Enhanced Negative Emotion and Alcohol Craving, and Altered Physiological Responses Following Stress and Cue Exposure in Alcohol Dependent Individuals
Enhanced Negative Emotion and Alcohol Craving, and Altered Physiological Responses Following Stress and Cue Exposure in Alcohol Dependent Individuals
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DOI：
10.1038/npp.2008.78
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发表时间：
2009-04-01
影响因子：
7.6
通讯作者：
Siedlarz, Kristen M.
中科院分区：
文献类型：
--
作者：
Sinha, Rajita;Fox, Helen C.;Siedlarz, Kristen M.
慢性酒精滥用与压力和奖励途径的变化有关，这些变化可能会改变对情绪压力和酒精渴望的脆弱性。本研究旨在探讨慢性酒精滥用是否与压力和酒精渴望反应的改变有关。参与治疗的28天戒酒酒精依赖者（AD; 6 F/22 M）和社交饮酒者（SD; 10 F/18 M）暴露于个性化压力，酒精相关和中性放松情况的简短引导图像，每个会话一个图像条件，在3天内以随机顺序呈现。酒精渴望，焦虑和情绪评级，行为困扰反应，心率，血压和唾液皮质醇的措施进行了评估。酒精患者基础心率和唾液皮质醇水平显著升高。压力和酒精线索暴露各自产生了显着增强和持久的渴望状态，酒精患者的显着增加焦虑，消极情绪，收缩压反应，并在酒精线索的情况下，行为困扰反应，相比SD。与SD组相比，AD组的应激诱导皮质醇反应减弱。这些数据是第一个文件，压力和线索曝光诱导持续的负面情绪相关的酒精渴望状态，伴随着HPA和生理唤醒反应失调的戒酒者。由于压力和消极情绪诱导的酒精渴望的实验室模型预测复发结果，当前数据的一个含义是，针对压力和酒精线索诱导的渴望和压力反应的调节的治疗可能有利于改善酒精复发结果。
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.