Neuroendocrine, Psychophysiological and Subjective Reactivity to an Alcohol Placebo in Male Alcoholic Patients

Abstract

Alteration in neuroendocrine activity associated with the regulation of energy metabolism and food intake may play a role in characterizing the alcohol dependent state. Alcoholics, when compared to controls, demonstrated significantly larger and more rapid glucose and insulin responses following the consumption of a placebo beer, which they believed contained alcohol. The existence of significant correlations between peak neuroendocrine responses and desire to drink, anxiety, as well as psychophysiological responses in alcoholics suggests the potential multivariate nature of the biological/behavioral state associated with alcohol dependence.

Conditioned learning in alcohol dependence: implications for cue exposure treatment

“…Such observed responses are also inconsistent with a model of CAntRs to ARCs (described above) since alcohol has been consistently shown to have the unconditioned effects of tachycaria (Docter & Perkins, 1960;Docter et al, 1966;Holmberg & Martens, 1955;Mendelson & LaDou, 1984) and increased skin conductance (Carpenter, 1957;Greenberg & Carpenter;Levenson et al, 1980). Two studies have found a peripheral hypothermic response to CE (Laberg, 1986;Dolinsky, 1987) and two have found no measurable change (Kaplan et al, 1983;Corty et al, 1988), although the latter study found that temperature was affected by the order of presentation of neutral and alcoholic stimuli in alcoholics. Again this would appear antithetic to a CAntR model where conditioned hyperthermia is predicted (Crowell et al, 1981;Le et al, 1979;Mansfield & Cunningham, 1980).…”

“…Other responses to ARCs which have been reported include raised serum insulin and glucose and decreased cortisol (Dolinsky et al, 1987) the significance of which is at present unclear. One early study found pupillary dilation in response to the smell of a favourite alcoholic drink in alcoholics (Kennedy, 1971).…”

“…Increased subjective desire for alcohol, skin conductance level and heart rate have been observed to differentiate alcoholics from controls following CE (Kaplan et al, 1983;Kaplan et al, 1985;Laberg, 1986). A greater number of studies have found no differences on these measures (Pomerleau et al, 1983;Dolinsky et al, 1987;Monti et al, 1987;Corty et al, 1988).…”

“…In effect, aversive CRs to ARCs act as discriminative stimuli (SDs) for operant drinking behaviour. While it should be noted that Wikler later acknowledged that these CRs may be, in some cases, drug-like and that drug taking may also be motivated by the pursuit of positive hedonic effects of the drug, this early theory remains popular with contemporary researchers in the cue exposure field (Pomerleau, 1981;Melchior & Tabakoff, 1984;McLellan et al, 1986;Laberg & EUertsen, 1987;Dolinsky et al, 1987;Bradley & Moorey, 1988).…”

The Importance of Glucocorticoids in AlcoholDependence and Neurotoxicity

“…As acute alcohol consumption triggers cortisol release, it is possible that conditioning results in an appetitive response to cues which also includes cortisol release and which may be involved in motivation to drink. However, depressed cortisol plasma levels at baseline, throughout alcohol cue exposure, and during consumption of alcohol have also been observed in inpatient alcoholics relative to controls (Dolinsky et al., 1987). The mixed findings from research investigating the relationship between cortisol function and alcohol cues, suggests a dysfunctional HPA system rather than specific cortisol hyporesponsivity.…”