Association between problematic alcohol use and reactivity to uncertain threat in two independent samples
Open accessAbstract
Background Recent laboratory studies have shown that acute alcohol intoxication selectively and effectively dampens aversive responding to uncertain threat. An emerging hypothesis is that individuals who exhibit heightened reactivity to uncertain threat may be especially motivated to use alcohol to dampen their distress, setting the stage for negative reinforcement processes to drive excessive alcohol use. However, no study to date has directly examined whether current problematic drinkers exhibit heightened reactivity to uncertain threat as would be expected. Methods The present study was therefore designed to examine the association between current problematic alcohol use and reactivity to uncertain threat during sobriety in two, independent samples. In Study 1 (n=221) and Study 2 (n=74), adult participants completed the same well-validated threat-of-shock task which separately probes responses to temporally predictable and unpredictable threat. Startle potentiation was measured as an index of aversive responding. Problematic alcohol use was defined as number of binge episodes within the past 30days in Study 1 and total scores on a self-report measure of hazardous drinking in Study 2. Results As hypothesized, across both studies greater levels of problematic drinking were associated with greater startle potentiation to unpredictable threat. In Study 2, hazardous drinking scores were also positively associated with startle potentiation to predictable threat. Conclusions The findings are notably consistent with the notion that heightened reactivity to uncertain threat is an important individual difference factor associated with the onset and/or maintenance of problematic drinking behaviors and may therefore be a novel prevention and intervention target.
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Intolerance of uncertainty is a key driver of problematic alcohol drinking.
“Intolerance of uncertainty is a key driver of problematic alcohol drinking (Gorka et al. 2016).”
From Decoding the bidirectional links between alcohol misuse and aggression: toward a unified translational framework (2026) · cites this paper as Gorka et al. 2016
The Discussion reports that problematic drinking was associated with greater reactivity to uncertain threat in two samples and says the findings converge with literature suggesting intolerance of uncertainty underlies motivation to use drugs. But this study measured threat reactivity, not intolerance of uncertainty, and an association does not establish that intolerance is a key driver of problematic drinking. Page numbers are not provided in our copy. (LLM, conf=0.87)
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Radoman, M., Phan, K. L., Ajilore, O., & Gorka, S. M. (2024) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2024.07.023 · Cited by 1 · see citing works
Self-citationWahesh, E., & Ondrejack, L. (2024) · Journal of Addictions & Offender Counseling · doi:10.1002/jaoc.12145 · Cited by 1 · see citing works
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Self-citation
- Authors
- Gorka, S. M., Lieberman, L., Phan, K. L., & Shankman, S. A.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Gorka, Stephanie M.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 164
- Pages
- 89-96
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC4893928
- OpenAlex
- W2345349049
- Cited by
- 47
- References
- 67
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 2 · 2022: 6 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 10 · 2016: 2
- FWCI
- 6.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH101497, R01MH098093)
- National Institute on Alcohol Abuse and Alcoholism (F31AA22273)
- University of Illinois at Chicago (UL1RR029879)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- alcohol abuse, threat reactivity, startle potentiation, negative reinforcement, binge drinking, hazardous drinking, individual differences, alcohol use disorder prevention
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Alcoholic Intoxication, Alcoholism, Mental Disorders, Electroshock, Fear, Female, Humans, Male, Reflex, Startle, Statistics as Topic, Temperance, Comorbidity, Uncertainty, Young Adult, Binge Drinking
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