Sex Differences in the Association between Heavy Drinking and Behavioral Distress Tolerance and Emotional Reactivity Among Non-Depressed College Students

Development of Comorbid Alcohol Use and Depressive Symptoms During Late Adolescence: Examining the Roles of Emotion Regulation and Gender Differences

Depression and alcohol use are highly comorbid, and often emerge during adolescence. Depressive symptoms may precede alcohol use, via the self-medication pathway, or alcohol use may precede depressive symptoms, via the alcohol induced disruption pathway. Yet little is known about other risks for developing comorbidity via either path. The present study hypothesized that poor cognitive and physiological emotion regulation (ER) are risk factors implicated in the development of comorbid depression and alcohol use during late adolescence. Participants were 229 (113 girls) Mexican-origin youth who reported on depressive symptoms and alcohol use at ages 17 (Time 1) and 19 years (Time 2). At age 17, cognitive reappraisal (CR), an adaptive ER strategy, and baseline respiratory sinus arrhythmia (RSA), a physiological index of ER capacity, were assessed. CR, RSA and gender were examined as predictors and moderators of the developing comorbidity of alcohol use and depression in cross-lagged panel models. Lower use of CR was concurrently associated with more depressive symptoms at age 17 and predicted greater depression at age 19. Age 17 alcohol use predicted age 19 depressive symptoms for boys. Lower RSA at age 17 also predicted more depressive symptoms at age 19 for boys. Neither CR nor RSA moderated the predicted relations between depression and alcohol use. Findings supported the alcohol induced disruption model of comorbidity for boys, and showed that poor cognitive and physiological ER increased risk for exacerbating depressive symptoms in late adolescence.

Within-person associations between daily stress and physical activity during working and non-working hours

People experience stressors on 40% of days, and emotional responses to stressors increase the risk for poor health, in part by impacting health behaviors like physical activity (PA). However, whether associations of daily psychological stressors with PA after the self-reported stressor occurs (post-stressor PA) differ across working and non-working hours is unclear. This study used the National Study of Daily Experiences III (2017-2019) to examine within-person associations between stressors and post-stressor PA during working and non-working hours and moderation by age and biological sex. Participants completed interviews across eight consecutive days about daily stress and the amount and timing of PA participation during the past 24 hours. Multilevel models with days nested in people examined the within-person associations of stressors with the odds and amount of post-stressor PA participation, with separate models during versus outside of working hours on working days and for non-working days. Participants (N = 564) had higher odds of post-stressor PA during working hours when they experienced greater than usual anger (OR = 3.24, p < .001), sadness (OR = 2.41, p < .001), or shame (ORs = 2.59, p < .001) due to stress. Sex moderated the within-person associations between stressor frequency (OR = 0.29, p < .001), intensity (OR = 0.49, p < .001), and anxiety (OR = 0.58, p = .002) on odds of post-stressor PA during working hours, such that the increased odds were higher in males. Participants had higher odds of post-stressor PA outside of working hours when they experienced greater stress intensity, anger, sadness, shame, or anxiety (OR = 3.94-7.35, p < .001). Research clarifying how age, sex, and/or occupation intersect with individuals' daily stress experiences and PA could inform occupational health policies and/or interventions.

Age and Sex Differences in the Associations Among Socioeconomic Status, Affective Reactivity to Daily Stressors, and Physical Health in the MIDUS Study

BACKGROUND

Low socioeconomic status (SES) is robustly associated with increased risks of morbidity and mortality. Affective reactivity to daily stressors has been proposed to be a mediator for this association. However, few longitudinal studies have empirically tested the indirect effect of SES on health through affective reactivity to daily stressors.

PURPOSE

This study aimed to test the indirect effect of SES on physical health via affective reactivity to daily stressors over a 10-year period and to explore age and sex differences in such indirect effect.

METHODS

Data were drawn from a subsample of 1,522 middle-aged and older adults (34-83 years of age, 57.2% female, 83.5% White) from the Midlife in the United States study. SES (i.e., education, household income, indicators of financial distress) was assessed in 2004-2006. Affective reactivity to daily stressors was computed using data collected during the 8-day daily stress assessment in 2004-2009. Self-reported physical health conditions were assessed in 2004-2006 and 2013-2014.

RESULTS

There was a significant indirect effect of lower SES on more physical health conditions via elevated negative affective reactivity to daily stressors among women but not men. The indirect effect of SES on physical health conditions via negative affective reactivity to daily stressors was consistent across the middle and older adulthood.

CONCLUSIONS

Our findings suggest that negative affective reactivity to daily stressors might be a key intermediate process contributing to persistent SES disparities in physical health, particularly among women.

Distress symptoms and alcohol consumption: anxiety differentially mediates drinking across gender

Introduction

The consumption of alcohol remains a significant health concern and represents a prevalent form of substance use worldwide. Previous research has identified sex differences in the consumption of alcohol. This study explores the relationship between drinking and the presence of distress symptoms across gender. Based on previous research, it was hypothesized that presence of distress symptoms, defined as increases in anxiety and depression, would be prominent features associated with alcohol consumption among women compared to men.

Methods

A sample of undergraduate students (N = 448) participated in an online-based questionnaire (71% female; M age = 22.1; 42.9% Hispanic/Latino). The questionnaire contained assessments related to demographic information and alcohol consumption over the past 30 days. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale.

Results

Gender differences were observed with men consuming more alcoholic drinks than women. However, women who consumed alcohol reported having more distress symptoms relative to their male counterparts. A logistic regression revealed that this gender difference was moderated by anxiety, such that greater anxiety scores associates with whether women consumed alcohol. However, an ordinary least squares regression revealed that for men, anxiety scores significantly related to the amount of drinks consumed. Gender differences were not detected in relation to alcohol consumption and depression.

Conclusion

Our findings contribute to the literature by indicating that the mere presence of distress symptoms reveals distinctive gender-specific differences in relation to alcohol consumption in a non-clinical population. Identifying the distinct associations linked with alcohol use for men and women can aid in reducing drinking disparities among young adults.

Distress tolerance and emotional regulation in individuals with alcohol use disorder

Background

Previous research suggests that low distress tolerance may be associated with poor emotion regulation, contribute to drinking to cope motives, and predict alcohol-related problems in non-clinical populations. However, little is known about the ability to tolerate distress among individuals with alcohol use disorder (AUD) and its association with emotional dysregulation. The aim of this study was to examine the link between emotional dysregulation and a behavioral measure of distress tolerance among individuals with AUD.

Methods

The sample consisted of 227 individuals with AUD enrolled in an 8-week abstinence-based inpatient treatment program. Behavioral distress tolerance was assessed using a test of ischemic pain tolerance and the Difficulties in Emotion Regulation Scale (DERS) was used to assess emotion dysregulation.

Results

Distress tolerance was significantly associated with emotional dysregulation even when accounting for alexithymia, depressive symptomatology, age, and biological sex.

Conclusion

The current study provides preliminary support for an association between low distress tolerance and emotion dysregulation in a clinical group of patients with AUD.

Prelimbic Cortex Activity during a Distress Tolerance Task Predicts Cocaine-Seeking Behavior in Male, But Not Female Rats

Distress tolerance (DT) is defined as the ability to persist in challenging goal-directed behavior in the face of stress, and individuals with low DT exhibit heightened drug-seeking behavior. However, no preclinical studies have examined the neurobiology underlying this phenomenon. To assess this, in vivo electrophysiology was used in Long Evans male and female rats during a DT task to record neural activity in the prelimbic cortex (PrL), a brain region implicated in drug-seeking. Rats were first assessed for DT, defined as the amount of time elapsed before rats quit seeking reward in an increasingly difficult operant task. Subsequently, rats underwent 2 weeks of self-administration for either water/saline or cocaine for 6 h/day. Animals then began a 1 month period of experimenter-imposed abstinence to induce heightened drug-seeking behavior. On day 28 of abstinence, DT and neural activity were reassessed; and on day 30, cocaine-seeking behavior was examined under extinction. Males had significantly higher DT than females and exhibited significantly more phasic PrL activity during the DT task. Furthermore, in male rats with a history of cocaine, PrL activity shifted to track DT; and this change in activity significantly correlated with the change in DT. Additionally, male (but not female) rats with low DT after 28 d of abstinence had significantly heightened drug-seeking behavior. Finally, PrL activity during the DT task predicted cocaine-seeking behavior. Collectively, these data demonstrate an important role for the PrL in DT in males, and link this neural activity and behavior to drug-seeking, particularly in males.SIGNIFICANCE STATEMENT Distress tolerance (DT) is defined as the ability to persist in challenging goal-directed behavior in the face of stress, and individuals with low DT exhibit heightened drug-seeking. Here, we investigated the role of the prelimbic cortex (PrL) in DT and its relationship to cocaine-seeking in male and female rats. We found that males had significantly higher DT than females and exhibited significantly more PrL activity during the DT task. Furthermore, male (but not female) rats with low DT after 28 d of abstinence had significantly heightened drug-seeking behavior. Finally, PrL activity during the DT task predicted cocaine-seeking. These data demonstrate an important role for the PrL in DT and link this neural activity and behavior to drug-seeking in males.

Large-scale brain network activation during emotional inhibitory control: Associations with alcohol misuse in college freshmen

BACKGROUND

The transition to college is associated with increased risk of alcohol misuse and a consequent increase in negative, alcohol-related social and health impacts. Traits associated with ongoing brain maturation during this period, including impulsivity in emotional contexts, could contribute to risky alcohol use.

METHODS

This functional magnetic resonance imaging (fMRI) study examined brain network activation strength during an emotional inhibitory control task (Go-NoGo), which required participants to ignore background images with negative or neutral emotional valence during performance. Participants were 60 college freshmen (aged 18-20 years, 33 women). Survey measures, completed at baseline and one-year follow-up (follow-up n = 52, 29 women), assessed alcohol misuse alcohol use disorders identification test (AUDIT), alcohol/substance use counseling center assessment of psychological symptoms (C-CAPS), and negative consequences of alcohol use young adult alcohol consequences questionnaire (YAACQ). Measures were examined relative to network activation strength, on the Negative NoGo > Neutral NoGo contrast, of four large-scale brain networks implicated in top-down regulation of cognition and attention: right and left lateral frontoparietal networks (rL-FPN; lL-FPN), dorsal attention network (DAN), and salience network (SN).

RESULTS

Activation strength of DAN was negatively associated with scores on the AUDIT (p = 0.013) and YAACQ (p = 0.004) at baseline, and with C-CAPS score at baseline and follow-up (p = 0.002; p = 0.005), and positively associated with accuracy on NoGo trials with negative backgrounds (p = 0.014). Activation strength of rL-FPN was positively associated with C-CAPS score at follow-up (p = 0.003). SN activation strength was negatively associated with accuracy on NoGo trials with negative (p < 0.001) and neutral (p = 0.002) backgrounds and with the accuracy difference between negative versus neutral NoGo trials (p = 0.003).

CONCLUSION

These findings suggest that less engagement of large-scale brain circuitry that supports top-down attentional control, specifically during negative emotions, is associated with more problematic drinking in emerging adults who attend college. This pattern of network activation may serve as a risk marker for ongoing self-regulation deficits during negative emotion that could increase risk of problematic alcohol use and negative impacts of drinking.

A biological framework for emotional dysregulation in alcohol misuse: from gut to brain

Alcohol use disorder (AUD) has been associated with impairments in social and emotional cognition that play a crucial role in the development and maintenance of addiction. Repeated alcohol intoxications trigger inflammatory processes and sensitise the immune system. In addition, emerging data point to perturbations in the gut microbiome as a key regulator of the inflammatory cascade in AUD. Inflammation and social cognition are potent modulators of one another. At the same time, accumulating evidence implicates the gut microbiome in shaping emotional and social cognition, suggesting the possibility of a common underlying loop of crucial importance for addiction. Here we propose an integrative microbiome neuro-immuno-affective framework of how emotional dysregulation and alcohol-related microbiome dysbiosis could accelerate the cycle of addiction. We outline the overlapping effects of chronic alcohol use, inflammation and microbiome alterations on the fronto-limbic circuitry as a convergence hub for emotional dysregulation. We discuss the interdependent relationship of social cognition, immunity and the microbiome in relation to alcohol misuse- from binge drinking to addiction. In addition, we emphasise adolescence as a sensitive period for the confluence of alcohol harmful effects and emotional dysregulation in the developing gut-brain axis.

Associations between affect and alcohol consumption in adults: an ecological momentary assessment study

Background: Consuming alcohol for coping with negative affect (NA) or enhancing positive affect (PA) may lead to risky drinking patterns. Previous research has yielded mixed findings regarding these affective drinking associations.Objectives: To examine support for the self-medication and expectancy models of alcohol use in an adult community sample, by examining reciprocal associations between alcohol consumption and NA and PA within and between persons.Methods: During seven consecutive days, 162 adults from the community (109 female) reported their affective experiences and alcohol consumption, following a signal contingent ecological momentary assessment protocol on their smartphones.Results: Within-person daily NA preceding the first drinking event was associated with increased likelihood of same-day alcohol consumption. Within-person momentary NA was associated with a decrease in the amount of next-moment alcohol consumption. Within-person momentary PA was positively associated with likelihood of next-moment alcohol consumption. Between persons, levels of daily and momentary NA and PA were not associated with any index of alcohol consumption. The intercepts and slopes of NA were not significantly different before and after alcohol consumption. The intercept of PA was higher after alcohol consumption, whereas the slope of PA decreased after alcohol consumption.Conclusion: In the current sample affective drinking was a within-person process (i.e. persons were sensitive to their varying levels of affect). Some support was found for the self-medication and expectancy models. People may drink for coping with NA, but may also be at risk for developing affective drinking patterns in response to PA.