A prospective study of stress and alcohol craving in heavy drinkers

Recent work has examined the relationship between stress and relapse to alcohol use in clinical populations. Few prospective studies, however, have examined stress as a precipitant of alcohol problems. The present study is a longitudinal examination of the role of stress reactivity and alcohol craving in the etiology of alcohol problems in a sample of 41 (mean age = 20.8), heavy-drinking, young adults. Participants completed a guided imagery exposure to stressful life events, followed by exposure to a neutral imagery control. Following the exposure, participants completed an alcohol cue exposure paradigm. Measures of negative mood (Profile of Mood States (POMS) depression/dejection scale), tension (POMS tension/anxiety scale) and alcohol craving (measured by the Alcohol Urge Questionnaire (AUQ)) were used as indicators of reactivity to stress and to alcohol cues. Polymorphisms of the corticotropin-releasing hormone binding protein (CRH-BP) gene and of the μ-opioid receptor (OPRM1) gene were examined as moderators of this relationship. Results revealed that stress-induced negative mood predicted negative consequences of drinking (scores on the Drinker's Inventory of Consequences (DrInC-2R)), whereas stress and cue-induced alcohol craving did not predict alcohol use or problems. Additionally, the CRH-BP genotype was found to moderate the relationship between stress-induced negative affect and the negative consequences of drinking. The current study supports and extends laboratory research describing phenotypes of stress-induced alcohol craving.

► This study tested whether stress reactivity predicts the course of alcohol use and consequences. ► Stress-induced negative mood predicted an increase in consequences of drinking at follow up. ► CRH-BP moderated the relationship between stress-reactivity and consequences of drinking.