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Enhanced Negative Emotion and Alcohol Craving

04 Aug
Researchers from the Department of Psychiatry at Yale University’s School of Medicine investigated whether people who chronically abuse alcohol are extra-vulnerable to changes in stress levels altering their alcohol cravings. Twenty-eight treatment-engaged, 28-day abstinent, alcohol-dependent (AD) individuals - 6 females, 22 males - and another twenty-eight social drinkers (SD) - 10 females, 18 males - were exposed to three different brief, stress-evoking, guided imagery exercises: (1) a personalized stressful imagery, (2) an alcohol-related stressful imagery and (3)a neutral-relaxing imagery - one condition per session, presented in random order across 3 days.
Alcohol craving, anxiety and emotion ratings, behavioral distress responses, heart rate, blood pressure, and salivary cortisol measures were taken, pre- and post.

Alcohol-dependent patients showed significantly elevated basal heart rate and salivary cortisol levels. Personal stress and alcohol cue exposure each produced a significantly enhanced and persistent craving state in alcohol patients that was marked by increased anxiety, negative emotion, systolic blood pressure responses, and, in the case of the alcohol cue, behavioral distress responses, as compared to the social drinkers. Blunted stress-induced cortisol responses were observed in the AD group, as compared to the SD group.

These data are the first to document that stress and cue exposure induce a persistent negative emotion-related alcohol craving state in abstinent alcoholics, accompanied by dysregulated HPA and physiological arousal responses.

As laboratory models of stress and negative mood-induced alcohol craving are predictive of relapse outcomes, one implication of the current data is that treatments targeting decreases in stress and alcohol cue-induced craving and regulation of stress responses could be of benefit in improving alcohol relapse.

Citation:Sinha R, Fox HC, Hong KA, Bergquist K, Bhagwagar Z, Siedlarz KM. Enhanced Negative Emotion and Alcohol Craving, and Altered Physiological Responses Following Stress and Cue Exposure in Alcohol Dependent Individuals. Neuropsychopharmacology. 2008 Jun 18. [Epub ahead of print]
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award