Premium
Methods for inducing alcohol craving in individuals with co‐morbid alcohol dependence and posttraumatic stress disorder: behavioral and physiological outcomes
Author(s) -
Kwako Laura E.,
Schwandt Melanie L.,
Sells Joanna R.,
Ramchandani Vijay A.,
Hommer Daniel W.,
George David T.,
Sinha Rajita,
Heilig Markus
Publication year - 2015
Publication title -
addiction biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.445
H-Index - 78
eISSN - 1369-1600
pISSN - 1355-6215
DOI - 10.1111/adb.12150
Subject(s) - craving , trier social stress test , psychology , alcohol use disorder , clinical psychology , cue reactivity , anxiety , psychiatry , alcohol dependence , alcohol use disorders identification test , addiction , alcohol , medicine , poison control , injury prevention , fight or flight response , biochemistry , chemistry , environmental health , gene
Alcohol addiction is a chronic relapsing disorder that presents a substantial public health problem, and is frequently co‐morbid with posttraumatic stress disorder ( PTSD ). Craving for alcohol is a predictor of relapse to alcohol use, and is triggered by cues associated with alcohol and trauma. Identification of reliable and valid laboratory methods for craving induction is an important objective for alcoholism and PTSD research. The present study compares two methods for induction of craving via stress and alcohol cues in individuals with co‐morbid alcohol dependence ( AD ) and PTSD : the combined T rier social stress test and cue reactivity paradigm ( T rier/ CR ), and a guided imagery ( S cripts) paradigm. Outcomes include self‐reported measures of craving, stress and anxiety as well as endocrine measures. Subjects were 52 individuals diagnosed with co‐morbid AD and PTSD seeking treatment at the N ational I nstitute on A lcohol A buse and A lcoholism inpatient research facility. They participated in a 4‐week inpatient study of the efficacy of a neurokinin 1 antagonist to treat co‐morbid AD and PTSD , and which included the two challenge procedures. Both the T rier/ CR and S cripts induced craving for alcohol, as well as elevated levels of subjective distress and anxiety. The T rier/ CR yielded significant increases in adrenocorticotropic hormone and cortisol, while the S cripts did not. Both paradigms are effective laboratory means of inducing craving for alcohol. Further research is warranted to better understand the mechanisms behind craving induced by stress versus alcohol cues, as well as to understand the impact of co‐morbid PTSD and AD on craving.