The impact of stress on steroid hormones and cue reactivity in smokers and gamblers

 描述(由申请人提供)：成瘾，无论是物质上的还是行为上的，都被概念化为具有不同机会主义表现的共同生物心理社会过程(Shaffer等人，2004年)。传统上，由于物质的固有成瘾性质，物质使用障碍在文献中受到了极大的关注。相比之下，研究较少关注基于行为的成瘾，如赌博。生物过程，如通过皮质醇、脱氢表雄酮(DHEA)和皮质醇/DHEA的比率测量的荷尔蒙对压力的反应，可能是发展成瘾障碍的倾向的基础，无论它是基于物质还是所谓的行为成瘾。这项拟议的研究将在重度吸烟者、问题刮刮赌徒和健康对照组中进行，以调查急性社会应激源对吸烟或赌博线索的反应的影响。主观(冲动、渴望)和生理反应(皮肤电导和心率)将根据吸烟或赌博线索与中性线索的反应进行测量，一次是在正常情况下，另一次是在暴露于社交压力源之后。应激激素(唾液皮质醇和脱氢表雄酮)将在手术过程中重复测量。据推测，与对照组相比，吸烟者和问题赌徒对急性应激源的皮质醇反应相似。此外，重度吸烟者和问题赌徒对急性压力源的皮质醇反应也同样迟钝。此外，与非压力线索暴露相比，吸烟者和赌徒在应激源后的线索反应性会增加。最后，假设较高的基线皮质醇/脱氢表雄酮比率将预示较高的主观和生理唤醒。 与活跃的线索有关，并与成瘾的症状增加和更多的不良后果有关。

 DESCRIPTION (provided by applicant): Addictions, both substance and behavioral, have been conceptualized as having common biopsychosocial processes with different opportunistic expressions (Shaffer et al., 2004). Traditionally, substance use disorders have received significant attention in the literature due to presumed inherently addictive nature of the substance. In contrast, research has focused much less on behaviorally based addictions, such as gambling. Biological processes such as the hormonal response to stress, measured by cortisol, dehydroepiandrosterone (DHEA), and the ratio of the cortisol/DHEA, may underlie the disposition to develop an addictive disorder, regardless of whether it is a substance-based or a so-called behavioral addiction. The proposed study will be conducted with heavy smokers, problem scratch-off gamblers, and healthy controls to investigate the effect of an acute social stressor on reactivity to smoking or gambling cues. Subjective (urges, cravings) and physiological responses (skin conductance and heart rate) will be measured in response to smoking or gambling cues versus neutral cues, once under normal conditions and again after exposure a social stressor. Stress hormones (salivary cortisol and DHEA) will be measured repeatedly during the procedures. It is hypothesized that cigarette smokers and problem gamblers will display a similar cortisol response to the acute stressor in comparison to the control group. In addition, heavy smokers and problem gamblers will display similarly blunted cortisol responses to an acute stressor. In addition, cue reactivity in smokers and gamblers will increase following a stressor compared to non-stressed cue exposure. Finally, it is hypothesized that a higher baseline cortisol/DHEA ratio will predict higher subjective and physiological arousal to active cues and be associated with increased symptoms and more adverse consequences of addiction.