RationaleChronic alcohol misuse can escalate into alcohol use disorder (AUD). The causal mechanisms throughwhich recreational social drinking develops into compulsive uncontrolled alcohol misuse aremultifaceted. For example, stress is an important risk factor that influences alcohol craving in bothhealthy and addicted individuals. In addition, those that are high in impulsivity/risk taking drink moreand are at greater risk of developing addiction. At present, however, it is not possible accurately topredict those at risk of escalation in alcohol use, or of developing AUD.ObjectivesThe aim of this study was to investigate how underlying physiological and personality traits affectstress-induced craving for, and consumption of, alcohol, in a sample of healthy social drinkers. Theprimary hypothesis was that impulsivity/risk-taking would modulate stress-induced alcohol cravingand consumption.MethodsThirty-nine participants (22 male and 17 female; mean age = 23.92 years [SD = 4.90]) were randomlyallocated to “stress” and “no-stress” groups; in the stress group participants took part in the TrierSocial Stress Test (TSST). Participants completed several questionnaires and computer tasks in orderto assess prior alcohol use, impulsivity/risk-taking, stress-reactivity, craving and physiologicalbiomarkers of stress. Finally, participants completed a voluntary drinking task, in which increasingnumbers of presses on a computer keyboard were reinforced with 5ml shots of 37% ABV vodka (plusmixer).ResultsParticipants exposed to the TSST showed an increase in craving following the stressor. Severalfactors predicted voluntary drinking, including risky decision making, slow HR recovery from stress,poor vagal tone during recovery from stress and greater stress reactivity. Surprisingly, we found nocorrelation between craving and consumption.ConclusionsOur data suggest that variation in physiological stress parameters and poor decision-making abilitiesincrease risk of stress-induced alcohol consumption. This may provide a useful translationalframework through which we can further study early predictive markers for the shift betweencontrolled recreational drinking to uncontrolled alcohol misuse, including AUD.
The role of stress-reactivity, stress-recovery and risky decision-making in psychosocial stress-induced alcohol consumption in social drinkers
