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Alcohol’s Negative Emotional Side: The Role of Stress Neurobiology in Alcohol Use Disorder

Introduction

The word “alcohol” often conjures up positive feelings and associations with fun, socializing, relaxing, and partying. Yet there is another side to drinking alcohol, especially with risky, hazardous levels of consumption. This side is associated with distress and may include anxiety, loneliness, pain, and depressive symptoms.1 This has been labeled the “dark side,” or “negative...

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...

Early Life Stress as a Predictor of Co-Occurring Alcohol Use Disorder and Post-Traumatic Stress Disorder

During the critical developmental periods of childhood when neural plasticity is high, exposure to early life stress (ELS) or trauma may lead to enduring changes in physiological stress systems and enhanced vulnerability for psychopathological conditions such as post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) in adulthood. Clinical and preclinical studies have sought to...

Functional and Psychiatric Correlates of Comorbid Post-Traumatic Stress Disorder and Alcohol Use Disorder

Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are common comorbid conditions that affect large segments of the population. Individuals with comorbid PTSD/AUD face greater clinical and functional stressors than those with diagnoses of either PTSD or AUD alone. The purpose of this article is to review the phenomenology and functional associations of PTSD/AUD and address the...

Alcohol and Stress in the Military

Problematic alcohol use within the United States military has been linked to substantial financial and productivity losses. Data from 2006 revealed that excessive alcohol consumption cost the U.S. military $1.12 billion per year (Harwood et al. 2009). Regarding medical expenditures, studies have found that excessive alcohol use by military members results in an annual cost of $425 million...

Behavioral Treatments for Alcohol Use Disorder and Post-Traumatic Stress Disorder

Alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD) are highly prevalent and debilitating psychiatric conditions that commonly co-occur. Individuals with comorbid AUD and PTSD incur heightened risk for other psychiatric problems (e.g., depression and anxiety), impaired vocational and social functioning, and poor treatment outcomes. This review describes evidence-supported...

The Epidemiology of Post-Traumatic Stress Disorder and Alcohol Use Disorder

For more than 40 years, research has shown that individuals with post-traumatic stress disorder (PTSD) use alcohol and experience alcohol use disorder (AUD) to a greater degree than those with no PTSD. AUD and PTSD have shown a durable comorbidity that has extended through decades and through changes in disorder definitions. Some research shows that veterans who have experienced PTSD have a high...

Treatment Interventions for Women With Alcohol Use Disorder

Women with alcohol use disorder (AUD) experience more barriers to AUD treatment and are less likely to access treatment than men with AUD. A literature review identified several barriers to women seeking help: low perception of a need for treatment; guilt and shame; co-occurring disorders; employment, economic, and health insurance disparities; childcare responsibilities; and fear of child...

Sex and Gender Effects in Recovery from Alcohol Use Disorder

The current article provides a brief summary of biopsychosocial gender differences in alcohol use disorder (AUD), then reviews existing literature on gender differences in treatment access, retention, outcomes, and longer-term recovery. Among psychotherapies for AUD, there is support for the efficacy of providing female-specific treatment, and for female-only treatment settings but only when...