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How Does Stress Lead to Risk of Alcohol Relapse?

It has long been known that stress increases the risk of alcohol relapse (Sinha 2001). Clinical observations, surveys, and epidemiological studies document an association between self-reports of stressors and subsequent return to drinking. Studies assessing alcohol relapse after treatment completion and discharge also indicate the contribution of highly stressful events independent of alcohol use...

Neuroplasticity and Predictors of Alcohol Recovery

Recovery from alcoholism is a complex and long-term process with high relapse rates. Therefore, understanding why people relapse has been critically important to improving treatment outcomes. To that end, researchers are looking for clinical and biological markers that predict relapse after treatment and to use those risk factors to develop effective treatments to reduce relapse rates. One...

Ecological Momentary Assessment and Alcohol Use Disorder Treatment

The ability to capture real-time data on human behavior inexpensively, efficiently, and accurately holds promise to transform and broaden our understanding of many areas of health science. One approach to acquiring this type of real-time data is ecological momentary assessment (EMA). This method has been used to collect data in many domains of addiction research, including research on the...

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...

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...

Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments

Understanding the mechanisms that underlie recovery from alcohol use disorder (AUD) is critical to advancing AUD treatment science (Huebner and Tonigan 2007; National Institute on Alcohol Abuse and Alcoholism [NIAAA] 2009). Scientific progress over the last three decades has led to the development of a number of effective behavioral and pharmacological AUD interventions (Dutra et al. 2008)...

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...

The Emergence, Role, and Impact of Recovery Support Services

Across the different developmental stages of the life course, alcohol and other drugs play an influential role in health, functioning, disease, disability, and premature mortality. A number of different approaches have emerged during the past 60 years to address areas impacted by alcohol and drug use, including formal professional treatment services, but also—in recognition of the need for ongoing...

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...

Recovery and Youth: An Integrative Review

Although rates of alcohol and other substance use disorders in adolescents have been estimated for decades, little is known about the prevalence, pathways, and predictors of remission and long-term recovery among adolescents. This article provides an integrative review of the literature on youth recovery. A final selection of 39 relevant articles was grouped into five sections: treatment outcomes...