Association between problematic alcohol use and reactivity to uncertain threat in two independent samples

Abstract

Background Recent laboratory studies have shown that acute alcohol intoxication selectively and effectively dampens aversive responding to an uncertain threat. An emerging hypothesis is that individuals who exhibit heightened reactivity to an 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 an 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 an 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 30 days 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 an 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 an 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.

Preliminary evidence that reactivity to uncertain threat is an endophenotype for alcohol use disorder

“…Details of the laboratory procedures have been published previously (Gorka et al, 2016a,b) and are briefly noted here. Participants first completed a 2-min startle habituation task during which 6 acoustic probes were administered.…”

“…Participants completed the threat task modeled after the No-Predictable-Unpredictable (NPU) task developed by Grillon and colleagues (Schmitz and Grillon, 2012), extensively used in our lab (Gorka et al, 2013, 2016a,b; Shankman et al, 2013). The task includes three within-subject conditions - no shock (N), predictable shock (P), and unpredictable shock (U).…”

“…Startle data collection and processing has been published previously (Gorka et al, 2016a,b) and is briefly noted here. Data acquisition used BioSemi Active Two system (BioSemi, Amsterdam, The Netherlands) and PSYLAB (Contact Precision Instruments, London, UK).…”

“…However, a few recent studies indicate that individuals who engage in problematic alcohol use also display heightened reactivity to U-threat. In two independent samples, our lab found that greater levels of current problematic alcohol use (e.g., binge drinking) were associated with greater aversive reactivity to U-threat, measured via startle eyeblink potentiation (Gorka et al, 2016a). Recently, Moberg et al (2017) replicated and extended the findings in Gorka et al (2016a) by demonstrating that individuals with current alcohol dependence displayed greater startle potentiation to U-threat, but not P-threat, compared with controls.…”

“…In two independent samples, our lab found that greater levels of current problematic alcohol use (e.g., binge drinking) were associated with greater aversive reactivity to U-threat, measured via startle eyeblink potentiation (Gorka et al, 2016a). Recently, Moberg et al (2017) replicated and extended the findings in Gorka et al (2016a) by demonstrating that individuals with current alcohol dependence displayed greater startle potentiation to U-threat, but not P-threat, compared with controls. In a separate sample of panic disorder patients, it was similarly shown that individuals with remitted alcohol dependence displayed greater startle potentiation to U-threat, but not P-threat, compared with individuals with no lifetime diagnosis of alcohol use disorder (AUD; Gorka et al, 2013).…”