Craving, cortisol and behavioral alcohol motivation responses to stress and alcohol cue contexts and discrete cues in binge and non‐binge drinkers

Abstract

Alcohol use disorders are associated with high craving and disruption of stress biology, but their role in behavioral alcohol motivation is less clear. We examined the effects of craving and cortisol responses on behavioral alcohol motivation to stress, alcohol cue and neutral-relaxing context cues, in addition to discrete alcohol cues, in demographically matched binge/heavy (BH) and moderate (MD) social drinkers. Subjects participated in a 3-day laboratory experiment of provocation by three personalized guided imagery contexts and discrete alcohol cues followed by the 'alcohol taste test' (ATT) to assess behavioral motivation, as measured by ATT intake. Post-ATT alcohol effects on craving and cortisol responses were also examined. Results indicate BH consumed significantly more alcohol than MD in the ATT. Stress and alcohol cue contexts, relative to neutral, led to significantly greater ATT intake across both groups, which also correlated positively with self-reported alcohol use in past 30 days. Stress and alcohol context and discrete alcohol cues each significantly increased alcohol craving, more so in the BH than MD, and significantly predicted greater ATT intake in BH only. The BH showed significantly lower cortisol responses than MD overall and blunted cortisol responses to cues predicted significantly greater ATT intake in the stress condition for BH and in the alcohol cue condition for MD. Higher ATT intake predicted greater cortisol response and higher craving post-ATT, and these effects were moderated by group status. In sum, findings suggest a role for sensitized context-induced craving and blunted cortisol responses in increased behavioral motivation for alcohol.

A Reinforcer Pathology perspective on relapse

“…Among the conditions that have been documented to shorten temporal perspective and increase the consumption or valuation of substances include experiencing or reading a narrative describing scarcity-related events such as job loss or monetary loss Sze et al, 2017), natural disasters , and an opportunity for a brief sexual experience (Athamneh et al, 2019). These empirical demonstrations are consistent with research on the determinants of relapse suggesting a positive association between emotional and social stressors and contexts and relapse (Abrams et al, 1987;Blaine, Nautiyal, Hart, Guarnaccia, & Sinha, 2019;Sinha, 2001;Sinha & Li, 2007). Many significant stressful life events (e.g., a job loss, a partner loss) may lead to a significant shift in one's focus from the future to the present (especially if such events decrease the number of other longterm positive reinforcers available to the individual; i.e., whatever future reinforcement the drug user was gaining from having a job or partner, respectively, would be unavailable), and therefore, leading to a long-lasting effect on the temporal window and an enduring valuation of drugs (causing a relapse).…”

Early Life Stress and Substance Use Disorders: Underlying Neurobiology and Pathways to Adverse Outcomes

“…Human studies have shown that blunted stress-induced cortisol responses predict subsequent increases in both frequency and quantity of substance use (Moss, Vanyukov, Yao, & Kirillova, 1999). For example, Blaine, Nautiyal, Hart, Guarnaccia, & Sinha, (2019) found that lower cortisol responses to stress and drug cues in heavy and moderate social adult drinkers predicted greater alcohol consumption during an alcohol taste test (Blaine et al, 2019). Blunted HPA activity following stress has also been observed in individuals with SUDs (Sinha, 2009) and appears to be predictive of relapse (Higley, Crane, Spadoni, Quello, Goodell, & Mason, 2011).…”

Emotion Regulation and Desire Thinking as Predictors of Problematic Facebook Use

“…Along with difficulties in emotion regulation, Hormes and colleagues (2014) have shown that problematic Facebook users tend to also report high levels of craving. Craving is a powerful and automatic experience that motivates people to seek out the craved activity (Marlatt, 1987;Spada, Caselli, Slaifer, Nikcevic, & Sassaroli, 2014) and is characterized by strong physiological 'markers' typically involved in substance and behavioural addictions (e.g., Blaine, Nautiyal, Hart, Guarnaccia, & Sinha, 2018;Wise & Koob, 2014;Clark & Goudriaan, 2018). It follows that a strong urge to access social networking sites might be a predictor of PFU.…”