Errico A L, Parsons O A, King A C, Lovallo W R
Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City 73104.
J Stud Alcohol. 1993 Jul;54(4):393-8. doi: 10.15288/jsa.1993.54.393.
Sober alcoholics show an attenuated hormonal response to pharmacological agents that normally stimulate the hypothalamic-pituitary-adrenocortical (HPAC) axis. To determine if this same result would be found using biobehavioral stressors, 52 detoxified (mean = 32 days) male alcoholics and 30 male nonalcoholic controls were given two moderately aversive tasks (mental arithmetic and cold pressor test). Three samples of blood were drawn during a 2.5-hour prestressor baseline, a fourth immediately following the stressors and a fifth, 20 minutes later. At each of these times, subjects were asked to report their degree of distress. Serum cortisol concentrations did not differ between groups at baseline or immediately following the stressors, but 20 minutes later alcoholics had significantly lower concentrations than controls. The groups did not differ on their degree of self-reported distress in response to the stressors. Thus, while alcoholics appeared to affectively experience stressful events in a manner similar to that of controls, they had an attenuated cortisol response. A possible pathophysiological mechanism for this dysregulation is discussed in addition to the potential existence of a premorbid condition.
戒酒的酗酒者对通常刺激下丘脑 - 垂体 - 肾上腺皮质（HPAC）轴的药物制剂表现出激素反应减弱。为了确定使用生物行为应激源是否会得到相同的结果，对52名已戒酒（平均戒酒32天）的男性酗酒者和30名男性非酗酒对照组进行了两项中等强度的厌恶任务（心算和冷加压试验）。在2.5小时的应激源前基线期采集三份血样，应激源结束后立即采集第四份血样，20分钟后采集第五份血样。在每个时间点，要求受试者报告他们的痛苦程度。在基线期或应激源结束后立即采血时，两组的血清皮质醇浓度没有差异，但20分钟后，酗酒者的皮质醇浓度显著低于对照组。两组在对应激源的自我报告痛苦程度上没有差异。因此，虽然酗酒者在情感上体验应激事件的方式似乎与对照组相似，但他们的皮质醇反应减弱。除了可能存在病前状况外，还讨论了这种调节异常的一种可能的病理生理机制。
