Department of Neuroscience, Medical University of South Carolina, Charleston, SC 29425, United States.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, United States.
Physiol Behav. 2019 May 1;203:91-99. doi: 10.1016/j.physbeh.2017.09.027. Epub 2017 Sep 30.
Despite considerable evidence of higher rates of alcohol use disorders (AUDs) in men than in women, there is a dearth of research into the underlying causes of this disparity. As the gap in high risk drinking between men and women closes, it is critical to disentangle the biological factors that may place men and women at different risk for the development of AUDs as well as AUD-associated health problems. While sex differences in alcohol drinking have been reported in animal models and in human alcoholics, it increasingly seems that consummatory behavior may be dissociated from propensity toward inflexible and cue-elicited drug seeking and taking that characterize alcohol use disorders. While much of this work was initially performed in males a growing, yet limited, body of literature suggests that there are sex differences in both cue reactivity, and further, the relationship between cue reactivity and the maintenance of addictive behavior, indicating that males may be at greater risk for the development of a subset of addiction-related behaviors independent of alcohol consumption. Here, we will review the current literature on sex effects on the relationship between incentive motivation and addictive behavior and discuss unanswered questions that we expect will inform the development of individualized and sex-specific treatment and prevention strategies for AUDs. We believe that a greater understanding of how sex interacts with in cue reactivity to independently mediate the drug taking and risk for the development of uncontrolled drug or alcohol-seeking and -taking will inform the development of individualized treatment and prevention strategies for addiction.
尽管有大量证据表明男性的酒精使用障碍（AUD）发生率高于女性，但对于这种差异的根本原因的研究却很少。随着男性和女性高危饮酒之间的差距缩小，厘清可能使男性和女性面临不同 AUD 发展风险以及 AUD 相关健康问题的生物学因素至关重要。虽然在动物模型和人类酗酒者中已经报道了性别差异在饮酒方面的情况，但越来越多的证据表明，摄食行为可能与僵化和线索诱发的药物寻求和摄取的倾向脱钩，而这些正是酒精使用障碍的特征。虽然最初的大部分工作都是在男性中进行的，但越来越多的有限文献表明，线索反应和进一步的关系在性别上存在差异，即线索反应与成瘾行为的维持之间的关系，这表明男性可能更容易发展出与酒精消费无关的一组成瘾相关行为。在这里，我们将回顾目前关于性别的文献，探讨激励动机与成瘾行为之间的关系，并讨论我们预计将为 AUD 的个体化和性别特异性治疗和预防策略提供信息的未解决问题。我们相信，更好地了解性别如何与线索反应相互作用，独立调节药物摄入和失控药物或酒精寻求和摄入的风险，将为成瘾的个体化治疗和预防策略的制定提供信息。
