Gender differences in stress reactivity among cocaine-dependent individuals

Abstract

The current findings are among the first to report on gender differences in stress reactivity among cocaine-dependent individuals. The findings suggest that the mechanisms linking stress and substance use may be gender-specific, and that stress reactivity may play a different role for women than for men. Future research and implications for clinical interventions are discussed.

Enhanced Sensitivity to Stress and Drug/Alcohol Craving in Abstinent Cocaine-Dependent Individuals Compared to Social Drinkers

“…Higher stress-induced anxiety and sadness in all females are consistent with previous work suggesting greater susceptibility to sadness and anxiety in women (Brody, 1999;Eisenberg et al, 1991) and greater anxiety in cocainedependent females (Back et al, 2005). Our findings that men were more reactive to the cue condition than females are consistent with some previous research.…”

“…It may therefore be the case that increased heart rate and blood pressure represent a non-specific physiological marker of stress-and cue-induced craving state that may be elevated during cocaine abstinence. Although no association was seen between these physiological measures and subjective craving-related states, the disparity between subjective and physiological data is not uncommon and has often been discussed in stress studies (Cohen et al, 1995;Back et al, 2005). We have previously suggested that stress-and cuerelated subjective and physiological responses represent semiindependent systems impacting different aspects of adaptation to stressful situations (see Sinha et al, 2003 for review).…”

“…Stress and cue-related increases in heart rate and blood pressure have been observed alongside increases in cocaine craving within recently abstinent cocaine abusers in several studies (Back et al, 2005;Sinha et al, 2001Sinha et al, , 2003Fox et al, 2005Fox et al, , 2006. b-Adrenergic blockade by drugs such as propranolol have also been shown to reduce the symptoms of autonomic arousal associated with early cocaine abstinence and improve treatment outcome (Kampman et al, 2001b(Kampman et al, , 2006.…”

“…Furthermore, recent findings have highlighted that some of the physiological and biochemical mechanisms associated with stress-and cue-induced craving may be gender sensitive. Sex differences have been reported in HPA drive, physiological response, and subjective reactivity to stress and drug cue in recently abstinent cocaine patients (Fox et al, 2006;Back et al, 2005). We therefore hypothesize that cocaine patients will demonstrate an enhanced drug/alcohol craving and emotional and physiological response to stressand cue-related imagery compared with social drinkers and that gender plays an important role in these effects.…”

Altered levels of sex and stress steroid hormones assessed daily over a 28-day cycle in early abstinent cocaine-dependent females

“…Disparity between subjective and biological data, particularly across numerous time points, is a common issue and consistent with previous findings (Back et al 2005;Cohen et al 1995) and may reflect the existence of semi-independent behavioral and neurovegetative stress systems which impact different aspects of adaptation to distressing situations (Fox et al 2006a;Sinha et al 2003).…”