMID: 39188288 PMC: 11345646. DOI: 10.1016/j.bpsgos.2024.100358.

Cerebellar Contributions to Traumatic Autobiographical Memory in People with Post-Traumatic Stress Disorder.

Blithikioti C, Duek O, Gordon C, Krystal J, Levy I, Harpaz-Rotem I Cerebellum. 2024; 23(6):2332-2340.

PMID: 39180693 DOI: 10.1007/s12311-024-01731-9.

References

Koob G, Kreek M . Stress, dysregulation of drug reward pathways, and the transition to drug dependence. Am J Psychiatry. 2007; 164(8):1149-59. PMC: 2837343. DOI: 10.1176/appi.ajp.2007.05030503. View

Heinz A, Siessmeier T, Wrase J, Buchholz H, Grunder G, Kumakura Y . Correlation of alcohol craving with striatal dopamine synthesis capacity and D2/3 receptor availability: a combined [18F]DOPA and [18F]DMFP PET study in detoxified alcoholic patients. Am J Psychiatry. 2005; 162(8):1515-20. DOI: 10.1176/appi.ajp.162.8.1515. View

Thayer J, Hall M, Sollers 3rd J, Fischer J . Alcohol use, urinary cortisol, and heart rate variability in apparently healthy men: Evidence for impaired inhibitory control of the HPA axis in heavy drinkers. Int J Psychophysiol. 2005; 59(3):244-50. DOI: 10.1016/j.ijpsycho.2005.10.013. View

Shaham Y, Shalev U, Lu L, de Wit H, Stewart J . The reinstatement model of drug relapse: history, methodology and major findings. Psychopharmacology (Berl). 2002; 168(1-2):3-20. DOI: 10.1007/s00213-002-1224-x. View

Sinha R, Talih M, Malison R, Cooney N, Anderson G, Kreek M . Hypothalamic-pituitary-adrenal axis and sympatho-adreno-medullary responses during stress-induced and drug cue-induced cocaine craving states. Psychopharmacology (Berl). 2003; 170(1):62-72. DOI: 10.1007/s00213-003-1525-8. View

Kutscher S, Heise D, Banger M, Saller B, Michel M, Gastpar M . Concomitant endocrine and immune alterations during alcohol intoxication and acute withdrawal in alcohol-dependent subjects. Neuropsychobiology. 2002; 45(3):144-9. DOI: 10.1159/000054955. View

Koob G, Ahmed S, Boutrel B, Chen S, Kenny P, Markou A . Neurobiological mechanisms in the transition from drug use to drug dependence. Neurosci Biobehav Rev. 2004; 27(8):739-49. DOI: 10.1016/j.neubiorev.2003.11.007. View

Matsuzawa S, Suzuki T, Misawa M . Conditioned fear stress induces ethanol-associated place preference in rats. Eur J Pharmacol. 1998; 341(2-3):127-30. DOI: 10.1016/s0014-2999(97)01456-8. View

Sinha R . The role of stress in addiction relapse. Curr Psychiatry Rep. 2007; 9(5):388-95. DOI: 10.1007/s11920-007-0050-6. View

10.

Grusser S, Morsen C, Wolfling K, Flor H . The relationship of stress, coping, effect expectancies and craving. Eur Addict Res. 2006; 13(1):31-8. DOI: 10.1159/000095813. View

11.

Shively C, Mietus J, Grant K, Goldberger A, Bennett A, Willard S . Effects of chronic moderate alcohol consumption and novel environment on heart rate variability in primates (Macaca fascicularis). Psychopharmacology (Berl). 2007; 192(2):183-91. DOI: 10.1007/s00213-007-0709-z. View

12.

Laberg J, Ellertsen B . Psychophysiological indicators of craving in alcoholics: effects of cue exposure. Br J Addict. 1987; 82(12):1341-8. DOI: 10.1111/j.1360-0443.1987.tb00437.x. View

13.

Bhagwagar Z, Hafizi S, Cowen P . Increase in concentration of waking salivary cortisol in recovered patients with depression. Am J Psychiatry. 2003; 160(10):1890-1. DOI: 10.1176/appi.ajp.160.10.1890. View

14.

Beresford T, Arciniegas D, Alfers J, Clapp L, Martin B, Beresford H . Hypercortisolism in alcohol dependence and its relation to hippocampal volume loss. J Stud Alcohol. 2006; 67(6):861-7. DOI: 10.15288/jsa.2006.67.861. View

15.

Measelle J, Stice E, Springer D . A prospective test of the negative affect model of substance abuse: moderating effects of social support. Psychol Addict Behav. 2006; 20(3):225-33. PMC: 1560098. DOI: 10.1037/0893-164X.20.3.225. View

16.

Holsboer F, von Bardeleben U, Buller R, Heuser I, Steiger A . Stimulation response to corticotropin-releasing hormone (CRH) in patients with depression, alcoholism and panic disorder. Horm Metab Res Suppl. 1987; 16:80-8. View

17.

Shaw J, Kolesar G, Sellers E, KAPLAN H, Sandor P . Development of optimal treatment tactics for alcohol withdrawal. I. Assessment and effectiveness of supportive care. J Clin Psychopharmacol. 1981; 1(6):382-89. DOI: 10.1097/00004714-198111000-00006. View

18.

Breese G, Chu K, Dayas C, Funk D, Knapp D, Koob G . Stress enhancement of craving during sobriety: a risk for relapse. Alcohol Clin Exp Res. 2005; 29(2):185-95. PMC: 2868509. DOI: 10.1097/01.alc.0000153544.83656.3c. View

19.

Lang P, Levin D, Miller G, KOZAK M . Fear behavior, fear imagery, and the psychophysiology of emotion: the problem of affective response integration. J Abnorm Psychol. 1983; 92(3):276-306. DOI: 10.1037//0021-843x.92.3.276. View

20.

Goldman D, Oroszi G, Ducci F . The genetics of addictions: uncovering the genes. Nat Rev Genet. 2005; 6(7):521-32. DOI: 10.1038/nrg1635. View