Relations Between Cognitive Functioning and Alcohol Use, Craving, and Post-Traumatic Stress: An Examination Among Trauma-Exposed Military Veterans With Alcohol Use Disorder

Heinz, Adrienne J.; Pennington, David; Cohen, Nicole; Schmeling, Brandi; Lasher, Brooke; Schrodek, Emily; Batki, Steven L.

doi:10.7205/milmed-d-15-00228

Cited by 15 publications

(8 citation statements)

References 83 publications

(74 reference statements)

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“…The current study builds on previous work (e.g., Brennan et al, 2005; Witkiewitz, McCallion, et al, 2015) to provide causal evidence that acute pain may be a critical determinant of urge to drink and intention to use alcohol, which are known to be highly correlated with alcohol consumption (Heinz et al, 2016; Ooteman et al, 2006). These findings are consistent with a conceptual model of pain and alcohol use (Zale et al, 2015) as well as the negative reinforcement and self-medication models of substance use (e.g., Khantzian, 1985).…”

Section: Discussionmentioning

confidence: 93%

“…Researchers have included proximal predictors of alcohol consumption, such as craving and demand, as outcome measures in clinical trials, and craving has been the target of many treatment interventions (Murphy et al, 2015; Oslin, Leong, Lynch, & et al, 2015). Although alcohol use is not always preceded by increased urge, intent, or demand (Kavanagh et al, 2013; Shiffman, 1987), these variables often are also highly correlated with alcohol use (Flannery, Poole, Gallop, & Volpicelli, 2003; Heinz et al, 2016; Ooteman, Koeter, Vserheul, Schippers, & van den Brink, 2006). Further, a benefit of examining proximal predictors of alcohol consumption over ad lib alcohol consumption is the ability to explore important alcohol-related relationships independent of factors that may constrain alcohol use, such as cost, availability, and legality.…”

Section: Methodsmentioning

confidence: 99%

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Effects of experimental pain induction on alcohol urge, intention to consume alcohol, and alcohol demand.

Moskal

Maisto

Víta

et al. 2018

Experimental and Clinical Psychopharmacology

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Research suggests one determinant of alcohol consumption may be physical pain, but there is no empirical evidence that pain has a causal effect on drinking. Therefore, the primary aim of this study was to test experimental pain as a determinant of several alcohol consumption proxies: self-reported urge to drink, intention to consume alcohol, and alcohol demand. This study also was designed to test negative affect as a mediator of the effects of pain on alcohol use proxies. We hypothesized that participants randomized to experimental pain induction (vs. no pain) would report greater urge, intention, and alcohol demand, and that these effects would be mediated by increased negative affect. Participants were healthy undergraduates who were moderate-heavy drinkers (N = 61). Experimental pain was induced using a novel capsaicin-heat model intended to approximate key features of clinical pain. Results indicated that participants in the pain condition subsequently endorsed greater urge and intention to drink. Furthermore, these effects were mediated by pain-induced negative affect. We observed no effect of pain on alcohol demand. This is the first study to demonstrate a causal effect of acute pain on urge and intention to drink. Given the close association between alcohol consumption, urge and intention to drink, these findings suggest that pain may influence alcohol consumption, which can have implications for individuals with co-occurring pain and alcohol use disorder (AUD). Specifically, individuals with co-occurring pain and AUD may drink to alleviate pain-related negative affect. Therefore, improving pain-coping skills may enhance pain-management abilities, subsequently reducing coping-motivated drinking. (PsycINFO Database Record

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Effects of experimental pain induction on alcohol urge, intention to consume alcohol, and alcohol demand.

Moskal

Maisto

Víta

et al. 2018

Experimental and Clinical Psychopharmacology

View full text Add to dashboard Cite

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“…Recent estimates suggest that about one-third of people with lifetime PTSD have lifetime alcohol use disorder (AUD; Kessler et al 1995). People with PTSD cite their PTSD symptoms as a reason for their alcohol consumption, and total PTSD symptoms are positively associated with craving and quantity of alcohol consumption (Heinz et al, 2016; Nishith et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Predator odor stress blunts alcohol conditioned aversion

et al. 2019

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Alcohol use disorder is highly co-morbid with traumatic stress disorders in humans, and dually diagnosed individuals cite negative affective symptoms as a primary reason for drinking alcohol. Therefore, it is reasonable to hypothesize that traumatic stress history increases the rewarding properties and/or blunts the aversive properties of alcohol. We used a place conditioning procedure to test the rewarding/aversive properties of alcohol in adult male Wistar rats with or without a traumatic stress (i.e., predator odor exposure) history, and with or without an alcohol drinking history. Because extended amygdala regions have documented roles in stress, reward, and stress-induced changes in reward, we also tested the effect of acute alcohol on CREB phosphorylation (pCREB) and striatal-enriched protein tyrosine phosphatase (STEP) expression in central amygdala (CeA) and bed nucleus of stria terminalis (BNST). Our results show that a moderate alcohol dose (1.0 g/kg) produces conditioned place aversion (CPA) that is blunted by stress history but is not affected by alcohol drinking history, and this effect differed in pair-housed versus single-housed rats. Stress history reduced pCREB expression in BNST of rats with and without an alcohol drinking history. Finally, acute alcohol effects on pCREB and STEP expression in CeA were positively associated with preference for the alcohol-paired chamber. These data suggest that stress history reduces the aversive properties of moderate alcohol doses, and that alcohol aversion is associated with acute alcohol effects on pCREB and STEP expression in the extended amygdala.

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“…Dependent Variables Proximal predictors of alcohol consumption offer the ability to explore important alcoholrelated relationships independent of factors that may constrain alcohol use, such as cost, availability, and legality. Additionally, these variables often are highly correlated with alcohol use (Flannery et al 2003;Heinz et al 2016). Therefore, urge and intent were selected as proxies of alcohol consumption.…”

Section: Methodsmentioning

confidence: 99%

Pain-Induced Alcohol Urge and Intention to Drink: the Role of Dispositional Mindfulness

2019

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Objectives Experimental findings have shown that pain increased alcohol urge and intention to use alcohol, and that this relation was mediated by pain-induced negative affect. We sought to extend this research by examining (a) whether dispositional mindfulness moderates the indirect effect of experimental pain induction on alcohol use proxies via negative affect and (b) whether the five mindfulness facets, tested independently, differentially moderate the mediation model. Methods Secondary data analysis of a repeated measures experimental study was conducted using moderated mediation analyses. Participants included 61 undergraduate students (M age = 18.7, SD = 0.82; 50.8% male) who endorsed risky drinking. Results Results showed that the index of moderated mediation was significant for the mindfulness facets of observing, describing, and non-reactivity. Specifically, pain increased alcohol use proxies via increased negative affect for participants who were either low in non-reactivity or high in the observing or describing mindfulness facets. Conversely, negative affect was less important in the pain-alcohol relation for individuals high in non-reactivity or low in observing or describing mindfulness facets. There were no significant moderating effects of overall mindfulness or the awareness and non-judging facets. Conclusions The differential relations of mindfulness facets found in this study highlight the need to consider the multifaceted nature of mindfulness when exploring the physical pain and alcohol relation. Further research should confirm whether lower levels of non-reactivity and higher levels of observing or describing may be indicators that an individual suffering from painrelated alcohol use will benefit from pain treatment that targets pain-related negative affect.

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Relations Between Cognitive Functioning and Alcohol Use, Craving, and Post-Traumatic Stress: An Examination Among Trauma-Exposed Military Veterans With Alcohol Use Disorder

Cited by 15 publications

References 83 publications

Effects of experimental pain induction on alcohol urge, intention to consume alcohol, and alcohol demand.

Effects of experimental pain induction on alcohol urge, intention to consume alcohol, and alcohol demand.

Predator odor stress blunts alcohol conditioned aversion

Pain-Induced Alcohol Urge and Intention to Drink: the Role of Dispositional Mindfulness

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