Gorka S M, Hee D, Lieberman L, Mittal V A, Phan K L, Shankman S A
Department of Psychiatry,University of Illinois at Chicago,Chicago, IL,USA.
Department of Psychology,University of Illinois at Chicago,Chicago, IL,USA.
Psychol Med. 2016 Dec;46(16):3349-3358. doi: 10.1017/S0033291716002415. Epub 2016 Sep 14.
When sober, problematic drinkers display exaggerated reactivity to threats that are uncertain (U-threat). Since this aversive affective state can be alleviated via acute alcohol intoxication, it has been posited that individuals who exhibit heightened reactivity to U-threat at baseline are motivated to use alcohol as a means of avoidance-based coping, setting the stage for excessive drinking. To date, however, no study has attempted to characterize the dispositional nature of exaggerated reactivity to U-threat and test whether it is a vulnerability factor or exclusively a disease marker of problematic alcohol use.
The current investigation utilized a family study design to address these gaps by examining whether (1) reactivity to U-threat is associated with risk for problematic alcohol use, defined by family history of alcohol use disorder (AUD) and (2) reactivity to U-threat is correlated amongst adult biological siblings. A total of 157 families, and 458 individuals, participated in the study and two biological siblings completed a threat-of-shock task designed to probe reactivity to U-threat and predictable threat (P-threat). Startle potentiation was collected as an index of aversive responding.
Within biological siblings, startle potentiation to U-threat [intraclass correlation (ICC) = 0.35] and P-threat (ICC = 0.63) was significantly correlated. In addition, independent of an individuals' own AUD status, startle potentiation to U-threat, but not P-threat, was positively associated with risk for AUD (i.e. AUD family history).
This suggests that heightened reactivity to U-threat may be a familial vulnerability factor for problematic drinking and a novel prevention target for AUD.
清醒时，有问题的饮酒者对不确定威胁（U威胁）表现出过度反应。由于这种厌恶情绪状态可通过急性酒精中毒得到缓解，因此有人认为，在基线时对U威胁表现出高反应性的个体有动机将饮酒作为一种基于回避的应对方式，从而为过度饮酒埋下伏笔。然而，迄今为止，尚无研究试图描述对U威胁的过度反应的特质本质，也未测试它是一个易感性因素还是仅仅是酒精使用问题的疾病标志物。
当前的调查采用家族研究设计来填补这些空白，通过检查（1）对U威胁的反应性是否与酒精使用问题的风险相关，酒精使用问题由酒精使用障碍（AUD）家族史定义，以及（2）对U威胁的反应性在成年亲生兄弟姐妹之间是否相关。共有157个家庭和458名个体参与了该研究，两名亲生兄弟姐妹完成了一项电击威胁任务，旨在探究对U威胁和可预测威胁（P威胁）的反应性。收集惊吓增强作为厌恶反应的指标。
在亲生兄弟姐妹中，对U威胁的惊吓增强[组内相关系数（ICC）=0.35]和对P威胁的惊吓增强（ICC = 0.63）显著相关。此外，独立于个体自身的AUD状态，对U威胁而非P威胁的惊吓增强与AUD风险（即AUD家族史）呈正相关。
这表明对U威胁的反应性增强可能是饮酒问题的家族易感性因素，也是AUD的一个新的预防靶点。
