Reactivity to combined experimental stress- and alcohol cue-exposure predicts real-life alcohol use and alcohol craving in individuals with alcohol use disorder

Hintergrund und Fragestellung: Exposure to stress- and alcohol cues elicits changes in physiological and psychological states and both were identified as triggers for alcohol craving and alcohol consumption in alcohol use disorder (AUD). However, the relative contributions of stress and alcohol cues and associated changes on physiological and psychological states to increases in craving and alcohol use are not understood yet.

Methoden/Erläuterung des Versorgungsprojektes: We compared the effects of psychosocial stress against physical stress and control intervention followed by alcohol cue exposure on alcohol craving, subjective stress and cortisol levels in N=121 individuals with mild to moderate AUD using a 1:1:1 randomized-controlled experimental study design. Real-life alcohol use and alcohol craving were assessed during a one-year follow-up every other day using ecological momentary assessments. We applied linear mixed models to investigate the effects of stress- and alcohol cue-exposure on the primary outcomes and the relative contributions of the observed changes to predicting stress and alcohol craving during the experiment and alcohol use during follow-up.

Ergebnisse/Erfahrungen, Erwartungen: Combined exposure to psychosocial stress and alcohol cues induced higher cortisol levels (time x group (F(10,580.420)=10.819, p<.001)), subjective stress (time x group (F(2,117.197)=10.520, p<.001)) and alcohol craving (time x group (F(6,348.583)=4.313, p<.001)) compared to the control condition and physiological stress. Subjective stress was the most significant predictor for craving during the experiment (F(1,92)=9.43, p<.003) and during the follow-up phase (beta=0.16, p=.039). Cortisol reactivity predicted real-life alcohol consumption (beta=9.76, p=.043).

Diskussion und Schlussfolgerung: Our results highlight the role of psychosocial stress- and alcohol cue-induced effects on the neuroendocrine stress system for the emergence of alcohol craving and subjective stress and alcohol craving and alcohol use in real-life settings.

Offenlegung von Interessenskonflikten sowie Förderungen: Ich und die Koautorinnen und Koautoren erklären, dass während der letzten 3 Jahre keine wirtschaftlichen Vorteile oder persönlichen Verbindungen bestanden, welche die Arbeit zum eingereichten Abstract beeinflusst haben könnten. Erklärung zur Finanzierung: This study was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – Project-ID 402170461 – TRR 265. The funding source had no role in the collection, analysis and interpretation of data or in the writing of the report.

Publication History

Article published online:
19 September 2024