Anxiety, Anxiety Sensitivity, and Perceived Stress as Predictors of Recent Drinking, Alcohol Craving, and Social Stress Response in Heavy Drinkers.
Anxiety, Anxiety Sensitivity, and Perceived Stress as Predictors of Recent Drinking, Alcohol Craving, and Social Stress Response in Heavy Drinkers.
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DOI：
10.1111/acer.13350
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发表时间：
2017-04
期刊：
影响因子：
--
通讯作者：
Wand GS
中科院分区：
文献类型：
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作者：
McCaul ME;Hutton HE;Stephens MA;Xu X;Wand GS
人们普遍认为压力和焦虑与对酒精的渴望和饮酒以及酒精使用障碍（AUD）的发展和维持存在因果关系。然而，许多检验压力或焦虑对饮酒和酒精相关问题影响的临床前和人体研究一直是模棱两可的。本研究探讨了 AUD 重度饮酒者的自我报告焦虑、焦虑敏感性和压力测量得分与近期饮酒频率和强度、早期戒酒期间对酒精的渴望以及对酒精渴望和压力反应性的实验室测量之间的关系。对媒体招募的澳元重度饮酒者 (N = 87) 进行了近期饮酒量评估。使用纸笔测量来表征焦虑和压力水平，包括贝克焦虑量表（BAI）、焦虑敏感性指数‐3（ASI‐3）和感知压力量表（PSS）。符合条件的受试者 (N = 30) 在临床研究单位进行了戒酒；每天两次收集对酒精渴望的测量结果。第4天，受试者参加特里尔社会压力测试；收集皮质醇和酒精渴望的测量值。在多变量分析中，较高的 BAI 分数与较低的饮酒频率和减少的饮酒量/饮酒日相关；相反，较高的 ASI-3 分数与较高的饮酒频率相关。 BAI 焦虑症状和 ASI-3 评分也与酒精使用障碍识别测试总分以及 AUD 症状和问题分量表测量呈正相关。较高的 BAI 和 ASI-3 分数（而非 PSS 分数）与早期戒酒期间自我报告的酒精渴望程度较高相关。最后，BAI 评分与实验室压力引起的皮质醇和酒精渴望呈正相关。相比之下，PSS 与大多数酒精渴望或压力反应性指标没有关系。总体而言，与感知压力相比，临床导向的焦虑测量与当前 AUD 重度饮酒者的各种酒精相关测量密切相关。
Stress and anxiety are widely considered to be causally related to alcohol craving and consumption, as well as development and maintenance of alcohol use disorder (AUD). However, numerous preclinical and human studies examining effects of stress or anxiety on alcohol use and alcohol‐related problems have been equivocal. This study examined relationships between scores on self‐report anxiety, anxiety sensitivity, and stress measures and frequency and intensity of recent drinking, alcohol craving during early withdrawal, as well as laboratory measures of alcohol craving and stress reactivity among heavy drinkers with AUD. Media‐recruited, heavy drinkers with AUD (N = 87) were assessed for recent alcohol consumption. Anxiety and stress levels were characterized using paper‐and‐pencil measures, including the Beck Anxiety Inventory (BAI), the Anxiety Sensitivity Index‐3 (ASI‐3), and the Perceived Stress Scale (PSS). Eligible subjects (N = 30) underwent alcohol abstinence on the Clinical Research Unit; twice daily measures of alcohol craving were collected. On day 4, subjects participated in the Trier Social Stress Test; measures of cortisol and alcohol craving were collected. In multivariate analyses, higher BAI scores were associated with lower drinking frequency and reduced drinks/drinking day; in contrast, higher ASI‐3 scores were associated with higher drinking frequency. BAI anxiety symptom and ASI‐3 scores also were positively related to Alcohol Use Disorders Identification Test total scores and AUD symptom and problem subscale measures. Higher BAI and ASI‐3 scores but not PSS scores were related to greater self‐reported alcohol craving during early alcohol abstinence. Finally, BAI scores were positively related to laboratory stress‐induced cortisol and alcohol craving. In contrast, the PSS showed no relationship with most measures of alcohol craving or stress reactivity. Overall, clinically oriented measures of anxiety compared with perceived stress were more strongly associated with a variety of alcohol‐related measures in current heavy drinkers with AUD.