Stephanie E Wemm1, Chloe Larkin1, Gretchen Hermes1, Howard Tennen2, Rajita Sinha3. 1. Yale Stress Center, Yale School of Medicine, 2 Church St South Suite 209, New Haven, CT, 06379, USA. 2. Department of Community Medicine, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06032, USA. 3. Yale Stress Center, Yale School of Medicine, 2 Church St South Suite 209, New Haven, CT, 06379, USA. Electronic address: Rajita.Sinha@yale.edu.
Abstract
BACKGROUND: Stress has been known to increase craving in individuals with Alcohol Use Disorders (AUD) and predict future alcohol relapse risk, but whether stress on a particular day affects craving on that day to impact prospective alcohol intake in the real world, particularly during early treatment and recovery, has not been studied thus far. METHOD: The first study included 85 AUD individuals who reported their daily stress, craving, and alcohol intake in the first two weeks of early treatment. A second validation study included 28 AUD patients monitored daily during eight weeks of outpatient 12-Step based behavioral counseling treatment for AUD. Data were collected from telephone-based daily diaries for 903 days in Study 1 and 1488 in Study 2. Multilevel latent models tested if daily and person-averaged craving mediated the link between stressful events and next day drinking during treatment. RESULTS: In both Study 1 and 2, exposure to a stressful event on a particular day predicted increased craving on that day (p's≤.002); and such increases in craving predicted the likelihood of drinking the next day (p's≤.014) and the drinking amount (p's< = 008). Individuals who experienced more stressful events reported higher craving (p's≤.012), and higher cravers reported greater next day drinking (p's<.001). CONCLUSIONS: The results across two studies with separate samples are the first to establish that craving directly mediates the association between stress and next day alcohol intake in individuals with AUD. Findings suggest a need for novel treatment approaches to address stress-induced craving to improve alcohol use outcomes.
BACKGROUND:Stress has been known to increase craving in individuals with Alcohol Use Disorders (AUD) and predict future alcohol relapse risk, but whether stress on a particular day affects craving on that day to impact prospective alcohol intake in the real world, particularly during early treatment and recovery, has not been studied thus far. METHOD: The first study included 85 AUD individuals who reported their daily stress, craving, and alcohol intake in the first two weeks of early treatment. A second validation study included 28 AUD patients monitored daily during eight weeks of outpatient 12-Step based behavioral counseling treatment for AUD. Data were collected from telephone-based daily diaries for 903 days in Study 1 and 1488 in Study 2. Multilevel latent models tested if daily and person-averaged craving mediated the link between stressful events and next day drinking during treatment. RESULTS: In both Study 1 and 2, exposure to a stressful event on a particular day predicted increased craving on that day (p's≤.002); and such increases in craving predicted the likelihood of drinking the next day (p's≤.014) and the drinking amount (p's< = 008). Individuals who experienced more stressful events reported higher craving (p's≤.012), and higher cravers reported greater next day drinking (p's<.001). CONCLUSIONS: The results across two studies with separate samples are the first to establish that craving directly mediates the association between stress and next day alcohol intake in individuals with AUD. Findings suggest a need for novel treatment approaches to address stress-induced craving to improve alcohol use outcomes.
Authors: William J Kowalczyk; Karran A Phillips; Michelle L Jobes; Ashley P Kennedy; Udi E Ghitza; Daniel A Agage; John P Schmittner; David H Epstein; Kenzie L Preston Journal: Am J Psychiatry Date: 2015-03-17 Impact factor: 18.112
Authors: Sherry A McKee; Rajita Sinha; Andrea H Weinberger; Mehmet Sofuoglu; Emily L R Harrison; Meaghan Lavery; Jesse Wanzer Journal: J Psychopharmacol Date: 2010-09-03 Impact factor: 4.153
Authors: Tara M Chaplin; Kwangik Hong; Helen C Fox; Kristen M Siedlarz; Keri Bergquist; Rajita Sinha Journal: Hum Psychopharmacol Date: 2010-07 Impact factor: 1.672
Authors: Kenzie L Preston; William J Kowalczyk; Karran A Phillips; Michelle L Jobes; Massoud Vahabzadeh; Jia-Ling Lin; Mustapha Mezghanni; David H Epstein Journal: Psychopharmacology (Berl) Date: 2018-07-07 Impact factor: 4.530
Authors: Kenzie L Preston; William J Kowalczyk; Karran A Phillips; Michelle L Jobes; Massoud Vahabzadeh; Jia-Ling Lin; Mustapha Mezghanni; David H Epstein Journal: Neuropsychopharmacology Date: 2017-11-06 Impact factor: 7.853
Authors: Verica Milivojevic; Gustavo A Angarita; Gretchen Hermes; Rajita Sinha; Helen C Fox Journal: Alcohol Clin Exp Res Date: 2020-06-12 Impact factor: 3.455
Authors: Vanessa A Jimenez; Nicole A R Walter; Tatiana A Shnitko; Natali Newman; Kaya Diem; Lauren Vanderhooft; Hazel Hunt; Kathleen A Grant Journal: J Pharmacol Exp Ther Date: 2020-09-01 Impact factor: 4.030
Authors: Mary Beth Miller; Lindsey Freeman; Chan Jeong Park; Nicole A Hall; Chelsea Deroche; Pradeep K Sahota; Christina S McCrae Journal: Alcohol Clin Exp Res Date: 2021-04-05 Impact factor: 3.455
Authors: Rajita Sinha; Stephanie Wemm; Nia Fogelman; Verica Milivojevic; Peter M Morgan; Gustavo A Angarita; Gretchen Hermes; Helen C Fox Journal: Am J Psychiatry Date: 2020-11-19 Impact factor: 18.112