Problematic drinking and physiological responses among female college students

Neuroendocrine responses and coupling to laboratory-induced stress in problem gambling and heavy smoking

Identifying common biological and psychological features of substance and behavioral addictions promises to shed light on the pathophysiology of addictive disorders. By identifying constructs that might be related to common risk factors or learned patterns, we gain insights into addiction mechanisms. Previous studies have shown altered levels of the stress hormone cortisol in individuals with problem gambling. However, it remains unclear whether these alterations extend to other hormones in the hypothalamic-pituitary-adrenal axis (HPA) and to sex steroids in the hypothalamic-pituitary-gonadal axis (HPG) as well as the coupling of these hormones with cortisol. In this study, we examined the effects of a laboratory stressor on HPG axis response as measured by levels of testosterone, progesterone and the downstream neuroactive metabolites dehydroepiandrosterone [DHEA] and its sulfate [DHEA-S]) as well as the coupling of these HPG hormones with HPA axis response in cortisol. We compared individuals with problem gambling or heavy cigarette smoking to healthy controls. While DHEA increased following a stressor implemented via the Trier Social Stress Test (TSST), no other hormones showed stress-related changes. Healthy control participants exhibited increased coupling of cortisol with DHEA during stress. In contrast, coupling remained unchanged in problem gamblers or heavy smokers. These findings suggest that, in addition to attenuated cortisol, the feedback between cortisol and neuroactive steroids like DHEA are similarly altered in individuals with behavioral and substance addictions.

Sex and sobriety: Human brain structure and function in AUD abstinence

Women are drinking alcohol as much as men for the first time in history. Women experience more health-related consequences from alcohol use disorder (AUD), like increased prevalence of alcohol-related cancers, faster progression of alcohol-related liver disease, and greater risk for relapse compared to men. Thus, sex differences in chronic alcohol use pose a substantial public health problem. Despite these evident sex differences, our understanding of how these differences present during alcohol abstinence is limited. Investigations of brain structure and function are therefore critical for disentangling factors that lead to sex differences in AUD abstinence. This review will discuss current human neuroimaging data on sex differences in alcohol abstinence, focusing on structural and functional brain measures. Current structural imaging literature reveals that abstinent men have smaller gray and white matter volume and weaker structural connectivity compared to control men. Interestingly, abstinent women do not show differences in brain structure when compared to controls; instead, abstinent women show a relation between alcohol use and decreased measures of brain structure. Current functional brain studies reveal that abstinent men exhibit greater brain activation and stronger task-based functional connectivity to aversive stimuli than control men, while abstinent women exhibit lesser brain activation and weaker task-based functional connectivity than control women. Together, the current literature suggests that sex differences persist well into alcohol abstinence and impact brain structure and function differently. Understanding how men and women differ during alcohol abstinence can improve our understanding of sex-specific effects of alcohol, which will be critical to augment treatment methods to better serve women.

Sex differences in binge drinking-related higher morning cortisol levels and in prospective association with future alcohol intake

AIMS

Peripheral cortisol represents one biological measure of the hypothalamic-pituitary-adrenal (HPA) axis, a significant component of the stress system, which is altered by chronic alcohol consumption. However, whether heavy alcohol use affects the HPA axis differentially between the sexes and whether basal cortisol levels are a biomarker of prospective alcohol intake is unknown.

METHODS

We recruited light moderate (LM) and binge-heavy (BH) drinkers of alcohol (n = 118). Repeated fasting morning cortisol levels were studied over a 2-hour period to assess basal levels while participants underwent a neuroimaging scan.

RESULTS

Significantly higher average cortisol levels in BH compared to LM groups across four timepoints were observed (P < .018). Overall sex differences were observed with women showing higher initial cortisol levels at the first timepoint with a blunted decrease over the morning relative to men (P < .003). Average morning cortisol differentially predicted prospective future 30-day daily reports of alcohol consumption by sex and group, such that LM males had a positive significant relationship and BH males had a negative non-significant relationship between cortisol and drinking.

CONCLUSIONS

Findings indicate that morning plasma cortisol is upregulated in the BH vs. LM group. Although females had higher initial morning cortisol levels, BH males showed a dysregulated negative relationship between stress and binge drinking in contrast to the LM group. Future work should further investigate the role of cortisol and other stress hormones as biomarkers of problematic drinking behaviors in men and women.

The role of neurosteroids in posttraumatic stress disorder and alcohol use disorder: A review of 10 years of clinical literature and treatment implications

Rates of alcohol use disorder (AUD) are increasing in men and women and there are high rates of concurrent posttraumatic stress disorder (PTSD) and AUD. AUD and PTSD synergistically increase symptomatology and negatively affect treatment outcomes; however, there are very limited pharmacological treatments for PTSD/AUD. Neurosteroids have been implicated in the underlying neurobiological mechanisms of both PTSD and AUD and may be a target for treatment development. This review details the past ten years of research on pregnenolone, progesterone, allopregnanolone, pregnanolone, estradiol, testosterone and dehydroepiandrosterone/dehydroepiandrosterone-sulfate (DHEA/DHEA-S) in the context of PTSD and AUD, including examination of trauma/alcohol-related variables, such as stress-reactivity. Emerging evidence that exogenous pregnenolone, progesterone, and allopregnanolone may be promising, novel interventions is also discussed. Specific emphasis is placed on examining the application of sex as a biological variable in this body of literature, given that women are more susceptible to both PTSD diagnoses and stress-related alcohol consumption.

Healthy lifestyle status related to alcohol and food addiction risk among college students: a logistic regression analysis

OBJECTIVE

This study aimed to determine whether low healthy lifestyle (HL) status was associated with alcohol and food addiction risks among college students.

METHOD

The data were gathered through an online survey questionnaire from 311 college students. The students were divided into either a lower or a higher HL status group, based on HL mean score, and the major statistical method used was a binary logistic regression.

RESULTS

There were significant differences in alcohol and food addiction score between the two groups. The lower HL status group showed a 3.06 times higher risk of problematic drinking and a 2.44 times higher risk of food addiction compared with the higher HL status group.

CONCLUSIONS

The results of this study suggest the importance of HL in the prevention of alcohol and food addiction. HL information can be used to develop health education programs aimed at preventing addiction for college students.

Pain-induced alterations in the dynorphinergic system within the mesocorticolimbic pathway: Implication for alcohol addiction

Latest studies have revealed that pain negatively impacts on reward processing and motivation leading to negative affective states and stress. These states not only reduce quality of life of patients by increasing the appearance of psychiatric comorbidities, but also have an important impact on vulnerability to drug abuse, including alcohol. In fact, clinical, epidemiological but also preclinical studies have revealed that the presence of pain is closely related to alcohol use disorders (AUDs). All this evidence suggests that pain is a factor that increases the risk of suffering AUD, predicting heavy drinking behavior and relapse drinking in those patients with a previous history of AUD. The negative consequences of chronic pain and its impact on stress and AUD are likely mediated by alterations in the central nervous system, especially in the stress and reward systems. Therefore, pain and stress impact on dopaminergic mesolimbic pathway can lead to an increase in drug abuse liability. In this mini review we analyze the interaction between pain, stress, and alcohol addiction, and how dynamic changes in the kappa opioid system might play a crucial role in the development of compulsive alcohol drinking in chronic pain patients.

The Moderating Role of Coping Style on Chronic Stress Exposure and Cardiovascular Reactivity Among African American Emerging Adults

Chronic stress exposure may contribute to dysregulation of cardiovascular functions and increase CVD risk among African Americans. This study investigated the direct and interactive effects of chronic stress exposure and coping styles on cardiovascular reactivity to acute stress. A sample of African American emerging adults (n = 277) completed a battery of self-report assessments and underwent the Trier Social Stress Test (TSST) across two time points. Prior chronic stress exposure was negatively associated with heart rate (HR) reactivity among females at 1-month follow-up. Task-oriented coping was positively associated with HR reactivity, while avoidance-oriented coping showed a negative association. Higher use of emotion-oriented coping moderated the relationship between chronic stress exposure and HR reactivity, resulting in more robust reactivity. Among females, but not males, lower use of avoidance-oriented coping moderated the relationship between prior chronic stress exposure and HR reactivity, also resulting in more robust reactivity. Prior chronic stress exposure and the use of maladaptive coping strategies may confer negative impacts on cardiovascular reactivity, particularly among African American females. Using adaptive coping styles may mitigate these effects and improve cardiovascular reactivity. These findings provide preliminary support for psychosocial determinants of health within a controlled laboratory experiment and highlight important gender differences to consider in prevention efforts for African American cardiovascular health disparities.

Hormonal responses in gambling versus alcohol abuse: A review of human studies

The endocrine system plays an essential role in communication between various organs of the body to maintain homeostasis. Both substance use disorders (SUDs) and non-substance abuse disrupt this system and lead to hormonal dysregulations. Here, we focus on the comparison between the function of the endocrine system in gambling disorders and alcohol addiction to understand the commonalities and differences in their neurobiological and psychological underpinnings. We review human research to compare findings on gambling addiction and alcohol dependence pertaining to the dynamic interplay between testosterone and cortisol. Understanding and classifying similarities in hormonal responses between behavioural addiction and SUDs may facilitate development of treatments and therapeutic interventions across different types of addictive disorders, while describing differences may shed light on therapeutic interventions for specific disorders. Although research on gambling addiction is in its infancy, such evaluation may still have a positive effect for addiction research, thereby stimulating discovery of "crossover" pharmacotherapies with benefits for both SUDs and nonsubstance addictions.

Drug-induced stress responses and addiction risk and relapse

A number of studies have assessed the effects of psychoactive drugs on stress biology, the neuroadaptations resulting from chronic drug use on stress biology, and their effects on addiction risk and relapse. This review mainly covers human research on the acute effects of different drugs of abuse (i.e., nicotine, cannabis, psychostimulants, alcohol, and opioids) on the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS) responses. We review the literature on acute peripheral stress responses in naïve or light recreational users and binge/heavy or chronic drug users. We also discuss evidence of alterations in tonic levels, or tolerance, in the latter relative to the former and associated changes in the phasic stress responses. We discuss the impact of the stress system tolerance in heavy users on their response to drug- and stress-related cue responses and craving as compared to control subjects. A summary is provided of the effects of glucocorticoid responses and their adaptations on brain striatal and prefrontal cortices involved in the regulation of drug seeking and relapse risk. Finally, we summarize important considerations, including individual difference factors such as gender, co-occurring drug use, early trauma and adversity and drug use history and variation in methodologies, that may further influence the effects of these drugs on stress biology.

Effects of Acute Stress on Decision Making

The study examined the effects of a social stressor (Trier Social Stress Test) on 24 male and 32 female college students' affective and physiological reactivity and their subsequent performance on a decision-making task (Iowa Gambling Task). The 56 participants were randomly assigned to a social stressor or a control condition. Compared to controls, participants in the stress condition responded with higher heart rates and skin conductance responses, reported more negative affect, and on the decision-making task made less advantageous choices. An exploratory regression analysis revealed that among men higher levels of heart rate were positively correlated with riskier choices on the Iowa Gambling Task, whereas for women this relationship was curvilinear. Exploratory correlational analyses showed that lower levels of skin conductance within the stress condition were associated with greater levels of substance use and gambling. The results suggest that the presence of a stressor may generally result in failure to attend to the full range of possible consequences of a decision. The relationship pattern between the degree of stress responding and successful decision making may be different for men and women.

Adolescent binge alcohol exposure increases risk assessment behaviors in male Wistar rats after exposure to an acute psychological stressor in adulthood

Teenage binge drinking is a common practice that has been shown to increase the risk for developing mood disorders in adulthood. The hypothalamo-pituitary-adrenal (HPA) axis is often dysfunctional in mood disorder patients, and animal models of adolescent binge alcohol exposure similarly show disordered HPA axis function, even after long periods of alcohol abstinence. Here, we sought to investigate the anxiety-like behavioral consequences of binge alcohol exposure in a Wistar rat model. Male rats were administered alcohol in a binge pattern during peri-puberty, and one month later, anxiety-like behaviors were measured using the elevated plus maze. A subset of the rats then underwent 30min of restraint stress, and the anxiety-like behaviors were measured again. We observed an increase in risk assessment behaviors due to both adolescent binge alcohol exposure and restraint stress, but no differences in canonical anxiety-like behaviors. We also repeated the observation that adolescent binge alcohol induces long-term changes in HPA axis sensitivity. Therefore, we concluded that a history of peri-pubertal binge alcohol exposure subtly alters the behavioral response to subsequent acute psychological stress during adulthood, which may over time contribute to the development of mood disorders. This relatively pragmatic animal model represents a more clinically relevant tool in understanding the molecular mechanisms underlying the long-term effects of adolescent binge drinking.

The Effects of Alcohol and Cigarette Consumption on Dehydroepiandrosterone (DHEA) in Rural African Americans

Objective: Rurally situated African Americans suffer from stress and drug-related health disparities. Unfortunately, research on potential mechanisms that underlie this public health problem have received limited focus in the scientific literature. This study investigated the physiological impact of nicotine and alcohol use on dehydroepiandrosterone (DHEA) functioning, a biomarker previously linked to hypothalamic-pituitary-adrenal functioning. Method: A rural sample of African American emerging adults ( n = 84) completed a battery of assessments and provided six samples of salivary DHEA at wakeup, 30 minutes postwakeup, 90 minutes postwakeup, 3:00 p.m., 3:30 p.m., and 4:30 p.m. Results: Participants had more DHEA on waking as a function of smoking greater number of cigarettes throughout the day. Although this effect was not replicated with increased levels of alcohol consumption, the interaction between cigarette and alcohol use was associated with increased levels of DHEA on waking. Conclusion: While use of a single substance (i.e., cigarettes) was related to higher DHEA and greater hypothalamic-pituitary-adrenal activation, the addition of a second substance (i.e., alcohol) shifted the individual toward the hyperactive arousal profile common within chronically stressed or challenged populations. These findings support the need to further investigate the relationship between polysubstance use and physiological functioning that may be linked to known health disparities in the African American community.

Increased steroid hormone dehydroepiandrosterone and pregnenolone levels in post-mortem brain samples of alcoholics

Intra-tissue levels of steroid hormones (e.g., dehydroepiandrosterone [DHEA], pregnenolone [PREGN], and testosterone [T]) may influence the pathological changes seen in neurotransmitter systems of alcoholic brains. Our aim was to compare levels of these steroid hormones between the post-mortem brain samples of alcoholics and non-alcoholic controls. We studied steroid levels with quantitative liquid chromatography-tandem mass spectrometry (LC-MS/MS) in post-mortem brain samples of alcoholics (N = 14) and non-alcoholic controls (N = 10). Significant differences were observed between study groups in DHEA and PREGN levels (p values 0.0056 and 0.019, respectively), but not in T levels. Differences between the study groups were most prominent in the nucleus accumbens (NAC), anterior cingulate cortex (ACC), and anterior insula (AINS). DHEA levels were increased in most alcoholic subjects compared to controls. However, only a subgroup of alcoholics showed increased PREGN levels. Negative Spearman correlations between tissue levels of PREGN and previous reports of [(3)H]naloxone binding to μ-opioid receptors were observed in the AINS, ACC, NAC, and frontal cortex (R values between -0.6 and -0.8; p values ≤ 0.002), suggesting an association between the opioid system and brain PREGN levels. Although preliminary, and from relatively small diagnostic groups, these results show significantly increased levels of DHEA and PREGN in the brains of alcoholics, and could be associated with the pathology of alcoholism.

Structural equation modeling to assess gender differences in the relationship between psychological symptoms and dental visits after dental check-ups for university students

OBJECTIVE

Some studies have shown a relationship between psychological symptoms and oral health behaviors. However, it is unknown whether gender differences affect the relationship between psychological symptoms and oral health behaviors. In addition, gender differences in the relationship between dental anxiety and dental visits for treatment or regular check-up are unclear. The objective of the present study was to explain the relationships among gender differences, psychological symptoms, oral health behaviors, dental anxiety and 'expectation of dental visit', evaluated as 'dental visits when treatments are recommended' in university students.

MATERIALS AND METHODS

A total of 607 students (311 males, 296 females) aged 18-38 years old were examined. The information was collected via questionnaire regarding gender, psychological symptoms and oral health behaviors. Psychological symptoms were assessed using the Hopkins Symptom Checklist. Structural equation modeling was used to test pathways from these factors to 'expectation of dental visit'. Multiple-group modeling was also conducted to test for gender differences.

RESULTS

Psychological symptoms were related to low expectation of dental visit in females, but there was no such relationship in males. Oral health behaviors were related to expectation of dental visit in both genders.

CONCLUSIONS

Psychological symptoms were directly related to expectation of dental visit in females and oral health behaviors were related to expectation of dental visit in both genders. To promote dental visits after dental check-ups at school, it might be necessary to improve oral health behaviors in both genders and to evaluate psychological symptoms, especially in females.

Problematic Internet use, excessive alcohol consumption, their comorbidity and cardiovascular and cortisol reactions to acute psychological stress in a student population

BACKGROUND AND AIMS

Problematic Internet use and excessive alcohol consumption have been associated with a host of maladaptive outcomes. Further, low (blunted) cardiovascular and stress hormone (e.g. cortisol) reactions to acute psychological stress are a feature of individuals with a range of adverse health and behavioural characteristics, including dependencies such as tobacco and alcohol addiction. The present study extended this research by examining whether behavioural dependencies, namely problematic Internet use, excessive alcohol consumption, and their comorbidity would also be associated with blunted stress reactivity.

METHODS

A large sample of university students (N = 2313) were screened using Internet and alcohol dependency questionnaires to select four groups for laboratory testing: comorbid Internet and alcohol dependence (N = 17), Internet dependence (N = 17), alcohol dependence (N = 28), and non-dependent controls (N = 26). Cardiovascular activity and salivary cortisol were measured at rest and in response to a psychological stress protocol comprising of mental arithmetic and public speaking tasks.

RESULTS

Neither problematic Internet behaviour nor excessive alcohol consumption, either individually or in combination, were associated with blunted cardiovascular or cortisol stress reactions. Discussion It is possible that problematic Internet behaviour and excessive alcohol consumption in a student population were not related to physiological reactivity as they may not reflect ingrained addictions but rather an impulse control disorder and binging tendency.

CONCLUSIONS

The present results serve to indicate some of the limits of the developing hypothesis that blunted stress reactivity is a peripheral marker of the central motivational dysregulation in the brain underpinning a wide range of health and behavioural problems.

Alcohol, stress hormones, and the prefrontal cortex: a proposed pathway to the dark side of addiction

Chronic exposure to alcohol produces changes in the prefrontal cortex that are thought to contribute to the development and maintenance of alcoholism. A large body of literature suggests that stress hormones play a critical role in this process. Here we review the bi-directional relationship between alcohol and stress hormones, and discuss how alcohol acutely stimulates the release of glucocorticoids and induces enduring modifications to neuroendocrine stress circuits during the transition from non-dependent drinking to alcohol dependence. We propose a pathway by which alcohol and stress hormones elicit neuroadaptive changes in prefrontal circuitry that could contribute functionally to a dampened neuroendocrine state and the increased propensity to relapse-a spiraling trajectory that could eventually lead to dependence.

Developmental and contextual considerations for adrenal and gonadal hormone functioning during adolescence: Implications for adolescent mental health

Substantial research has implicated the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes independently in adolescent mental health problems, though this literature remains largely inconclusive. Given the cross-talk between the HPA and HPG axes and their increased activation in adolescence, a dual-axis approach that examines both axes simultaneously is proposed to predict the emergence and persistence of adolescent mental health problems. After briefly orienting readers to HPA and HPG axis functioning, we review the literature examining associations between hormone levels and changes with behavior during adolescence. Then, we provide a review of the literature supporting examination of both axes simultaneously and present the limited research that has taken a dual-axis approach. We propose future directions including consideration of between-person and within-person approaches to address questions of correlated changes in HPA and HPG hormones. Potential moderators are considered to increase understanding of the nuanced hormone-behavior associations during key developmental transitions.

Within-adolescent coupled changes in cortisol with DHEA and testosterone in response to three stressors during adolescence

It is hypothesized that hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes function together to maintain adaptive functioning during stressful situations differently in adolescence than the characteristic inverse relations found in adulthood. We examined within-person correlated changes (coupling) in cortisol, DHEA and testosterone in response to parent-adolescent conflict discussion, social performance, and venipuncture paradigms. Data are derived from two samples of boys and girls from the Northeastern US (213 adolescents aged 11-16, M=13.7, SD=1.5 years; 108 adolescents aged 9-14, M=11.99, SD=1.55) using different biological sampling vehicles (saliva and blood). Results consistently show that across samples, vehicles, and contexts, cortisol and DHEA and cortisol and testosterone are positively coupled in response to environmental stimuli. Findings underscore the importance of considering the effects of multiple hormones together in order to further our understanding of the biological underpinnings of behavior, especially during adolescence, as adolescence is a developmental transition period that may be qualitatively different from adulthood in terms of hormone functioning.