Amlung Michael, MacKillop James
Department of Psychological Sciences, University of Missouri, Columbia, Missouri; Department of Psychology, University of Georgia, Athens, Georgia.
Alcohol Clin Exp Res. 2014 Jun;38(6):1780-9. doi: 10.1111/acer.12423. Epub 2014 May 30.
Psychological stress and alcohol cues are common antecedents of both ongoing drinking and relapse. One candidate mechanism of risk from these factors is acute increases in craving, but experimental support for this hypothesis is mixed. Furthermore, the combination of stress and cues has been largely unstudied. The current study employed a behavioral economic approach to investigate the combined roles of psychosocial stress and alcohol cues on motivation for alcohol.
In a sample of 84 adult heavy drinkers, we examined the effects of an acute laboratory stress induction and an alcohol cue exposure on subjective craving and stress, arousal, and behavioral economic decision making. Primary dependent measures included an intertemporal cross-commodity multiple-choice procedure (ICCMCP), incorporating both price and delay elements, an alcohol purchase task (APT), measuring alcohol demand, and a monetary delay discounting task, measuring intertemporal choice.
The stress induction significantly increased stress, craving, and the incentive value of alcohol on the ICCMCP and APT. Stress-related increases in value on the ICCMCP were mediated by increased alcohol demand. Exposure to alcohol cues only significantly affected craving, APT breakpoint, and arousal. Delay discounting was not affected by either stress or cues.
These results reveal unique behavioral economic dimensions of motivation for alcohol following acute stress and an alcohol cue exposure. More broadly, as the first application of this approach to understanding the role of stress in drug motivation, these findings support its utility and potential in future applications.
心理压力和酒精线索是持续饮酒及复发的常见诱因。这些因素导致风险的一种潜在机制是渴望感的急性增加，但这一假设的实验支持并不一致。此外，压力和线索的组合在很大程度上尚未得到研究。当前研究采用行为经济学方法来探究心理社会压力和酒精线索对饮酒动机的综合作用。
在84名成年重度饮酒者的样本中，我们考察了急性实验室压力诱导和酒精线索暴露对主观渴望、压力、唤醒以及行为经济决策的影响。主要的因变量测量包括一个跨商品跨期多项选择程序（ICCMCP），该程序纳入了价格和延迟因素；一个酒精购买任务（APT），用于测量酒精需求；以及一个货币延迟折扣任务，用于测量跨期选择。
压力诱导显著增加了压力、渴望感，以及ICCMCP和APT上酒精的激励价值。ICCMCP上与压力相关的价值增加是由酒精需求增加介导的。暴露于酒精线索仅显著影响渴望感、APT断点和唤醒。延迟折扣不受压力或线索的影响。
这些结果揭示了急性压力和酒精线索暴露后饮酒动机独特的行为经济学维度。更广泛地说，作为这种方法首次应用于理解压力在药物动机中的作用，这些发现支持了其在未来应用中的效用和潜力。
