Markus Muehlhan1,2, Anja Höcker3, Michael Höfler4, Klaus Wiedemann3, Sven Barnow5, Ingo Schäfer3,6. 1. Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany. markus.muehlhan@tu-dresden.de. 2. Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany. markus.muehlhan@tu-dresden.de. 3. Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany. 4. Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany. 5. Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany. 6. Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany.
Abstract
RATIONALE: Alcohol-dependent (AD) patients with a history of childhood maltreatment (CM) have shown a more severe clinical profile and a higher risk of relapse than those without CM. It was hypothesized that stress responsivity plays an important role in moderating the relationship between CM and AD. Surprisingly, systematic investigations about the stress responsivity in AD patients with CM are rare. OBJECTIVE: This study compared physiological and subjective stress responses in AD patients with and without CM as well as in healthy controls with and without CM. METHODS: A total of 130 participants performed the Trier Social Stress Test (TSST). Physiological stress reactivity related to the noradrenergic system was assessed by salivary alpha-amylase (sAA) activity. Subjective ratings of anxiety, nervousness, distress, and mood were rated on visual analogue scales. RESULTS: AD patients showed significantly lower stress-related sAA activity than healthy controls (p ≤ 0.024; z ≥ 1.97). A different pattern was found in the subjective ratings. In particular, anticipatory anxiety revealed a clear effect of CM (p ≤ 0.005; z ≥ 2.43) but no difference between AD patients and healthy controls (p > 0.05). After the TSST, distress ratings differed between AD patients with CM and AD patients without CM (p ≤ 0.009; z ≥ 2.61). CONCLUSION: The discrepancy between physiological responsivity and subjective stress experiences may account for an increased inability to cope with stressful situations, which in turn might explain the enhanced risk of relapse in AD patients with a history of CM during early abstinence.
RATIONALE: Alcohol-dependent (AD) patients with a history of childhood maltreatment (CM) have shown a more severe clinical profile and a higher risk of relapse than those without CM. It was hypothesized that stress responsivity plays an important role in moderating the relationship between CM and AD. Surprisingly, systematic investigations about the stress responsivity in ADpatients with CM are rare. OBJECTIVE: This study compared physiological and subjective stress responses in ADpatients with and without CM as well as in healthy controls with and without CM. METHODS: A total of 130 participants performed the Trier Social Stress Test (TSST). Physiological stress reactivity related to the noradrenergic system was assessed by salivary alpha-amylase (sAA) activity. Subjective ratings of anxiety, nervousness, distress, and mood were rated on visual analogue scales. RESULTS:ADpatients showed significantly lower stress-related sAA activity than healthy controls (p ≤ 0.024; z ≥ 1.97). A different pattern was found in the subjective ratings. In particular, anticipatory anxiety revealed a clear effect of CM (p ≤ 0.005; z ≥ 2.43) but no difference between ADpatients and healthy controls (p > 0.05). After the TSST, distress ratings differed between ADpatients with CM and ADpatients without CM (p ≤ 0.009; z ≥ 2.61). CONCLUSION: The discrepancy between physiological responsivity and subjective stress experiences may account for an increased inability to cope with stressful situations, which in turn might explain the enhanced risk of relapse in ADpatients with a history of CM during early abstinence.
Authors: Daniel S Quintana; Iain S McGregor; Adam J Guastella; Gin S Malhi; Andrew H Kemp Journal: Alcohol Clin Exp Res Date: 2012-07-26 Impact factor: 3.455
Authors: Ingo Schäfer; Silke Pawils; Martin Driessen; Martin Härter; Thomas Hillemacher; Michael Klein; Markus Muehlhan; Ulrike Ravens-Sieberer; Martin Schäfer; Norbert Scherbaum; Barbara Schneider; Rainer Thomasius; Klaus Wiedemann; Karl Wegscheider; Sven Barnow Journal: Eur J Psychotraumatol Date: 2017-03-31