Zimmermann Ulrich, Spring Konstanze, Wittchen Hans-Ulrich, Holsboer Florian
Max-Planck-Institute of Psychiatry, Munich, Germany.
Alcohol Clin Exp Res. 2004 Mar;28(3):424-32. doi: 10.1097/01.alc.0000117835.49673.cf.
The high rate of comorbidity between alcoholism and anxiety disorders suggests some causal link. This study used the startle reflex to investigate whether increased reactivity to stimuli inducing fear or related affective states might be one mechanism by which a family genetic risk promotes the development of alcohol use disorders.
Thirty-one sons of alcoholics (PH+) were recruited from the participants of a longitudinal epidemiologic survey representative of the Munich area population between 18 and 25 years. Thirty male low-risk participants without parental alcoholism (PH-) were matched for age and history of psychiatric disorders. The baseline acoustic startle reflex was elicited before and after subjects drank 0.6 g/kg ethanol or placebo in a randomized, double-blind, placebo-controlled crossover design. Thereafter, the startle response was investigated while the subjects' affective state was manipulated by announcement of aversive electric finger stimuli to induce fear potentiation and by presentation of photographic slides previously rated to be pleasant, unpleasant, or neutral in their emotional valence.
Plain startle response was lower in PH+ than PH- participants and was equally dampened by alcohol in PH+ and PH- subjects. Threat of finger shocks increased the startle response to the same extent in both groups. This fear potentiation effect was significantly attenuated by alcohol given on the second experimental day but not if alcohol was administered first and placebo on the second day. Pleasant and unpleasant slides decreased and increased startle response, respectively, and this effect was influenced by neither risk group nor alcohol.
The acoustic startle reflex seems to be reduced in sons of alcoholics. The nonsignificant results during startle modification do not support the concept of increased reactivity to anxiety-related environmental stimuli as a mechanism promoting alcohol use disorders in subjects at increased family genetic risk for alcoholism.
酒精中毒与焦虑症之间的高共病率表明存在某种因果联系。本研究利用惊吓反射来探究对诱发恐惧或相关情感状态的刺激反应性增加是否可能是家族遗传风险促进酒精使用障碍发展的一种机制。
从慕尼黑地区18至25岁具有代表性的纵向流行病学调查参与者中招募了31名酗酒者的儿子(PH +)。30名无父母酗酒史的男性低风险参与者(PH -)在年龄和精神疾病史方面进行了匹配。在受试者饮用0.6 g/kg乙醇或安慰剂之前和之后,采用随机、双盲、安慰剂对照交叉设计诱发基线听觉惊吓反射。此后,通过宣布厌恶的电击手指刺激以诱发恐惧增强,并呈现先前评定为具有愉悦、不愉快或中性情绪效价的照片幻灯片来操纵受试者的情感状态,同时研究惊吓反应。
PH +参与者的单纯惊吓反应低于PH -参与者,并且PH +和PH -受试者的酒精对惊吓反应的抑制作用相同。两组中,手指电击威胁均使惊吓反应增加相同程度。在第二个实验日给予酒精时,这种恐惧增强效应显著减弱,但如果第一天给予酒精而第二天给予安慰剂,则该效应并未减弱。愉悦和不愉快的幻灯片分别降低和增加了惊吓反应,并且这种效应既不受风险组的影响,也不受酒精的影响。
酗酒者的儿子的听觉惊吓反射似乎有所降低。惊吓调节过程中的无显著结果不支持以下概念,即对与焦虑相关的环境刺激反应性增加是家族遗传风险增加的酒精使用障碍受试者中促进酒精使用障碍的一种机制。