Modeling Relapse Situations in the Human Laboratory

Sinha, Rajita

doi:10.1007/7854_2011_150

Cited by 22 publications

(23 citation statements)

References 127 publications

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“…Increased cortisol and sympathetic dominance in the ANS have direct implications for the clinical experience of protracted withdrawal, acute stress and environmental and interoceptive alcohol cues (Sinha ). Behaviorally, this altered neurobiological state results in susceptibility to cue reactivity, anxious rumination, poor decision making and a reliance on habit‐based responding (Heilig & Koob ).…”

Section: Discussionmentioning

confidence: 99%

Peripheral and prefrontal stress system markers and risk of relapse in alcoholism

2015

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Previous research has shown that hyperactivation in ventral medial prefrontal cortex (VmPFC) and rostral anterior cingulate cortex (rACC) and high cortisol to corticotrophin ratio (cort:ACTH ratio) during neutral-relaxed states predict relapse in alcohol dependent (AD) patients. Other studies have shown that VmPFC/rACC deactivation and blunted cortisol release to stress and alcohol cues are predictive of time to relapse and relapse severity. However, no previous study has assessed the relationship between these markers of central and peripheral nervous system dysfunction in AD participants and their potential joint effects on relapse risk. Forty early abstinent, treatment engaged AD patients underwent a laboratory experiment with exposure to neutral, alcohol, and stress cues and a separate functional magnetic resonance imaging (fMRI) scan with similar cue exposure. Neutral-relaxed state cort:ACTH ratio was significantly associated with VmPFC hyperreactivity to neutral-relaxing cues, and also with hypoactivation in response to alcohol and stress cues in AD patients. Basal heart rate, neutral cort:ACTH ratio, and neutral VmPFC hyperreactivty were each associated with risk of relapse. However, abnormal VmPFC activation and elevated cort:ACTH ratio overlap in predicting risk for relapse, and dysfunctional VmPFC response was the sole significant predictor of odds of relapse in a joint model of relapse risk. These findings suggest that the Cort:ACTH ratio may serve as a peripheral marker of VmPFC brain dysfunction while aberrant VmPFC responses needs further evaluation as a potential biomarker of alcohol relapse risk in clinical outcome studies.

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Section: Discussionmentioning

confidence: 99%

Peripheral and prefrontal stress system markers and risk of relapse in alcoholism

2015

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“…Among studies in animals and people, it has been stated that stress is one of the major factors that determine striving for alcohol, continued drinking, and the occurrence of relapses after periods of abstinence (Sinha, 2013;De Witt, 1996;Le et al, 1998;Stewart, 2000). Many authors try to explain these relations by pointing out the marked tendency of using alcohol to reduce tension and anxiety (Sinha, Fox, Hong, Bhagwagar, & Siedlarz, 2009;Cappell, 1972;Conger, 1951;Hodgson, Stockwell, & Rankin, 1979).…”

Section: Discussionmentioning

confidence: 99%

Alcohol craving in relation to coping with stress and satisfaction with life in the addicted

Gąsior¹,

Biedrzycka²,

Chodkiewicz³

et al. 2015

Health Psychology Report

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Background The present study aimed at finding any relation between alcohol craving and strategies of coping with stress and satisfaction with life in the addicted. Until now, studies have shown that generalized deficits in coping with stress, and the dominance of avoidance strategies, are significantly related to the increase of the risk of addiction and the course of this disease. This relation, which could link strategies of coping with stress and quality of life with experiencing alcohol craving, has only been explained to a small extent. Also, the role of gender in explaining these relations is ambiguous. Participants and procedure The study was conducted in a group of 550 addicted subjects in out-patient or in-patient treatment (396 men and 114 women). In the present study the following instruments were used: the Craving Typology Questionnaire by Marinotti et al., the Yale-Brown Obsessive-Compulsive Drinking Scale by Modell et al., the Mini-Cope by Carver et al., SADD by Reistrick et al., and the Satisfaction with Life Scale by Diener et al. Statistical correlational analysis and structural equations were applied, namely partial least squares path modelling (PLS-PM). Results There are two types of links between craving and strategies of coping with stress among the addicted. The first dominating type is pointing at casual link between ineffective strategies of coping with stress and craving. The other weaker type indicates the diminishing influence of effective strategies of coping with stress on alcohol craving. Life satisfaction lowers alcohol craving. Conclusions Effective strategies of reacting to stress, together with life satisfaction, protect against increase of alcohol craving. Severity of dependence is an important factor which moderates the influence of strategies of coping with stress on alcohol craving.

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“…It would be interesting for future studies to evaluate whether CUD with two risk alleles have an elevated propensity toward poorer clinical outcomes. For instance, one could hypothesize that these CUD may be at increased risk for developing depression symptoms especially when confronted with aversive experiences (e.g., stress), which together with the genes may modulate relapse propensity (Sinha, 2013); conversely, CUD without these risk alleles may be better shielded from the effects of stress and/or other negative environmental stimuli on mood regulation that could derail abstinence.…”

Section: Discussionmentioning

confidence: 99%

Monoamine polygenic liability in health and cocaine dependence: Imaging genetics study of aversive processing and associations with depression symptomatology

Moeller

Parvaz

Shumay

et al. 2014

Drug and Alcohol Dependence

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Background Gene polymorphisms that affect serotonin signaling modulate reactivity to salient stimuli and risk for emotional disturbances. Here, we hypothesized that these serotonin genes, which have been primarily explored in depressive disorders, could also have important implications for drug addiction, with the potential to reveal important insights into drug symptomatology, severity, and/or possible sequelae such as dysphoria. Methods Using an imaging genetics approach, the current study tested in 62 cocaine abusers and 57 healthy controls the separate and combined effects of variations in the serotonin transporter (5-HTTLPR) and monoamine oxidase A (MAOA) genes on processing of aversive information. Reactivity to standardized unpleasant images was indexed by a psychophysiological marker of stimulus salience (i.e., the late positive potential (LPP) component of the event-related potential) during passive picture viewing. Depressive symptomatology was assessed with the Beck Depression Inventory (BDI). Results Results showed that, independent of diagnosis, the highest unpleasant LPPs emerged in individuals with MAOA-Low and at least one ‘Short’ allele of 5-HTTLPR. Uniquely in the cocaine participants with these two risk variants, higher unpleasant LPPs correlated with higher BDI scores. Conclusions Taken together, these results suggest that a multilocus genetic composite of monoamine signaling relates to depression symptomatology through brain function associated with the experience of negative emotions. This research lays the groundwork for future studies that can investigate clinical outcomes and/or pharmacogenetic therapies in drug addiction and potentially other psychopathologies of emotion dysregulation.

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Modeling Relapse Situations in the Human Laboratory

Cited by 22 publications

References 127 publications

Peripheral and prefrontal stress system markers and risk of relapse in alcoholism

Peripheral and prefrontal stress system markers and risk of relapse in alcoholism

Alcohol craving in relation to coping with stress and satisfaction with life in the addicted

Monoamine polygenic liability in health and cocaine dependence: Imaging genetics study of aversive processing and associations with depression symptomatology

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