Daily stress predicts later drinking initiation via craving in heavier social drinkers: A prospective in-field daily diary study.

Abstract

Stress has been linked to increased alcohol use but how stress may increase drinking in social drinkers is not well understood. Negative reinforcement processes may explain this link but the role of specific motivational processes, such as craving, and how these motivational processes are altered by drinking have not been studied. The current study assessed social drinkers (n = 81) for recent quantity and frequency of alcohol intake (quantity and frequency index, QFI) upon study enrollment, who then completed 30 days of electronic daily records of stress, craving, and alcohol intake. Multilevel structural equation models tested if person-averaged (between-person) and daily (within-person) craving mediated the link between stress and later drinking each evening and if recent quantity-frequency of drinking (QFI) moderated these associations. At the between-person level, both greater subjective stress, Est = .38, 95% confidence interval (CI) [.19, .57], and higher QFI predicted higher levels of craving, Est = .34, 95% CI [.20, .49]. Higher craving predicted more frequent drinking throughout the study, Est = .34, 95% CI [.01, .29]. At the within-person level, higher subjective stress predicted higher within-person craving; and the link between craving and later drinking was significant among those who had a higher QFI, Est = .84, 95% CI [.58, 1.12]. The subjective stress-drinking relationship was mediated by a greater alcohol craving response in social drinkers, and higher the QFI, greater the alcohol craving response. These results indicate that both higher levels of stress and greater recent alcohol intake patterns sensitize the craving response that in turn facilitates later alcohol intake. The findings suggest that higher recent alcohol use predict greater stress-potentiated initiation of drinking via higher craving responses.

Substance use patterns, quantities, and associated risk factors in women with polysubstance misuse

“…Our current findings do however show congruence with prior work by our group in a treatment‐based study in participants with AUD, where craving but not anxious or depressive symptoms were linked to heavier drinking during treatment, despite their relationships to one another 14 . Although not able to be tested in our current data set due to the cross‐sectional design, stress/trauma and craving variables may represent an incentive‐salience pathway to increased PSU 68,69 . This contrasts with a coping pathway that may be present for substance use relating to anxious or depressive symptoms 70 .…”

Network state dynamics underpin craving in a transdiagnostic population

“…Therefore, recruiting the NND state longer may permit more time for self-regulation to occur and interrupt potential undesirable impulsive or compulsive behaviors associated with craving (43, 44). Our interpretations suggest that individual differences in this self-regulation process may contribute to variations in basal craving, which has important implications for alcohol and substance misuse (45, 46). By shedding light on the neural mechanisms underpinning basal craving, the current investigations also reveal how aberrant inhibition and impulsive behavior may promote addictive engagement (44).…”

Alcohol�s Negative Emotional Side: The Role of Stress Neurobiology in Alcohol Use Disorder

“…9,12,14,15 These brain changes are associated with blunted autonomic and cortisol responses to stress and to acute alcohol intake, 6,8 as well as with increases in negative emotional and stress responses and greater alcohol craving. 6,9,[14][15][16][17] Together, these changes are part of the psychobiological adaptations in humans that occur with increasing patterns of binge and hazardous alcohol intake.…”

“…14,29 Along with these neural changes, increased salience of alcohol and greater alcohol craving levels have been observed in response to stress as well as in response to alcohol and to alcohol cues, which then promote increased alcohol intake and escalation to risky drinking. 8,15,17 These brain stress system, physiologic, and behavioral effects of binge drinking history need to be further examined by sex to better understand the recent data on greater escalation of binge drinking in women compared to men. 30 stress coping.…”