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

 描述（由申请人提供）：物质和行为成瘾已被概念化为具有不同机会主义表达的共同生物心理社会过程（Shaffer等人，2004年）。传统上，物质使用障碍在文献中受到了极大的关注，因为假定物质具有固有的成瘾性。相比之下，研究较少关注基于行为的成瘾，如赌博。生物过程，如激素对压力的反应，通过皮质醇，脱氢表雄酮（DHEA）和皮质醇/DHEA的比例来测量，可能是发展成成瘾性疾病的倾向的基础，无论它是基于物质的还是所谓的行为成瘾。这项研究将对重度吸烟者、问题刮刮乐赌徒和健康对照者进行研究，以调查急性社会压力对吸烟或赌博线索反应的影响。将测量对吸烟或赌博线索与中性线索的主观（冲动、渴望）和生理反应（皮肤电导和心率），一次在正常条件下，一次在暴露于社会应激源后。在手术过程中将重复测量应激激素（唾液皮质醇和DHEA）。据推测，吸烟者和问题赌徒将显示出类似的皮质醇反应的急性应激相比，对照组。此外，重度吸烟者和问题赌徒对急性应激源的皮质醇反应也会类似地迟钝。此外，吸烟者和赌徒的线索反应将增加以下的压力相比，非压力的线索曝光。最后，假设较高的基线皮质醇/脱氢表雄酮比率将预测较高的主观和生理唤醒 积极的线索，并与增加的症状和更多的不良后果成瘾。

 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.