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Resilience to Meet the Challenge of Addiction: Psychobiology and Clinical Considerations

Evidence from different disciplines suggests that acute and chronic stress–related mechanisms play an important role in both the development and the chronic, relapsing nature of addiction (Baumeister 2003; Baumeister et al. 1994; Brady and Sinha 2005). Stress is defined as the physiological and psychological process resulting from a challenge to homeostasis by any real or perceived demand on the...

Stress and the HPA Axis: Role of Glucocorticoids in Alcohol Dependence

Stress, generally defined as any stimulus that disrupts the body’s internal balance (i.e., physiological homeostasis), has long been suggested to be an important correlate of uncontrolled alcohol consumption or relapse to drinking following a period of abstinence. Large epidemiological studies have reported that a variety of stressors are associated with increased alcohol consumption and binge...

Anxiety and Alcohol Use Disorders: Comorbidity and Treatment Considerations

Co-occurring anxiety disorders and alcohol use disorders (AUDs) are of great interest to researchers and clinicians. Cumulative evidence from epidemiological and clinical studies over the past few decades has highlighted both the frequency and clinical impact of this comorbidity. Investigations into the unique connections between specific anxiety disorders and AUDs have shown that this association...

Stress, Epigenetics, and Alcoholism

Alcoholism is a complex disorder characterized by compulsive alcohol seeking and consumption that also is impacted by related psychiatric states, such as anxiety (Koob 2003; Pandey 2003). Both environmental and genetic factors influence alcohol drinking patterns and may increase susceptibility to the development of alcohol addiction (Cloninger 1987; Crabbe 2002). The presence or development of...

Childhood Trauma, Posttraumatic Stress Disorder, and Alcohol Dependence

Children exposed to severe adversity early in life are at increased risk of subsequently developing mental health problems, including alcohol dependence. In general, the onset of trauma precedes the onset of alcohol dependence. Although it is impossible to establish a direct causal relationship, this temporal relationship suggests a robust and positive relationship between exposure to early-life...

Overview: Stress and Alcohol Use Disorders Revisited

In the 13 years since Alcohol Research & Health (now titled Alcohol Research: Current Reviews) first visited the topic of “Alcohol and Stress” (see Vol. 23, No. 4, 1999), there has been a sustained flow of new information in the field prompting us to publish this updated edition. Indeed, one could argue that this second look at the topic is long overdue. An entirely new lexicon of terms1 has been...

Treatment of Alcohol Dependence With Drug Antagonists of the Stress Response

Although alcohol dependence affects 4 percent of the adult population and is the third leading cause of preventable death in the United States (Substance Abuse and Mental Health Services Administration 2009), fewer than 15 percent of people with alcoholism receive treatment (Hasin et al. 2007). The Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition Text Revision (DSM–IV–TR) ...

Neural Pathways of Stress Integration: Relevance to Alcohol Abuse

Adaptation in the face of physical or psychological adversity is required for the survival, health, and well-being of all organisms. Adverse events, often denoted as “stressors,” initiate a diverse physiological response from multiple sources, including activation of the hypothalamic–pituitary–adrenal (HPA) axis.1 The HPA axis is responsible for the glucocorticoid component of the stress response...

Clinical Laboratory Stressors Used to Study Alcohol–Stress Relationships

A comprehensive understanding of the relationship between stress and alcohol use is important for understanding the risks of developing alcohol problems and subsequent relapse. Although the relationship is complex, substantial evidence supports that exposure to chronic stress early in life (e.g., Sher et al. 1997), adult trauma (Kessler et al. 1995), and the presence of anxiety disorders (Grant et...

Effects of Alcohol Dependence and Withdrawal on Stress Responsiveness and Alcohol Consumption

Although stress is known to be an important contributing factor to alcohol abuse and alcoholism, the interaction between stress and alcohol drinking behavior, as well as the mechanisms underlying this interaction in the context of dependence are complex and not well understood. On the one hand, alcohol is an effective anxiety-reducing agent (i.e., anxiolytic). Hence, motivation for drinking may be...