Psychobiology of Stress and Alcohol Craving

Central Institute of Mental Health, Mannheim11 enrolled

Overview

In this feasibility study the investigators are using a setup of stress-related body sensors including established as well as innovative sensor-based measures to identify predictor profiles for alcohol-related behavioral and neural measures in Alcohol Use Disorder (AUD). Long-term aim is the definition of a setup of mobile sensors and their integration in a mobile infrastructure that allows the prediction of stress related alcohol intake in an ambulatory setting.

The long-term aim is the definition of a setup of mobile sensors and their integration in a mobile infrastructure that allows the prediction of stress related alcohol intake in an ambulatory setting. In patients with Alcohol Use Disorder (AUD) stress exposure is known to affect craving, cue-reactivity and relapse risk. Here, the investigators aim to identify stress- and alcohol cue-related physiological markers in a lab experiment to assess interactions between acute psychological stress exposure and alcohol cue-exposure regarding their effects on alcohol craving and related markers (attentional bias to alcohol-cues, implicit association task, neural cue-reactivity). In addition to applying established stress-related markers (cortisol in saliva, heart-rate variability, systolic blood pressure and electrodermal activity), the investigators will integrate innovative measures currently under investigation (e.g. voice stress analysis) to identify whether these additional parameters increase the predictive significance.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Alcohol Use Disorder

Interventions

Trier Social Stress TestBEHAVIORAL

Test to induce high levels of acute social stress, including actors and a faked exam situation

Reading NewspaperBEHAVIORAL

Participants read newspaper

Barlab-ExposureBEHAVIORAL

Participants are exposed to a bar situation with different sorts of alcohol available. They sniff at water and at one alcoholic drink.

Eligibility

Sex: MALEMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Heavy drinking, defined by alcohol consumption of at least 20g alcohol per day (at 5 days per week) * sufficient ability to communicate with the investigators, to answer questions in oral and written form * fully informed consent * written informed consent Exclusion Criteria: * withdrawal of the declaration of consent * positive urin drug screening (cannabis, amphetamine, opiates, benzodiazepines, cocaine) * Lifetime history of DSM-5 bipolar disorder, schizophrenia or schizophrenia spectrum disorder, or substance dependence other than alcohol or nicotine or cannabis dependence. * Current threshold DSM-5 diagnosis of major depressive disorder, or presence of suicidal intention * History of severe head trauma or other severe central nervous system disorder (e.g., dementia, Parkinson's disease, multiple sclerosis) * Current use of medications or drugs known to interact with the CNS within at least four half-lives post last intake

Outcomes

Primary Outcomes

change in heart rate

heart rate acquired with ear clip (continuous time series)

Time frame: at examination day: continuous measurement throughout the whole experiment (except during MRI scanning); duration around 2 hours; starting 1 hour 50 minutes after arrival of the proband

change in heart rate variability

heart rate variability acquired with ear clip (continuous time series)

Time frame: at examination day: continuous measurement throughout the whole experiment (except during MRI scanning); duration around 2 hours; starting 1 hour 50 minutes after arrival of the proband

change in blood pressure (systolic and diastolic)

acquired with pressure sleeve

Time frame: at examination day: 6 time points measured throughout the whole experiment (except during MRI scanning); at 2:20h, 2:50h, 3:20h, 3:50h, 4:50h, 5:05h after arrival of the proband

change in electrodermal activity

time series acquired with body sensor

Time frame: at examination day: continuous measurement throughout the whole experiment (except during MRI scanning); duration around 2 hour; starting 1h 50min after arrival of the proband

neural alcohol-related cue-reactivity

% signal change, measured with fMRI; paradigm Vollstädt-Klein et al. 2010 \[% signal change is not a change over time; it is measured during one experimental session\]

Time frame: at examination day: measured directly after the behavioral tasks at the end of the lab experiment

neural inhibition processing

% signal change, measured with fMRI; stop-signal reaction time task (Fauth-Buhler et al. 2012) \[% signal change is not a change over time; it is measured during one experimental session\]

Time frame: at examination day: measured directly after the behavioral tasks at the end of the lab experiment

neural emotion processing

% signal change, measured with fMRI; faces task (Hariri et al. 2002) \[% signal change is not a change over time; it is measured during one experimental session\]

Time frame: at examination day: measured directly after the behavioral tasks at the end of the lab experiment

resting state activity

resting state connectivity measured with fMRI

Time frame: at examination day: measured directly after the behavioral tasks at the end of the lab experiment

attentional bias to alcohol cues

measured with reaction time differences (in milliseconds) using the dotprobe-task (Vollstädt-Klein et al. 2009) \[reaction time differences is not a change over time; it is measured during one experimental session\]

Time frame: at examination day: measured directly after the stress task / newspaper reading; before "implicit alcohol association" and MRI session

implicit alcohol association

measured with reaction time differences (in milliseconds) using the implicit association task (Wiers et al. 2016) \[reaction time differences is not a change over time; it is measured during one experimental session\]

Time frame: at examination day: measured after the stress task / newspaper reading, directly after the "attentional bias to alcohol cues" ; before MRI session

change in level of cortisol

cortisol measured in saliva as a stress marker

Time frame: at examination day: 6 time points measured throughout the whole experiment (except during MRI scanning); at hours:minutes 2:20, 2:50, 3:20, 3:50, 4:50, 5:05 after arrival of the proband

change in voice stress pattern

audio file of participants' voice for voice stress pattern analysis will be recorded. From this a multivariate measure (i.e. multivariate vector) will be acquired (including frequency, loudness etc.)

Time frame: at examination day: 6 time points measured throughout the whole experiment (except during MRI scanning); at hours:minutes 2:20, 2:50, 3:20, 3:50, 4:50, 5:05 after arrival of the proband

change in alcohol urges

elf-report questionnaire: "Alcohol Urge Questionnaire (AUQ)"; Bohn et al. 1995

Time frame: at examination day: 6 time points measured throughout the whole experiment (except during MRI scanning); at hours:minutes 2:20, 2:50, 3:20, 3:50, 4:50, 5:05 after arrival of the proband

change in alcohol craving

self-report "How strong is your craving for alcohol?": reported on a visual analogue scale ranging from 0 to 100

Time frame: at examination day: 6 time points measured throughout the whole experiment (except during MRI scanning); at hours:minutes 2:20, 2:50, 3:20, 3:50, 4:50, 5:05 after arrival of the proband

Psychobiology of Stress and Alcohol Craving

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes