Effect of Stress on Precipitants to Alcohol Relapse

Medical University Of South Carolina, Charleston SC

Investigators

Linked publications, trials & patents

Abstract

Approximately 75% of alcoholics relapse within 12 months of attempted abstinence. Several risk factors for[unreadable] relapse have been identified, including stress, alcohol-associated cues (e.g., driving by the bar; seeing[unreadable] alcohol advertisements), and a priming dose of alcohol (the attempt to have "just one"). A recent cognitivebehavioral[unreadable] model of relapse proposes a dynamic system where risk factors interact to heighten the[unreadable] likelihood of relapse. Historical data from clinical studies and more recent results from controlled preclinical[unreadable] studies support this dynamic model of relapse, whereby one risk factor, such as stress, can increase the[unreadable] strength of another risk factor, such as cues, to induce reinstatement.[unreadable] Clinical laboratory studies enable investigators to examine the issue of interplay between risk factors in a[unreadable] methodologically rigorous manner. Using a clinical laboratory paradigm and non-treatment-seeking[unreadable] alcoholics, the proposed project will investigate whether a social stressor potentiates the strength of (1)[unreadable] alcohol cues (Experiment 1) and (2) an initial drink of alcohol (Experiment 2). The internal validity of the[unreadable] stressor will be confirmed with physiologic, neuroendocrine, and subjective measures. Response to cues[unreadable] and to alcohol will be measured using multi-modal, empirically-supported indices of appetitive response,[unreadable] motivation to drink, cognitive interference, and actual alcohol consumption (in Experiment 2). Primary[unreadable] analyses will address whether responses to cues and/or an alcohol "prime" are enhanced by stress (vs. nostress)[unreadable] and, importantly, whether this effect differs by gender. Exploratory analyses will examine whether[unreadable] person-centered characteristics (e.g., anxiety sensitivity, severity of alcohol dependence, family history of[unreadable] alcoholism, and propensity to drink in response to stress) predict in whom the main hypotheses are[unreadable] supported.[unreadable] The project will increase understanding about how risk factors interact to induce relapse, and may help[unreadable] direct future treatment approaches to reduce relapse in alcoholics. It will also suggest whether for men and[unreadable] women stress differentially alters the strength of known relapse risk factors (cues and an initial priming[unreadable] drink), an understudied issue that also has important treatment implications.