Stress‐Induced and Alcohol Cue‐Induced Craving in Recently Abstinent Alcohol‐Dependent Individuals
Abstract
Background: Research has shown that exposure to stress/negative affect and to alcohol cues can each increase alcohol craving and relapse susceptibility in alcohol‐dependent individuals. However, whether the emotional and physiological states associated with stress‐induced and alcohol cue‐induced craving are comparable has not been well studied. Therefore, this study examined the craving, emotional, and physiological responses to stress and to alcohol cues in treatment‐engaged, 4‐week abstinent, alcohol‐dependent individuals using analogous stress and alcohol cue imagery methods. Method: Twenty treatment‐seeking, alcohol‐dependent participants (18 males/2 females) were exposed to a brief 5‐minute guided imagery procedure that involved imagining a recent personal stressful situation, a personal alcohol cue‐related situation, and a neutral‐relaxing situation, 1 imagery per session presented in random order. Alcohol craving, anxiety and emotion rating scales, cardiovascular measures, and salivary cortisol were compared across the 3 conditions. Results: Exposure to stress and to alcohol cues each produced significant increases in alcohol craving, anxiety, and negative emotions and decreases in positive emotions. Stress‐induced alcohol craving was significantly correlated with increases in sadness, anger, and anxiety ratings, but alcohol cue‐induced craving was associated with decreases in positive affect (joy and neutral relaxed state) and increases in anxiety and fear ratings. Furthermore, stress increased systolic and diastolic blood pressure responses, but significant increases in salivary cortisol were only observed in the alcohol cue condition. Conclusions: Although both stress and alcohol cues produce increases in anxiety associated with alcohol craving, each produced a dissociable psychobiological state involving subjective emotional, cardiovascular, and cortisol responses. These data could have significant implications for understanding the specific psychobiology associated with stress or alcohol cue exposure and their potential effects on alcohol relapse susceptibility.
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Responses to stress cues were on the whole comparable to those induced by alcohol-associated cues.
“These responses to stress cues were on the whole comparable to those induced by alcohol-associated cues (Fox et al., 2007; Sinha et al., 2009; Sinha & Li, 2007)”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Fox et al., 2007
Stress cues significantly increased both alcohol craving and reported anxiety levels in abstinent alcohol-dependent individuals.
“Specifically, stress cues significantly increased both alcohol craving and reported anxiety levels in abstinent alcohol-dependent individuals (Fox et al., 2007)”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Fox et al., 2007
Stress cues similarly elicit craving by inducing anxiety.
“Furthermore, there is evidence that stress cues similarly elicit craving by inducing anxiety (Coffey, Stasiewicz, Hughes, & Brimo, 2006; Fox, Bergquist, Hong, & Sinha, 2007; Sinha & Li, 2007; Sinha et al., 2009; 2003).”
From Cued for Risk: Evidence for an Incentive Sensitization Framework to Explain the Interplay between Stress and Anxiety, Substance Abuse, and Reward Uncertainty in Disordered Gambling Behavior (2019) · cites this paper as Fox, Bergquist, Hong, & Sinha, 2007
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- Authors
- Fox, H. C., Bergquist, K. L., Hong, K., & Sinha, R.
- Affiliations
- Yale University (US)
- Corresponding author
- Fox, Helen C.
- Venue
- Alcoholism: Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2007-01-23
- Volume
- 31
- Issue
- 3
- Pages
- 395-403
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- OpenAlex
- W2075114927
- Cited by
- 315
- References
- 91
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 7 · 2023: 22 · 2022: 8 · 2021: 19 · 2020: 20 · 2019: 19 · 2018: 26 · 2017: 16 · 2016: 16 · 2015: 21 · 2014: 17 · 2013: 17 · 2012: 19
- FWCI
- 13.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA013892, R01-AA-13892)
- National Institute on Drug Abuse (K02 DA17232, K02DA017232)
- National Center for Research Resources (M01RR000125, M01 RR-00125)
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- alcohol craving, stress, alcohol cues, alcoholism, guided imagery, salivary cortisol, blood pressure, anxiety, negative affect, positive affect, emotional responses
- MeSH terms
- Adult, Alcoholism, Blood Pressure, Cues, Female, Humans, Hydrocortisone, Male, Middle Aged, Saliva, Stress, Psychological, Linear Models, Statistics, Nonparametric
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