Subjective Response to Alcohol Challenge: A Quantitative Review

Abstract

Background Individual differences in subjective response to alcohol, as measured by laboratory-based alcohol challenge, have been identified as a candidate phenotypic risk factor for the development of alcohol use disorders (AUDs). Two models have been developed to explain the role of subjective response to alcohol, but predictions from the two models are contradictory, and theoretical consensus is lacking. Methods This investigation used a meta-analytic approach to review the accumulated evidence from alcohol-challenge studies of subjective response as a risk factor. Data from 32 independent samples (total N = 1,314) were aggregated to produce quantitative estimates of the effects of risk group status (i.e., positive family history of AUDs or heavier alcohol consumption) on subjective response. Results As predicted by the Low Level of Response Model (LLRM), family history positive groups experienced reduced overall subjective response relative to family history negative groups. This effect was most evident among men, with family history positive men responding more than half a standard deviation less than family history negative men. In contrast, consistent with the Differentiator Model (DM), heavier drinkers of both genders responded 0.4 standard deviations less on measures of sedation than did lighter drinkers but nearly half a standard deviation more on measures of stimulation, with the stimulation difference appearing most prominent on the ascending limb of the blood alcohol concentration curve. Conclusions The accumulated results from three decades of family history comparisons provide considerable support for the LLRM. In contrast, results from typical consumption comparisons were largely consistent with predictions of the DM. The LLRM and DM may describe two distinct sets of phenotypic risk, with importantly different etiologies and predictions for the development of AUDs.

Reduced Subjective Response to Acute Ethanol Administration Among Young Men with a Broad Bipolar Phenotype

“…These findings are generally consistent with the LLRFbut not the differentiatorF model of vulnerability for AUDs (Quinn and Fromme, 2011;Morean and Corbin, 2010), suggesting that individuals with the BPP experienced a generalized decreased awareness of intoxication, which was not biphasic in character. Although the origins of this decreased awareness remain unclear, one possibility is that previous experiences of non-substancerelated mood elevation mean that individuals with BPP are less likely to attribute ethanol-induced mood variation (ie, intoxication) to alcohol.…”

“…However, given the conflicting findings of the literature, it is also possible that people with the BPP show greater stimulant effects during the ascending limb. We included only males in our experiment because problem drinking is more prevalent in men, and LLRs have been most robustly observed among men at-risk for AUDs (Quinn and Fromme, 2011).…”

Effects of naltrexone on alcohol self‐administration and craving: meta‐analysis of human laboratory studies

“…‘urge,’ ‘wanting’) contributed to the craving analysis ( k  = 16). For studies assessing craving at multiple points during the session, effects were averaged across time points at the study level (Quinn and Fromme, 2011). If studies reported data on more than one craving measure (e.g.…”

The Answer You Get Depends on the Question You Ask

“…The inclusion of drinkers with such high intake and prior potentially rewarding experiences with heavy drinking may have enhanced their responses to liking alcohol and wanting more, especially if some met criteria for an AUD at baseline. Finally, the absence of differences for sedation or stimulation on the rising and falling limbs of the BrAC curves may not support the differentiator model as defined in some other articles (9,10).…”