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Chen Y, Wang X, Xiao M, Kang N, Zeng W, Zhang J. Prenatal morphine exposure increases gamma oscillation and theta coherence in the rat reward system. Neurotoxicology 2022; 90:246-255. [DOI: 10.1016/j.neuro.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/13/2022] [Accepted: 04/16/2022] [Indexed: 10/18/2022]
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Clancy F, Prestwich A, Ferguson E, O’Connor DB. Cross-sectional and prospective associations between stress, perseverative cognition and health behaviours. Psychol Health 2021; 37:87-104. [DOI: 10.1080/08870446.2020.1867727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Faye Clancy
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - Andrew Prestwich
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
| | - Eamonn Ferguson
- Psychology, Faculty of Science, The University of Nottingham, Nottingham, UK
| | - Daryl B. O’Connor
- School of Psychology, Faculty of Medicine and Health, The University of Leeds, Leeds, UK
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Chen K, Hollunder B, Garbusow M, Sebold M, Heinz A. The physiological responses to acute stress in alcohol-dependent patients: A systematic review. Eur Neuropsychopharmacol 2020; 41:1-15. [PMID: 32994116 DOI: 10.1016/j.euroneuro.2020.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/22/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
Dysregulation of physiological stress reactivity plays a key role in the development and relapse risk of alcohol dependence. This article reviews studies investigating physiological responses to experimentally induced acute stress in patients with alcohol dependence. A systematic search from electronic databases resulted in 3641 articles found and after screening 62 articles were included in our review. Studies are analyzed based on stress types (i.e., social stress tasks and nonsocial stress tasks) and physiological markers (i.e., the nervous system, the endocrine system, somatic responses and the immune system). In studies applying nonsocial stress tasks, alcohol-dependent patients were reported to show a blunted stress response compared with healthy controls in the majority of studies applying markers of adrenocorticotropic hormone and cortisol. In studies applying social stress tasks, findings are inconsistent, with less than half of the studies reporting altered physiological stress responses in patients. We discuss the impact of duration of abstinence, comorbidities, baseline physiological arousal and intervention on the discrepancy of study findings. Furthermore, we review evidence for an association between blunted physiological stress responses and the relapse risk among patients with alcohol dependence.
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Affiliation(s)
- Ke Chen
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.
| | - Barbara Hollunder
- Charité Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany; Movement Disorder & Neuromodulation Unit, Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany; Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Maria Garbusow
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Miriam Sebold
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany; Department for Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
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Clancy F, O'Connor DB, Prestwich A. Do Worry and Brooding Predict Health Behaviors? A Daily Diary Investigation. Int J Behav Med 2020; 27:591-601. [PMID: 32424781 PMCID: PMC7497422 DOI: 10.1007/s12529-020-09898-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Meta-analyses have reported associations between perseverative cognition (both worry and brooding) and increased engagement in health-risk behaviors, poorer sleep, and poorer physiological health outcomes. METHOD Using a daily diary design, this study investigated the within- and between-person relationships between state and trait perseverative cognition and health behaviors (eating behavior, physical activity, alcohol consumption, and sleep) both cross-sectionally and prospectively. Participants (n = 273, 93% students, Mage = 20.2, SD = 4.11, 93% female) completed morning and evening diaries across 7 consecutive days. RESULTS Multilevel modeling analyses revealed that, cross-sectionally, higher levels of state worry were associated with more time spent sitting and higher levels of state brooding predicted less daily walking. CONCLUSION Worry and brooding may represent useful intervention targets for improving inactivity and walking levels, respectively.
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Affiliation(s)
- F Clancy
- Faculty of Medicine and Health, School of Psychology, The University of Leeds, Leeds, UK.
| | - D B O'Connor
- Faculty of Medicine and Health, School of Psychology, The University of Leeds, Leeds, UK
| | - A Prestwich
- Faculty of Medicine and Health, School of Psychology, The University of Leeds, Leeds, UK
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Fronk GE, Sant'Ana SJ, Kaye JT, Curtin JJ. Stress Allostasis in Substance Use Disorders: Promise, Progress, and Emerging Priorities in Clinical Research. Annu Rev Clin Psychol 2020; 16:401-430. [PMID: 32040338 PMCID: PMC7259491 DOI: 10.1146/annurev-clinpsy-102419-125016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Clinicians and researchers alike have long believed that stressors play a pivotal etiologic role in risk, maintenance, and/or relapse of alcohol and other substance use disorders (SUDs). Numerous seminal and contemporary theories on SUD etiology posit that stressors may motivate drug use and that individuals who use drugs chronically may display altered responses to stressors. We use foundational basic stress biology research as a lens through which to evaluate critically the available evidence to support these key stress-SUD theses in humans. Additionally, we examine the field's success to date in targeting stressors and stress allostasis in treatments for SUDs. We conclude with our recommendations for how best to advance our understanding of the relationship between stressors and drug use, and we discuss clinical implications for treatment development.
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Affiliation(s)
- Gaylen E Fronk
- Department of Psychology, University of Wisconsin, Madison, Wisconsin 53706, USA; , ,
| | - Sarah J Sant'Ana
- Department of Psychology, University of Wisconsin, Madison, Wisconsin 53706, USA; , ,
| | - Jesse T Kaye
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin 53705, USA;
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53711, USA
| | - John J Curtin
- Department of Psychology, University of Wisconsin, Madison, Wisconsin 53706, USA; , ,
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Lovallo WR, Cohoon AJ, Acheson A, Sorocco KH, Vincent AS. Blunted stress reactivity reveals vulnerability to early life adversity in young adults with a family history of alcoholism. Addiction 2019; 114:798-806. [PMID: 30461123 PMCID: PMC6529292 DOI: 10.1111/add.14501] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/10/2018] [Accepted: 11/02/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS People with blunted stress reactivity have poor impulse control and also show increased risk for alcoholism. Exposure to early life adversity (ELA) contributes to blunted reactivity, but individual differences in susceptibility to ELA are not well understood. This study aimed to determine whether exposure to ELA has a greater impact on stress reactivity in young adults with a family history of alcoholism (FH+) compared with young adults with no family history of alcoholism (FH-). DESIGN Observational study using linear modeling. SETTING Oklahoma, USA. PARTICIPANTS Seven hundred and nine young adults (398 females) recruited through community advertisement. MEASUREMENTS We obtained heart rates and cortisol levels in subjects while undergoing public speaking and mental arithmetic stress compared with a resting control day (1418 test sessions). ELA was quantified as 0, 1 or > 1 adverse events experienced by age 15 years. FH+ people had one or two parents with an alcohol use disorder, and FH- controls had no such history for two generations. FINDINGS Increasing levels of ELA predicted progressive blunting of cortisol and heart rate reactivity for the whole sample (Fs = 4.57 and 4.70, Ps ≤ 0.011), but examination by FH status showed that the effect of ELA was significant only among FH+ (Fs ≥ 3.5, Ps < 0.05) and absent in FH- (Ps > 0.40). This difference in ELA impact was not explained by the cortisol diurnal cycle or subjective evaluation of the stressors. CONCLUSIONS People with a family history of alcoholism appear to be vulnerable, in terms of changes to physiological stress response, to the impact of exposure to early life adversity while people with no family history of alcoholism appear to be resilient. Blunted stress reactivity may reflect differential vulnerability to early life adversity in young adults with a family history of alcoholism.
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Affiliation(s)
- William R. Lovallo
- Behavioral Sciences Laboratories, Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA,Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA
| | - Andrew J. Cohoon
- Behavioral Sciences Laboratories, Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA,Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA
| | - Ashley Acheson
- Department of Psychiatry, University of Arkansas Medical Center, Little Rock, AK 72205, USA
| | - Kristen H. Sorocco
- Behavioral Sciences Laboratories, Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA,Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA
| | - Andrea S. Vincent
- Cognitive Science Research Center, University of Oklahoma, Norman, OK 73109, USA
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Abstract
Persistent, in particular neuropathic pain affects millions of people worldwide. However, the response rate of patients to existing analgesic drugs is less than 50%. There are several possibilities to increase this response rate, such as optimization of the pharmacokinetic and pharmacodynamic properties of analgesics. Another promising approach is to use prognostic biomarkers in patients to determine the optimal pharmacological therapy for each individual. Here, we discuss recent efforts to identify plasma and CSF biomarkers, as well as genetic biomarkers and sensory testing, and how these readouts could be exploited for the prediction of a suitable pharmacological treatment. Collectively, the information on single biomarkers may be stored in knowledge bases and processed by machine-learning and related artificial intelligence techniques, resulting in the optimal pharmacological treatment for individual pain patients. We highlight the potential for biomarker-based individualized pain therapies and discuss biomarker reliability and their utility in clinical practice, as well as limitations of this approach.
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Clancy F, Prestwich A, Caperon L, O'Connor DB. Perseverative Cognition and Health Behaviors: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2016; 10:534. [PMID: 27877119 PMCID: PMC5099163 DOI: 10.3389/fnhum.2016.00534] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 10/10/2016] [Indexed: 12/01/2022] Open
Abstract
Recent developments in stress theory have emphasized the significance of perseverative cognition (worry and rumination) in furthering our understanding of stress-disease relationships. Substantial evidence has shown that perseverative cognition (PC) is associated with somatic outcomes and numerous physiological concomitants have been identified (i.e., cardiovascular, autonomic, and endocrine nervous system activity parameters). However, there has been no synthesis of the evidence regarding the association between PC and health behaviors. This is important given such behaviors may also directly and/or indirectly influence health and disease outcomes (triggered by PC). Therefore, the aim of the current review was to synthesize available studies that have explored the relationship between worry and rumination and health behaviors (health risk: behaviors which, if performed, would be detrimental to health; health promoting: behaviors which, if performed, would be beneficial for health). A systematic review and meta-analyses of the literature were conducted. Studies were included in the review if they reported the association between PC and health behavior. Studies identified in MEDLINE or PsycINFO (k = 7504) were screened, of which 19 studies met the eligibility criteria. Random-effects meta-analyses suggested increased PC was generally associated with increased health risk behaviors but not health promoting behaviors. Further analyses indicated that increases in rumination (r = 0.122), but not reflection (r = −0.080), or worry (r = 0.048) were associated with health risk behaviors. In conclusion, these results showed that increases in PC are associated with increases in health risk behaviors (substance use, alcohol consumption, unhealthy eating, and smoking) that are driven primarily through rumination. These findings provide partial support for our hypothesis that in Brosschot et al.'s (2006) original perseverative cognition hypothesis, there may be scope for additional routes to pathogenic disease via poorer health behaviors.
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Affiliation(s)
- Faye Clancy
- School of Psychology, University of Leeds Leeds, UK
| | | | - Lizzie Caperon
- Leeds Institute of Health Sciences, University of Leeds Leeds, UK
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Bujarski S, Ray LA. Experimental psychopathology paradigms for alcohol use disorders: Applications for translational research. Behav Res Ther 2016; 86:11-22. [PMID: 27266992 PMCID: PMC5067182 DOI: 10.1016/j.brat.2016.05.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/12/2016] [Accepted: 05/26/2016] [Indexed: 02/05/2023]
Abstract
In spite of high prevalence and disease burden, scientific consensus on the etiology and treatment of Alcohol Use Disorder (AUD) has yet to be reached. The development and utilization of experimental psychopathology paradigms in the human laboratory represents a cornerstone of AUD research. In this review, we describe and critically evaluate the major experimental psychopathology paradigms developed for AUD, with an emphasis on their implications, strengths, weaknesses, and methodological considerations. Specifically we review alcohol administration, self-administration, cue-reactivity, and stress-reactivity paradigms. We also provide an introduction to the application of experimental psychopathology methods to translational research including genetics, neuroimaging, pharmacological and behavioral treatment development, and translational science. Through refining and manipulating key phenotypes of interest, these experimental paradigms have the potential to elucidate AUD etiological factors, improve the efficiency of treatment developments, and refine treatment targets thus advancing precision medicine.
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Affiliation(s)
- Spencer Bujarski
- Department of Psychology, University of California, Los Angeles, United States.
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
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Manjoch H, Vainer E, Matar M, Ifergane G, Zohar J, Kaplan Z, Cohen H. Predator-scent stress, ethanol consumption and the opioid system in an animal model of PTSD. Behav Brain Res 2016; 306:91-105. [PMID: 26965572 DOI: 10.1016/j.bbr.2016.03.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/02/2016] [Accepted: 03/04/2016] [Indexed: 12/20/2022]
Abstract
Emerging literature points to stress exposure as a potential contributor to the development of alcohol abuse, but animal models have yielded inconsistent results. Converging experimental data indicate that the endogenous opioid system modulates alcohol consumption and stress regulation. The aim of the present study is to examine the interplay between stress exposure, behavioral stress responses, ethanol (EtOH) consumption and the endogenous opioid system in an animal model of posttraumatic stress disorder. Rats were exposed to stress and then tested in a two-bottle free choice (TBC) assay or in a conditioned place preference paradigm. In some experiments, the endogenous opioid system was pharmacologically manipulated prior to stress exposure. The behavioral outcomes of stress exposure were assessed in an elevated plus-maze, with the acoustic startle response, and by monitoring the freezing response to trauma reminder. Immunoreactivity of phosphorylated opioid receptors in hippocampal subregions was also measured. Stress significantly increased the consumption of EtOH in the TBC assay. The severity of the behavioral response to stress was associated with EtOH consumption, cue-triggered freezing response to a trauma reminder, and endogenous levels of phosphorylated opioid receptors in the hippocampus. Pharmacologically manipulating the endogenous opioid system prior to stress exposure attenuated trauma cue-triggered freezing responses and blocked predator scent stress-induced potentiation of EtOH consumption. These data demonstrate a stress-induced potentiation of EtOH self-administration and reveal a clear association between individual patterns of the behavioral response to stress and alcohol preference, while indicating a role for the endogenous opioid system in the neurobiological response to stress.
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Affiliation(s)
- Hadar Manjoch
- Ben-Gurion University of the Negev, Department of Psychology, Beer Sheva, Israel; Beer-Sheva Mental Health Center, Anxiety and Stress Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Ella Vainer
- Beer-Sheva Mental Health Center, Anxiety and Stress Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Michael Matar
- Beer-Sheva Mental Health Center, Anxiety and Stress Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Gal Ifergane
- Headache Clinic, Department of Neurology, Soroka Medical Center, Ben-Gurion University of the Negev Beer- Sheva, Israel
| | - Joseph Zohar
- Division of Psychiatry, The State of Israel Ministry of Health, The Chaim Sheba Medical Center, Sackler Medical School, Tel-Aviv University, Tel Hashomer, Israel
| | - Zeev Kaplan
- Beer-Sheva Mental Health Center, Anxiety and Stress Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Hagit Cohen
- Ben-Gurion University of the Negev, Department of Psychology, Beer Sheva, Israel; Beer-Sheva Mental Health Center, Anxiety and Stress Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
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Francès F, Portolés O, Castelló A, Costa JA, Verdú F. Association between Opioid Receptor mu 1 (OPRM1) Gene Polymorphisms and Tobacco and Alcohol Consumption in a Spanish Population. Bosn J Basic Med Sci 2015; 15:31-6. [PMID: 26042510 DOI: 10.17305/bjbms.2015.243] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/08/2015] [Accepted: 01/08/2015] [Indexed: 12/15/2022] Open
Abstract
Evidence gained from animals and humans suggests that the encephalic opioid system might be involved in the development of drug addiction through its role in reward. Our aim is to assess the influence of genetic variations in the opioid receptor mu 1 on alcohol and tobacco consumption in a Spanish population. 763 unrelated individuals (465 women, 298 men) aged 18-85 years were recruited between October 2011 and April 2012. Participants were requested to answer a 35-item questionnaire on tobacco and alcohol consumption, as well as to complete the AUDIT and Fagerström tests. Individuals were genotyped for three polymorphisms in the opioid receptor mu 1 (OPRM1) gene, using a TaqMan protocol. In males, the rs10485057 polymorphism was associated with total pure ethanol intake and with the risk of being an alcohol consumer. Also, this polymorphism was significantly associated with higher Fagerström scores. Rs1799971 had a different influence on adaptive and maladaptive patterns of alcohol use. Despite the limited sample size, our study might enrich current knowledge on patterns of alcohol use, because it encompasses both extreme and adaptive phenotypes, providing thus a wider perspective on this subject.
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Affiliation(s)
- Francesc Francès
- Department of Preventive and Legal Medicine, School of Medicine, University of Valencia, Valencia.
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12
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Snelleman M, Schoenmakers TM, van de Mheen D. The relationship between perceived stress and cue sensitivity for alcohol. Addict Behav 2014; 39:1884-9. [PMID: 25133978 DOI: 10.1016/j.addbeh.2014.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/09/2014] [Accepted: 07/23/2014] [Indexed: 11/16/2022]
Abstract
Previous research has shown that cue sensitivity and stress affect the risk for relapse in alcohol-dependent patients. Theoretically, a link between the two can be expected. However, a clear overview of the interplay of these factors is not yet available. The purpose of this review was to examine the empirical evidence for the influence of stress on sensitivity for alcohol-related cues. Empirical studies indexed in PubMed, EMBASE, PsycINFO, and Web of Knowledge that assessed the relation between stress and sensitivity for alcohol-related cues using subjective, behavioral and/or physiological measures were included in the review. Of the 359 articles screened, 12 were included in the review. Nine articles supported the existence of the relationship between stress and heightened cue sensitivity for alcohol-related cues, whereas three articles did not support our hypothesis. We conclude that the relationship between stress and sensitivity to alcohol cues appears to exist. In fact, there may be different factors at play: our review points toward (1) differences between the effect of psychological stress and physiological stress on cue-sensitivity, and (2) individual differences regarding coping drinking which may explain stress-induced cues sensitivity.
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Affiliation(s)
- Michelle Snelleman
- IVO Addiction Research Institute, Heemraadssingel 194, 3021 DM, Rotterdam, The Netherlands; Erasmus Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Tim M Schoenmakers
- IVO Addiction Research Institute, Heemraadssingel 194, 3021 DM, Rotterdam, The Netherlands; Erasmus Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Dike van de Mheen
- IVO Addiction Research Institute, Heemraadssingel 194, 3021 DM, Rotterdam, The Netherlands; Erasmus Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands; Department of Health Promotion, Maastricht University, P.O. box 616, 6200 MD Maastricht, The Netherlands.
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Owens MM, Ray LA, MacKillop J. Behavioral economic analysis of stress effects on acute motivation for alcohol. J Exp Anal Behav 2014; 103:77-86. [DOI: 10.1002/jeab.114] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/14/2014] [Indexed: 11/10/2022]
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Swann G, Byck GR, Dick DM, Aliev F, Latendresse SJ, Riley B, Kertes D, Sun C, Salvatore JE, Bolland J, Mustanski B. Effect of OPRM1 and stressful life events on symptoms of major depression in African American adolescents. J Affect Disord 2014; 162:12-9. [PMID: 24766998 PMCID: PMC4083691 DOI: 10.1016/j.jad.2014.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 03/14/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND In a community sample of low-income African American adolescents, we tested the interactive effects of variation in the mu 1 opioid receptor (OPRM1) gene and the occurrence of stressful life events on symptoms of depression. METHOD Interactive effects of 24 OPRM1 simple nucleotide polymorphisms (SNP) and adolescent report of stressful life events on depression were tested using multilevel regressions. SNPs were dummy coded to test both additive and dominate forms of coding. RESULTS Five OPRM1 SNPs showed significant evidence of interaction with stressful life events to alter depression risk (or symptoms) after adjusting for multiple testing and the correlated nature of the SNPs. Follow-up analyses showed significant differences based on OPRM1 genotype at both lower and higher frequencies of stressful life events, suggesting that participants with a copy of the minor allele on OPRM1 SNPs rs524731, rs9478503, rs3778157, rs10485057, and rs511420 have fewer symptoms in low stress conditions but more symptoms in high stress conditions compared to major allele homozygotes. LIMITATIONS The genetic variants associated with depression in African American adolescents may not translate to other ethnic groups. This study is also limited in that only one gene that functions within a complex biological system is addressed. CONCLUSIONS This current study is the first to find an interaction between OPRM1 and life stress that is associated with depression. It also addressed an understudied population within the behavioral genetics literature. Further research should test additional genes involved in the opioid system and expand the current findings to more diverse samples.
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Affiliation(s)
| | | | | | | | | | | | | | - Cuie Sun
- Virginia Commonwealth University
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15
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Amlung M, MacKillop J. Understanding the effects of stress and alcohol cues on motivation for alcohol via behavioral economics. Alcohol Clin Exp Res 2014; 38:1780-9. [PMID: 24890323 DOI: 10.1111/acer.12423] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 03/09/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Psychological stress and alcohol cues are common antecedents of both ongoing drinking and relapse. One candidate mechanism of risk from these factors is acute increases in craving, but experimental support for this hypothesis is mixed. Furthermore, the combination of stress and cues has been largely unstudied. The current study employed a behavioral economic approach to investigate the combined roles of psychosocial stress and alcohol cues on motivation for alcohol. METHODS In a sample of 84 adult heavy drinkers, we examined the effects of an acute laboratory stress induction and an alcohol cue exposure on subjective craving and stress, arousal, and behavioral economic decision making. Primary dependent measures included an intertemporal cross-commodity multiple-choice procedure (ICCMCP), incorporating both price and delay elements, an alcohol purchase task (APT), measuring alcohol demand, and a monetary delay discounting task, measuring intertemporal choice. RESULTS The stress induction significantly increased stress, craving, and the incentive value of alcohol on the ICCMCP and APT. Stress-related increases in value on the ICCMCP were mediated by increased alcohol demand. Exposure to alcohol cues only significantly affected craving, APT breakpoint, and arousal. Delay discounting was not affected by either stress or cues. CONCLUSIONS These results reveal unique behavioral economic dimensions of motivation for alcohol following acute stress and an alcohol cue exposure. More broadly, as the first application of this approach to understanding the role of stress in drug motivation, these findings support its utility and potential in future applications.
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Affiliation(s)
- Michael Amlung
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri; Department of Psychology, University of Georgia, Athens, Georgia
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Duffing TM, Greiner SG, Mathias CW, Dougherty DM. Stress, substance abuse, and addiction. Curr Top Behav Neurosci 2014; 18:237-263. [PMID: 24510301 DOI: 10.1007/7854_2014_276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Experiencing stressful life events is reciprocally associated with substance use and abuse. The nature of these relationships varies based on the age of stress exposure and stage of substance use involvement. This chapter reviews the developmental and biological processes involved in the relationship of stress exposure and substance use initiation, substance use maintenance and relapse, and response to substance abuse treatment. Special emphasis is given to describing the various stress-related mechanisms involved in substance use and abuse, highlighting the differences between each of these phases of drug use and drawing upon current research to make suggestions for treatments of substance use disorder (SUD) patients. Stress is inherent to the experience of life and, in many situations, unavoidable. Through ongoing research and treatment development, there is the potential to modify the relationship of stress with ongoing substance use and abuse.
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Rouvinen-Lagerström N, Lahti J, Alho H, Kovanen L, Aalto M, Partonen T, Silander K, Sinclair D, Räikkönen K, Eriksson JG, Palotie A, Koskinen S, Saarikoski ST. μ-Opioid receptor gene (OPRM1) polymorphism A118G: lack of association in Finnish populations with alcohol dependence or alcohol consumption. Alcohol Alcohol 2013; 48:519-25. [PMID: 23729673 PMCID: PMC4296254 DOI: 10.1093/alcalc/agt050] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Aims: The molecular epidemiological studies on the association of the opioid receptor µ-1 (OPRM1) polymorphism A118G (Asn40Asp, rs1799971) and alcohol use disorders have given conflicting results. The aim of this study was to test the possible association of A118G polymorphism and alcohol use disorders and alcohol consumption in three large cohort-based study samples. Methods: The association between the OPRM1 A118G (Asn40Asp, rs1799971) polymorphism and alcohol use disorders and alcohol consumption was analyzed using three different population-based samples: (a) a Finnish cohort study, Health 2000, with 503 participants having a DSM-IV diagnosis for alcohol dependence and/or alcohol abuse and 506 age- and sex-matched controls; (b) a Finnish cohort study, FINRISK (n = 2360) and (c) the Helsinki Birth Cohort Study (n = 1384). The latter two populations lacked diagnosis-based phenotypes, but included detailed information on alcohol consumption. Results: We found no statistically significant differences in genotypic or allelic distribution between controls and subjects with alcohol dependence or abuse diagnoses. Likewise no significant effects were observed between the A118G genotype and alcohol consumption. Conclusion: These results suggest that A118G (Asn40Asp) polymorphism may not have a major effect on the development of alcohol use disorders at least in the Finnish population.
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Affiliation(s)
- Noora Rouvinen-Lagerström
- Ministry of Social Affairs and Health, Department of Occupational Safety and Health, PO Box 33, FI-00023 Government, Finland
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Starcke K, van Holst RJ, van den Brink W, Veltman DJ, Goudriaan AE. Physiological and Endocrine Reactions to Psychosocial Stress in Alcohol Use Disorders: Duration of Abstinence Matters. Alcohol Clin Exp Res 2013; 37:1343-50. [DOI: 10.1111/acer.12103] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 01/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
| | - Ruth J. van Holst
- Department of Psychiatry ; Amsterdam Institute for Addiction Research; Academic Medical Center University of Amsterdam; Amsterdam; the Netherlands
| | - Wim van den Brink
- Department of Psychiatry ; Amsterdam Institute for Addiction Research; Academic Medical Center University of Amsterdam; Amsterdam; the Netherlands
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Ducat E, Ray B, Bart G, Umemura Y, Varon J, Ho A, Kreek MJ. Mu-opioid receptor A118G polymorphism in healthy volunteers affects hypothalamic-pituitary-adrenal axis adrenocorticotropic hormone stress response to metyrapone. Addict Biol 2013; 18:325-31. [PMID: 21507151 DOI: 10.1111/j.1369-1600.2011.00313.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The mu-opioid receptor encoded by the gene OPRM1 plays a primary role in opiate, alcohol, cocaine and nicotine addiction. Studies using opioid antagonists demonstrate that the mu-opioid receptor (MOP-r) also mediates the hypothalamic-pituitary-adrenal (HPA) axis stress response. A common polymorphism in exon one of the MOP-r gene, A118G, has been shown to significantly alter receptor function and MOP-r gene expression; therefore, this variant likely affects HPA-axis responsivity. In the current study, we have investigated whether the presence of the 118AG variant genotype affects HPA axis responsivity to the stressor metyrapone, which transiently blocks glucocorticoid production in the adrenal cortex. Forty-eight normal and healthy volunteers (32 men, 16 women) were studied, among whom nine men and seven women had the 118AG genotype. The 118G allele blunted the adrenocorticotropic hormone (ACTH) response to metyrapone. Although there was no difference in basal levels of ACTH, subjects with the 118AG genotype had a more modest rise and resultant significantly lower ACTH levels than those with the prototype 118AA at the 8-hour time point (P < 0.02). We found no significant difference between genders. These findings suggest a relatively greater tonic inhibition at hypothalamic-pituitary sites through the mu-opioid receptor and relatively less cyclical glucocorticoid inhibition in subjects with the 118G allele.
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Affiliation(s)
- Elizabeth Ducat
- The Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA.
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20
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Ferguson B, Hunter JE, Luty J, Street SL, Woodall A, Grant KA. Genetic load is associated with hypothalamic-pituitary-adrenal axis dysregulation in macaques. GENES BRAIN AND BEHAVIOR 2012; 11:949-57. [PMID: 22998353 DOI: 10.1111/j.1601-183x.2012.00856.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 08/24/2012] [Accepted: 09/17/2012] [Indexed: 01/21/2023]
Abstract
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis pathway is associated with several neuropsychiatric disorders, including post-traumatic stress disorder (PTSD), major depressive disorder (MDD), schizophrenia and alcohol abuse. Studies have demonstrated an association between HPA axis dysfunction and gene variants within the cortisol, serotonin and opioid signaling pathways. We characterized polymorphisms in genes linked to these three neurotransmitter pathways and tested their potential interactions with HPA axis activity, as measured by dexamethasone (DEX) suppression response. We determined the percent DEX suppression of adrenocorticotropic hormone (ACTH) and cortisol in 62 unrelated, male rhesus macaques. While DEX suppression of cortisol was robust amongst 87% of the subjects, ACTH suppression levels were broadly distributed from -21% to 66%. Thirty-seven monkeys from the high and low ends of the ACTH suppression distribution (18 'high' and 19 'low' animals) were genotyped at selected polymorphisms in five unlinked genes (rhCRH, rhTPH2, rhMAOA, rhSLC6A4 and rhOPRM). Associations were identified between three variants (rhCRH-2610C>T, rhTPH2 2051A>C and rh5-HTTLPR) and level of DEX suppression of ACTH. In addition, a significant additive effect of the 'risk' genotypes from these three loci was detected, with an increasing number of 'risk' genotypes associated with a blunted ACTH response (P = 0.0009). These findings suggest that assessment of multiple risk alleles in serotonin and cortisol signaling pathway genes may better predict risk for HPA axis dysregulation and associated psychiatric disorders than the evaluation of single gene variants alone.
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Affiliation(s)
- B Ferguson
- Division of Neurosciences, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, USA
| | - J E Hunter
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - J Luty
- Division of Neurosciences, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, USA
| | - S L Street
- Division of Neurosciences, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, USA
| | - A Woodall
- Division of Neurosciences, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, USA
| | - K A Grant
- Division of Neurosciences, Oregon National Primate Research Center, Oregon Health & Sciences University, Beaverton, OR, USA.,Behavioral Neurosciences Department, Oregon Health & Sciences University, Portland, OR, USA
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21
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Larsen H, Engels RCME, Granic I, Huizink AC. Does stress increase imitation of drinking behavior? An experimental study in a (semi-)naturalistic context. Alcohol Clin Exp Res 2012; 37:477-83. [PMID: 23025584 DOI: 10.1111/j.1530-0277.2012.01942.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 07/11/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND That alcohol consumption is strongly influenced by the drinking behavior of social company has been demonstrated in observational research. However, not everyone is equally vulnerable to other people's drinking, and it is important to unravel which factors underlie these individual differences. This study focuses on the role of psychosocial stress in attempting to explain individual differences in the propensity to imitate alcohol consumption. METHODS With a 2 (confederate's drinking condition: alcohol vs. soda) × 2 (participant's stress condition: stress vs. no stress) experimental design, we tested whether the tendency to imitate other people's drinking was related to participants' induced stress levels. The young male adults (N = 106) were randomly assigned to each of the conditions. In each session, directly after the stress or no-stress period, confederates and participants entered a bar laboratory where we observed their drinking behavior. Prior to entering the session, confederates were instructed to drink alcohol or soda. RESULTS Participants in both stress and no-stress conditions consumed substantially more alcohol when confederates drank alcohol than when they drank soda. There was no difference in alcohol consumed between stress and no-stress conditions. No moderating effect of stress on the tendency to drink along with peers was found. CONCLUSIONS Generally, it appears that among young male adults, imitation of alcohol consumption is a robust phenomenon not dependent on individual stress levels.
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Affiliation(s)
- Helle Larsen
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
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Kruse MI, Radnovich AJ, Kalapatapu RK, Mehdiyoun N, Chambers RA, Davidson D. Effects of alcohol availability, access to alcohol, and naltrexone on self-reported craving and patterns of drinking in response to an alcohol-cue availability procedure. J Stud Alcohol Drugs 2012; 73:205-15. [PMID: 22333328 DOI: 10.15288/jsad.2012.73.205] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Craving has long been cited by patients and providers as a principal construct in alcohol use disorders and an essential target for treatment. The goal of the current study was to examine the effects of alcohol availability (20% vs. 80% availability), access to alcohol ("open" vs. "locked" trials), and medication (oral naltrexone [Revia] vs. placebo) on self-reported craving and two behavioral measures of drinking (latency of attempt to access alcohol, amount of alcohol consumed when access permitted) in response to an alcohol-cue availability procedure. METHOD Non-treatment-seeking, alcohol-dependent men and women (N = 58) self-referred for an alcohol administration study and were administered a modified alcohol-cue availability procedure under two medication conditions (naltrexone, placebo) using a within-subjects, repeated-measures design. RESULTS Analyses demonstrated that the experimental manipulations used in this study had differential effects on craving and patterns of drinking. Specifically, reduced availability of alcohol (i.e., when alcohol was available in only 20% as opposed to 80% of trials) resulted in greater amounts of alcohol consumed per open trial; the unanticipated blocking of access to alcohol (i.e., a "locked" trial during the 80% availability condition) triggered more rapid attempts to obtain alcohol on subsequent trials. Naltrexone, relative to placebo, was associated with significant reductions in cravings for alcohol. CONCLUSIONS Taken together, these findings offer partial support for the cognitive processing model and reinforce the utility of evaluating both self-report and behavioral indicators of motivation to drink in studies designed to identify factors associated with the construct of craving.
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Affiliation(s)
- Marc I Kruse
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA.
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23
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Setiawan E, Pihl RO, Benkelfat C, Leyton M. Influence of the OPRM1 A118G polymorphism on alcohol-induced euphoria, risk for alcoholism and the clinical efficacy of naltrexone. Pharmacogenomics 2012; 13:1161-72. [DOI: 10.2217/pgs.12.99] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Alcohol-use disorders are thought to be heterogeneous in etiology, pathophysiology and response to treatment. One hypothesized contributor to this variability is the common A118G polymorphism of the µ-opioid receptor gene, OPRM1. This article critically evaluates the evidence that the A118G substitution affects subjective, behavioral and neurobiological responses to alcohol and the opioid receptor antagonist, naltrexone. Although screening of patients in a clinical setting remains premature, results suggest the A118G substitution may influence one etiological pathway to alcoholism, for which naltrexone pharmacotherapy is more effective.
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Affiliation(s)
- Elaine Setiawan
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Robert O Pihl
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, H3A 1A1, Canada
| | - Chawki Benkelfat
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, H3A 1A1, Canada
| | - Marco Leyton
- Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada
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Chen D, Liu L, Xiao Y, Peng Y, Yang C, Wang Z. Ethnic-specific meta-analyses of association between the OPRM1 A118G polymorphism and alcohol dependence among Asians and Caucasians. Drug Alcohol Depend 2012; 123:1-6. [PMID: 22071118 DOI: 10.1016/j.drugalcdep.2011.10.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Revised: 09/24/2011] [Accepted: 10/15/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND Many studies have investigated the association between the OPRM1 A118G polymorphism (rs1799971) and alcohol dependence, but the results were inconsistent. To better understand this relationship, ethnicity-specific meta-analyses were conducted. METHODS We retrieved all eligible studies published up to April 12, 2011 from the PubMed/MEDLINE, EMBASE, and ISI Web of Science databases. Ethnicity-specific meta-analyses were performed using either fixed- or random-effect models as appropriate. RESULTS Twelve independent studies with 1900 cases and 2382 controls were included. Five studies were conducted in Asians and seven in Caucasians. Ethnicity-specific meta-analyses revealed that the A118G polymorphism was significantly associated with alcohol dependence risk in Asians (GA vs. AA: odds ratio [OR], 1.73; 95% confidence interval [CI], 1.33-2.25; GA+GG vs. AA: OR, 1.57; 95% CI, 1.22-2.02), but not in Caucasians (GA vs. AA: OR, 1.05; 95% CI, 0.75-1.49; GA+GG vs. AA: OR, 1.11; 95% CI, 0.79-1.55). CONCLUSIONS The OPRM1 A118G polymorphism may contribute to the susceptibility of alcohol dependence in Asians but not in Caucasians.
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Affiliation(s)
- Dingyan Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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25
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A prospective study of stress and alcohol craving in heavy drinkers. Pharmacol Biochem Behav 2012; 101:625-31. [DOI: 10.1016/j.pbb.2012.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 03/02/2012] [Accepted: 03/06/2012] [Indexed: 11/19/2022]
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Ray LA, Barr CS, Blendy JA, Oslin D, Goldman D, Anton RF. The role of the Asn40Asp polymorphism of the mu opioid receptor gene (OPRM1) on alcoholism etiology and treatment: a critical review. Alcohol Clin Exp Res 2012; 36:385-94. [PMID: 21895723 PMCID: PMC3249007 DOI: 10.1111/j.1530-0277.2011.01633.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The endogenous opioid system has been implicated in the pathophysiology of alcoholism as it modulates the neurobehavioral effects of alcohol. A variant in the mu opioid receptor gene (OPRM1), the Asn40Asp polymorphism, has received attention as a functional variant that may influence a host of behavioral phenotypes for alcoholism as well as clinical response to opioid antagonists. This paper will review converging lines of evidence on the effect of the Asn40Asp SNP on alcoholism phenotypes, including: (i) genetic association studies; (ii) behavioral studies of alcoholism; (iii) neuroimaging studies; (iv) pharmacogenetic studies and clinical trials; and (v) preclinical animal studies. Together, these lines of research seek to elucidate the effects of this functional polymorphism on alcoholism etiology and treatment response.
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Affiliation(s)
- Lara A Ray
- Department of Psychology, University of California, Los Angeles, California 90095-1563, USA.
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Abstract
Stress has long been suggested to be an important correlate of uncontrolled drinking and relapse. An important hormonal response system to stress-the hypothalamic-pituitary-adrenal (HPA) axis-may be involved in this process, particularly stress hormones known as glucocorticoids and primarily cortisol. The actions of this hormone system normally are tightly regulated to ensure that the body can respond quickly to stressful events and return to a normal state just as rapidly. The main determinants of HPA axis activity are genetic background, early-life environment, and current life stress. Alterations in HPA axis regulation are associated with problematic alcohol use and dependence; however, the nature of this dysregulation appears to vary with respect to stage of alcohol dependence. Much of this research has focused specifically on the role of cortisol in the risk for, development of, and relapse to chronic alcohol use. These studies found that cortisol can interact with the brain's reward system, which may contribute to alcohol's reinforcing effects. Cortisol also can influence a person's cognitive processes, promoting habit-based learning, which may contribute to habit formation and risk of relapse. Finally, cortisol levels during abstinence may be useful clinical indicators of relapse vulnerability in alcohol-dependent people.
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28
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Thomas S. Clinical laboratory stressors used to study alcohol-stress relationships. Alcohol Res 2012; 34:459-67. [PMID: 23584112 PMCID: PMC3763687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Understanding the biologic systems that underlie the relationship between stress and alcohol consumption may lead to better prevention efforts and more effective treatments for alcoholism. Clinical laboratory studies offer a unique opportunity to examine these relationships by using a controlled environment to study how an acute stressor affects alcohol drinking and alcohol craving, how individuals in recovery or those at risk for alcoholism may respond differently to stressors relative to control subjects, and how alcohol differentially affects stress reactivity in these groups. This article reviews some of the most common physical, psychological, and pharmacological stressors used in stress-induction studies designed to reveal details about the relationship between stress reactivity and alcohol use and abuse.
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Higley AE, Crane NA, Spadoni AD, Quello SB, Goodell V, Mason BJ. Craving in response to stress induction in a human laboratory paradigm predicts treatment outcome in alcohol-dependent individuals. Psychopharmacology (Berl) 2011; 218:121-9. [PMID: 21607563 PMCID: PMC3191263 DOI: 10.1007/s00213-011-2355-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
Abstract
RATIONALE Alcohol dependence is associated with high rates of recidivism. Stress has been shown to increase alcohol craving in alcohol-dependent individuals, but the association between stress-induced craving and alcoholism treatment outcome is not well understood. OBJECTIVE The aim of the present study was to examine the relationship between strength of stress-induced alcohol craving in the human laboratory and subsequent drinking in a cohort of treatment-seeking, alcohol-dependent adults. MATERIALS AND METHODS This is a prospective study assessing stress-induced craving in the lab and subsequent treatment outcomes in alcohol-dependent subjects enrolled in a 12-week outpatient study. Stress was induced using a previously developed, individualized, audio recorded stress script and validated with objective (salivary cortisol) and subjective measures of distress. In vivo craving for alcohol was measured pre- and post-challenge using VAS. RESULTS Subjects were 28 (16 male, 12 female) alcohol-dependent outpatients. Greater stress-induced craving was associated with a blunted salivary cortisol response, significantly shorter time to alcohol relapse, higher mean drinks per week, fewer percent days abstinent, and lower rates of complete abstinence over the study duration (all p's < 0.05). Conversely, no demographic or baseline variables were significant predictors of any outcome variable. CONCLUSIONS These results suggest that greater stress-related increases in alcohol craving are associated with poorer alcohol treatment outcomes. The findings support the use of stress-induced craving as a predictor of alcohol relapse propensity. Furthermore, treatments that address high stress levels and the associated high levels of alcohol craving are likely to improve treatment outcomes in alcohol dependence.
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An acute psychosocial stressor increases drinking in non-treatment-seeking alcoholics. Psychopharmacology (Berl) 2011; 218:19-28. [PMID: 21274703 PMCID: PMC3115478 DOI: 10.1007/s00213-010-2163-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Accepted: 12/25/2010] [Indexed: 10/18/2022]
Abstract
RATIONALE Although studies suggest that stress is an important reason for relapse in alcoholics, few controlled studies have been conducted to examine this assumption. Evidence of stress-potentiated drinking would substantiate this clinical observation and would contribute to the development of a model that would be valuable to alcohol treatment research. OBJECTIVES The hypothesis was tested that an acute psychosocial stressor, the Trier Social Stress Test (TSST), increases alcohol consumption in non-treatment-seeking alcoholics. METHODS Seventy-nine alcohol-dependent participants (40 women) were randomly assigned to receive the TSST or a no-stress condition. Immediately afterward, all participants received an initial dose of their preferred alcoholic beverage to achieve a target blood alcohol concentration of 0.03 g/dl (to prime subsequent drinking in the laboratory). Participants then participated in a mock taste test of two glasses of beer. Primary dependent measures were whether s/he drank all of the beer available (yes/no) and total amount of beer consumed (milliliters). RESULTS Stressed participants were twice as likely as non-stressed participants to drink all of the beer available, a significant effect. Although the stressed group drank more milliliters than the non-stressed group, this effect failed to reach significance, likely due to ceiling effects. There were no significant stress group × gender effects on either outcome. CONCLUSIONS This study supports that stress-potentiated drinking is valid and can be modeled in a clinical laboratory setting.
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Schwandt ML, Lindell SG, Higley JD, Suomi SJ, Heilig M, Barr CS. OPRM1 gene variation influences hypothalamic-pituitary-adrenal axis function in response to a variety of stressors in rhesus macaques. Psychoneuroendocrinology 2011; 36:1303-11. [PMID: 21459516 PMCID: PMC3131436 DOI: 10.1016/j.psyneuen.2011.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 01/20/2011] [Accepted: 03/08/2011] [Indexed: 11/29/2022]
Abstract
The endogenous opioid system is involved in modulating a number of behavioral and physiological systems, including the hypothalamic-pituitary-adrenal (HPA) axis. In humans, a functional variant in the OPRM1 gene (OPRM1 A118G) is associated with a number of outcomes, including attenuated HPA axis responses to stress. A nonsynonymous variant (OPRM1 C77G) in the rhesus macaque has been shown to have similar effects in vivo to the human variant. The current study investigated whether OPRM1 C77G influences HPA axis response to stress in rhesus macaques. We analyzed plasma adrenocorticotropic hormone (ACTH) and cortisol levels measured in response to three different stressors: (1) maternal separation in infant subjects at 6 months of age, (2) acute ethanol administration in adolescent subjects at 4 years of age, and (3) postpartum HPA axis function in adult rhesus macaque females. For the maternal separation paradigm, ACTH and cortisol levels were determined at baseline as well as peak levels during each of 4 consecutive separation episodes. For the acute ethanol administration paradigm, hormone levels were determined at baseline and again at 5 min, 10 min, and 60 min following the ethanol infusion. For postpartum sampling, hormone levels were determined at postpartum days 7, 14, 21, 30, 60, 90, 120, and 150. Infants carrying the 77G allele exhibited lower levels of cortisol across all 4 separation episodes. Furthermore, adolescents carrying the 77G allele exhibited lower cortisol levels at 5 and 10 min following acute ethanol administration. Adult females with prior reproductive experience and who carry the 77G allele exhibited lower cortisol levels across the postpartum period. No significant genotype effects were found for ACTH, although there were some trends for lower ACTH levels in 77G allele carriers. These data are consistent with human studies that have demonstrated attenuated cortisol responses to stress among carriers of the OPRM1 118G allele, lending further support to the argument that the rhesus and human allelic variants are functionally similar. Our results also suggest that OPRM1 variation may influence coping style, as well as alcohol-induced and postpartum levels of HPA axis activity and, as such, may modify vulnerability to alcohol use disorders and postpartum depression.
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Affiliation(s)
- Melanie L. Schwandt
- Laboratory of Clinical and Translational Studies, NIH/NIAAA, Bethesda, MD,Corresponding Author: Melanie Schwandt, 10 Center Drive, 10CRC/1-5330, Bethesda, MD 20892. Phone: 301-451-6960. Fax: 301-402-0445
| | - Stephen G. Lindell
- Laboratory of Clinical and Translational Studies, NIH/NIAAA, Bethesda, MD,Section of Comparative Behavioral Genomics, LNG, NIH/NIAAA, Rockville, MD
| | - James D. Higley
- Department of Psychology, Brigham Young University, Provo, UT
| | | | - Markus Heilig
- Laboratory of Clinical and Translational Studies, NIH/NIAAA, Bethesda, MD
| | - Christina S. Barr
- Laboratory of Clinical and Translational Studies, NIH/NIAAA, Bethesda, MD,Section of Comparative Behavioral Genomics, LNG, NIH/NIAAA, Rockville, MD
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32
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Thomas SE, Randall PK, Brady K, See RE, Drobes DJ. An acute psychosocial stressor does not potentiate alcohol cue reactivity in non-treatment-seeking alcoholics. Alcohol Clin Exp Res 2010; 35:464-73. [PMID: 21143244 DOI: 10.1111/j.1530-0277.2010.01363.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Relapse risk factors, such as psychological stress and alcohol cues, are often encountered together. Understanding how they interact has the potential to improve alcoholism treatments. This study was conducted to examine whether an acute psychosocial stressor enhanced alcohol cue reactivity in non-treatment-seeking alcoholics. METHODS Seventy-nine alcohol-dependent individuals (39 women) randomly received either the Trier Social Stress Test or a no-stress control condition. Stress reactivity was measured with serum adrenocorticotropic hormone and cortisol, mean arterial blood pressure, and subjective distress. Immediately following the stress manipulation, participants held and sniffed a neutral cue then their preferred alcoholic beverage. Cue reactivity was measured by 2 subjective measures of craving following each cue. Additionally, general craving was assessed with the Alcohol Urge Questionnaire at the beginning and end of the laboratory procedure. RESULTS The stress manipulation showed internal validity on all measures of stress reactivity. There was not a main effect of stress nor a stress × cue interaction on either cue reactivity measure. As expected, there was a main effect of cue (alcohol > neutral cue) on both measures of cue reactivity. General craving increased during the challenge, but not differently by stress group. Magnitude of stress reactivity was not associated with magnitude of cue reactivity, and all results were independent of gender. CONCLUSION In this well-controlled clinical laboratory study of non-treatment-seeking alcoholics, an acute psychological stressor did not make an alcohol cue a more potent urge-inducing stimulus, and stress had no effect on general alcohol craving.
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Affiliation(s)
- Suzanne E Thomas
- Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, USA.
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Abstract
This paper is the 32nd consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2009 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration and thermoregulation (Section 16); and immunological responses (Section 17).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, 65-30 Kissena Blvd., Flushing, NY 11367, USA.
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Ray LA. Stress-induced and cue-induced craving for alcohol in heavy drinkers: Preliminary evidence of genetic moderation by the OPRM1 and CRH-BP genes. Alcohol Clin Exp Res 2010; 35:166-74. [PMID: 21039637 DOI: 10.1111/j.1530-0277.2010.01333.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Neurobiological theories of addiction have highlighted disruption in stress pathways as a central feature of addictive disorders, and pharmacological treatments targeting stress mechanisms hold great promise. This study examines genetic determinants of stress-induced and cue-induced craving in heavy drinkers by testing single-nucleotide polymorphisms (SNPs) of the corticotrophin-releasing hormone binding protein (CRH-BP) gene and the mu-opioid receptor (OPRM1) gene. METHODS This study combines guided imagery stress exposure and in vivo alcohol cue exposure in a sample of 64 (23 women) non-treatment-seeking heavy drinkers. RESULTS Analyses, uncorrected for multiple comparisons, revealed that a tag SNP of the CRH-BP gene (rs10055255) moderated stress-induced craving in this sample. The same SNP predicted greater affective responses to the stress manipulation, including greater levels of subjective tension and negative mood. The Asp40 allele of the OPRM1 was associated with greater cue-induced alcohol craving following the neutral imagery condition. CONCLUSIONS These initial results extend recent preclinical and clinical findings implicating the CRH-BP in stress-related alcoholism and confirm the role of the Asp40 allele of the OPRM1 gene in reward-driven alcohol phenotypes. Human laboratory models of stress and cue-induced craving may be useful in pharmacotherapy development targeting dysregulation of stress systems. Larger studies are needed to validate these preliminary findings, which should also be extended to clinical samples.
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Affiliation(s)
- Lara A Ray
- Department of Psychology, University of California, Los Angeles, 90095-1563, USA.
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Rose AK, Shaw SG, Prendergast MA, Little HJ. The importance of glucocorticoids in alcohol dependence and neurotoxicity. Alcohol Clin Exp Res 2010; 34:2011-8. [PMID: 21087289 DOI: 10.1111/j.1530-0277.2010.01298.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alterations in hypothalamo-pituitary adrenal (HPA) function have been described in alcoholics and in rodents after chronic alcohol consumption but the role of glucocorticoids in alcohol consumption, and the mechanisms involved, has received little attention until recently. Both alcohol consumption and withdrawal from chronic alcohol intake raise circulating glucocorticoid levels, and prolonged high concentrations of glucocorticoids are known to have detrimental effects on neuronal function and cognition. This minireview covers the ways in which glucocorticoids may be involved in drinking behavior, from social drinking to dependence, and the negative consequences of alcohol consumption seen during withdrawal which may have a detrimental effect on treatment outcome. Research shows prolonged increases in brain glucocorticoid concentrations and decreased brain glucocorticoid receptor availability (consistent with increased levels of endogenous ligand) after withdrawal from chronic alcohol treatment. Evidence suggests that increased glucocorticoid levels in the brain after chronic alcohol treatment are associated with the cognitive deficits seen during abstinence which impact on treatment efficacy and quality of life. Studies on organotypic cultures also demonstrate the importance of glucocorticoids in the neuropathological consequences of alcohol dependence.
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Affiliation(s)
- A K Rose
- Department of Psychology, University of Liverpool, Liverpool, UK.
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Mague SD, Blendy JA. OPRM1 SNP (A118G): involvement in disease development, treatment response, and animal models. Drug Alcohol Depend 2010; 108:172-82. [PMID: 20074870 PMCID: PMC2887703 DOI: 10.1016/j.drugalcdep.2009.12.016] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 12/17/2009] [Accepted: 12/17/2009] [Indexed: 12/21/2022]
Abstract
Endogenous opioids acting at mu-opioid receptors mediate many biological functions. Pharmacological intervention at these receptors has greatly aided in the treatment of acute and chronic pain, in addition to other uses. However, the development of tolerance and dependence has made it difficult to adequately prescribe these therapeutics. A common single nucleotide polymorphism (SNP), A118G, in the mu-opioid receptor gene can affect opioid function and, consequently, has been suggested to contribute to individual variability in pain management and drug addiction. Investigation into the role of A118G in human disease and treatment response has generated a large number of association studies across various disease states as well as physiological responses. However, characterizing the functional consequences of this SNP and establishing if it causes or contributes to disease phenotypes have been significant challenges. In this manuscript, we will review a number of association studies as well as investigations of the functional impact of this gene variant. In addition, we will describe a novel mouse model that was generated to recapitulate this SNP in mice. Evaluation of models that incorporate known human genetic variants into a tractable system, like the mouse, will facilitate the understanding of discrete contributions of SNPs to human disease.
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Affiliation(s)
| | - Julie A. Blendy
- Address correspondence to: Julie A. Blendy, Ph.D., Department of Pharmacology, University of Pennsylvania, TRL, 125 South 31st Street, Tel: (215) 898-0730, Fax: (215) 573-2041,
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