Journal of Neural Transmission

, Volume 113, Issue 10, pp 1519–1535 | Cite as

Physiological and subjective responding to alcohol cue exposure in alcoholics and control subjects: evidence for appetitive responding

  • M. S. Reid
  • F. Flammino
  • A. Starosta
  • J. Palamar
  • J. Franck
Article

Summary.

36 alcoholic patients, recruited from a treatment program, and 20 non-alcohol abusing control subjects were tested for their reactions to alcohol and non-alcohol cues. The cue exposure paradigm included audio-visual (video), tactile, olfactory, and guided imagery cue components related to alcohol and non-alcohol beverages. Response measures were analyzed for significant difference based on alcohol and non-alcohol cue and patient type. Among the subjective ratings, alcohol cue specific increases in alcohol craving, desire to drink, alcohol-like high, positive drinking expectancies and alcohol-like withdrawal were seen in alcoholic subjects. Among the physiological measures, alcohol cue specific increases in salivation were seen in alcoholic subjects. Changes in heart rate, skin conductance and temperature were not specific to alcohol cues, or to alcoholic patients. The smelling of alcohol had the greatest impact on alcohol craving and skin conductance in alcoholic subjects. These findings demonstrate robust subjective effects, and weak physiological effects, in response to a multidimensional alcohol cue exposure paradigm. The response profile indicates cue reactivity in alcoholics as an appetitive based form of alcohol craving.

Keywords: Alcohol, craving, withdrawal, cue reactivity. 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Psychiatric Association1994Diagnostic and statistical manual of mental disorder DSM-IVfourthAmerican Psychiatric AssociationWashington DCGoogle Scholar
  2. Anton, RF, Moak, DH, Latham, P 1995The obsessive-compulsive drinking scale: a self-rated instrument for the quantification of thoughts about alcohol and drinking behaviorAlcohol Clin Exp Res199299PubMedCrossRefGoogle Scholar
  3. Beck, AT 1978Beck Depression InventoryHarcourt Brace & CompanySan AntonioGoogle Scholar
  4. Berger, SP, Hall, SM, Mickalian, JD, Reid, MS, Crawford, CA, Delucchi, KL, Carr, K, Hall, S 1996Haloperidol antagonism of cue-elicited cocaine cravingLancet347504508PubMedCrossRefGoogle Scholar
  5. Binkoff JA, Abrams DB, Collins RL, Liepman MR, Monti PM, Nirenberg TD, Zwick WR (1984) Exposure to alcohol cues. Comunicación pre- sentada en The Association for Advancement of Behavior Therapy, FiladelfiaGoogle Scholar
  6. Bohn, MJ, Krahn, DD, Staehler, BA 1995Development and initial validation of a measure of drinking urges in abstinent alcoholicsAlcohol Clin Exp Res3600606CrossRefGoogle Scholar
  7. Braus, DF, Wrase, J, Grusser, S, Herman, D, Ruf, M, Flor, H, Mann, K, Heinz, A 2001Alcohol associated stimuli activate ventral striatum in abstinent alcoholicsJ Neural Transm108887894PubMedCrossRefGoogle Scholar
  8. Childress, AR, Mozley, D, McElgin, W, Fitzgerald, J, Reivich, M, O’Brien, CP 1999Limbic activation during cue-induced cocaine cravingAm J Psychiatry1561118PubMedGoogle Scholar
  9. Cooney, NL, Gillespie, RA, Baker, LH, Kaplan, RF 1987Cognitive changes after alcohol cue exposureJ Consult Clin Psychol55150155PubMedCrossRefGoogle Scholar
  10. Drummond, DC 1990The relationship between alcohol dependence and alcohol-related problems in a clinical populationBr J Addict85357366PubMedCrossRefGoogle Scholar
  11. Drummond, DC, Cooper, T, Glautier, SP 1990Conditioned learning in alcohol dependence: implications for cue exposure treatmentBr J Addict85725743PubMedCrossRefGoogle Scholar
  12. Flannery, BA, Volpicelli, JR, Pettinati, HM 1999Psychometric properties of the Penn Alcohol Craving ScaleAlcohol Clin Exp Res2312891295PubMedCrossRefGoogle Scholar
  13. George, MS, Raymond, RF, Bloomer, C, Teneback, C, Drobes, DJ, Lorberbaum, JP, Nahas, Z, Vincent, DJ 2001Activation of prefrontal cortex and anterior thalamus in alcoholic subjects on exposure to alcohol-specific cuesArch Gen Psychiatry58345352PubMedCrossRefGoogle Scholar
  14. Glautier, S, Drummond, DC 1994Alcohol dependence and cue reactivityJ Stud Alcohol55224229PubMedGoogle Scholar
  15. Grant, S, London, ED, Newlin, DB, Villemagne, VL, Liu, X, Contoreggi, C, Phillips, RL, Kimes, AS, Margolin, A 1996Activation of memory circuits during cue-elicited cocaine cravingProc Natl Acad Sci USA931204012045PubMedCrossRefGoogle Scholar
  16. Grusser, SM, Wrase, J, Klain, S, Hermann, D, Smolka, MN, Ruf, M, Weber-Fahr, W, Flor, H, Mann, K, Braus, DF, Heinz, A 2004Cue-induced activation of the striatum and medial prefrontal cortex is associated with subsequent relapse in abstinent alcoholicsPsychopharmacology175296302PubMedCrossRefGoogle Scholar
  17. Heinz, A, Lober, S, Georgi, A, Wrase, J, Herman, D, Rey, ER, Wellek, S, Mann, K 2003Reward craving and withdrawal relief craving: assessment of different motivational pathways to alcohol intakeAlcoholism Alcohol383539CrossRefGoogle Scholar
  18. Heinz, A, Siessmer, T, Wrase, J, Buchholz, HG, Grunder, G, Kumakura, Y, Cumming, P, Schreckenberger, M, Smolka, MN, Rosch, F, Mann, K, Bartenstein, P 2005Correlation of alcohol craving with striatal dopamine synthesis capacity and D2/D3 receptor availability: a combined (18F) DOPA and (18F) DMFP PET study in detoxified alcoholic patientsAm J Psychiatry16215151520PubMedCrossRefGoogle Scholar
  19. Johnson, CN, Fromme, K 1994An experimental test of affect, subjective craving, and alcohol outcome expectancies as motivators of young adult drinkingAddict Behav19631641PubMedCrossRefGoogle Scholar
  20. Kambouropoulos, N, Staiger, PK 2004Reactivity to alcohol cues: relationship among cue types, motivation process and personalityPsychol Addict Behav18275283PubMedCrossRefGoogle Scholar
  21. Kaplan, RF, Meyer, RF, Stroebel, CF 1983Alcohol dependence and responsivity to an ethanol stimulus as predictors of alcohol consumptionBr J Addict78259267PubMedCrossRefGoogle Scholar
  22. Laberg, JC 1990What is presented, and what prevented, in cue exposure and response prevention in alcohol dependent patients?Addict Behav15367386PubMedCrossRefGoogle Scholar
  23. Laberg, JC, Ellertson, B 1987Psychophysiological indicators of craving in alcoholics: effects of cue exposureBr J Addict8213411348PubMedCrossRefGoogle Scholar
  24. Litt, MD, Cooney, NL 1999Inducing craving for alcohol in the laboratoryAlcohol Res and Health23174178Google Scholar
  25. Litt, MD, Cooney, NL, Morse, P 2000Reactivity to alcohol-related stimuli in the laboratory and in the field: predictors of craving in treated alcoholicsAddiction95889900PubMedCrossRefGoogle Scholar
  26. Ludwig, AM, Wikler, A, Stark, LH 1974The first drink. Physiological aspects of cravingArch Gen Psychiatry30539547PubMedGoogle Scholar
  27. Marlatt, GA 1985

    Cognitive factors in the relapse process

    Marlatt, GAGordon, JR eds. Relapse prevention: maintenance strategies in the treatment of addictive behaviorsGuilford PressNew York128200
    Google Scholar
  28. Marlatt, GA, Gordon, JR 1985Relapse prevention: maintenance strategies in the treatment of addictive behaviorsGuilford PressNew York370Google Scholar
  29. McCaul, ME, Turkkan, JS, Stitzer, ML 1989aPsychophysiological effects of alcohol-related stimuli. I. The role of stimulus intensityAlcoholism Clin Exp Res13386398CrossRefGoogle Scholar
  30. McCaul, ME, Turkkan, JS, Stitzer, ML 1989bConditioned opponent responses: effects of placebo challenge in alcoholic subjectsAlcoholism Clin Exp Res13631635CrossRefGoogle Scholar
  31. McCusker, CG, Brown, K 1990Alcohol-predictive cues enhance tolerance to and precipitate “craving” for alcohol in social drinkersJ Studies Alcohol51494499Google Scholar
  32. McCusker, CG, Brown, K 1995Cue-exposure to alcohol-associated stimuli reduces autonomic reactivity, but not craving and anxiety, in dependent drinkersAlcohol Alcoholism30319327Google Scholar
  33. McLellan, AT, Luborsky, L, O’Brien, CP, Woody, GE 1980An improved evaluation instrument for substance abuse patients: the Addiction Severity IndexJ Nerv Ment Dis1682633PubMedGoogle Scholar
  34. Miller, NS, Gold, MS 1994Dissociation of “conscious desire” (craving) from and relapse in alcohol and cocaine dependenceAnn Clin Psych699106Google Scholar
  35. Modell, JG, Glaser, FB, Mountz, JM, Schmaltz, S, Cyr, L 1992aObsessive compulsive characteristics of alcohol abuse and dependence: quantification by a newly developed questionnaireAlcohol Clin Exp Res16266271CrossRefGoogle Scholar
  36. Modell, JG, Glaser, FB, Cyr, L, Mountz, JM 1992bObsessive and compulsive characterisitics of craving in alcohol abuse and dependenceAlcohol Clin Exp Res16272274CrossRefGoogle Scholar
  37. Modell, JG, Mountz, JM 1995Focal cerebral blood flow change during craving for alcohol measured by SPECTJ Neuropsychiatr Clin Neurosci71522Google Scholar
  38. Monti, PM, Binkoff, JA, Abrams, DB, Zwick, WR, Nirenberg, TD, Liebman, MR 1987Reactivity of alcoholics and non-alcoholics to drinking cuesJ Abnorm Psychol96122126PubMedCrossRefGoogle Scholar
  39. Mucha, RF, Geier, A, Pauli, P 1999Modulation of craving by cues having differential overlap with pharmacological effect: evidence for cue approach in smokers and social drinkersPsychopharmacol147306313CrossRefGoogle Scholar
  40. Mucha, RF, Geier, A, Stuhlinger, M, Mundle, G 2000Appetitive effects of drug cues modeled by pictures of the intake ritual: generally of cue-modulated startle examined with inpatient alcoholicsPsychopharmacol151428432CrossRefGoogle Scholar
  41. O’Brien, CP, Childress, AR, Ehrman, R, Robbins, SJ 1998Conditioning factors in drug abuse: can they explain compulsion?J Psychopharm121522Google Scholar
  42. Pommerleau, OF, Fertig, J, Baker, L, Cooney, N 1983Reactivity to alcohol cues in alcoholics and non-alcoholics: implications for a stimulus control analysis of drinkingAddict Behav8110CrossRefGoogle Scholar
  43. Rather, BC, Goldman, MS, Roehrich, L, Brannick, M 1992Empirical modeling of an alcohol expectancy memory network using multidimensional scalingJ Abnorm Psychol101174183PubMedCrossRefGoogle Scholar
  44. Reid, MS, Mickalian, JD, Delucchi, KL, Hall, SM, Berger, SP 1998An acute dose of nicotine enhances cue-induced cocaine cravingDrug Alcohol Depend4995104PubMedCrossRefGoogle Scholar
  45. Reid, MS, Prichep, L, O’Leary, S, Ciplet, D, Tom, ML, Howard, B, Rotrosen, J, John, R 2003Quantitative electroencephalographic studies of cue-induced cocaine cravingClinical EEG34110123Google Scholar
  46. Reid, MS, Mickalian, JD, Delucchi, KL, Berger, SP 1999A nicotine antagonist, mecamylamine, reduces cue-induced cocaine craving in cocaine-dependent subjectsNeuropsychopharmacology20297307PubMedCrossRefGoogle Scholar
  47. Rohsenow, DJ, Monti, PM, Abrams, DB, Rubonis, AV, Niaura, RS, Sirota, AD, Colby, SM 1992Cue elicited urge to drink and salivation in alcoholics: relationship to individual differencesAdv Behav Res Ther14195210CrossRefGoogle Scholar
  48. Rohsenow, DJ, Monti, PM, Rubonis, AV, Sirota, AD, Niaura, RS, Colby, SM, Wunschel, SM, Abrams, DB 1994Cue reactivity as a predictor of drinking among male alcoholicsJ Consult Clin Psychol62620626PubMedCrossRefGoogle Scholar
  49. Rohsenow, DJ, Monti, PM 1999Does urge to drink predict relapse after treatment?Alcohol Res Health23225232PubMedGoogle Scholar
  50. Rubonis, AV, Colby, SM, Monti, PM, Rohsenow, DJ, Gulliver, SB, Sirota, AD 1994Alcohol cue reactivity and mood induction in male and female alcoholicsJ Stud Alcohol55487494PubMedGoogle Scholar
  51. Sellers, EM, Kalant, H 1976Alcohol intoxication and withdrawalN Engl J Med294757762PubMedCrossRefGoogle Scholar
  52. Siegel, S 1979

    The role of conditioning in drug tolerance and addiction

    Keehn, DJ eds. Psychopathology in animals: research and clinical implicationsAcademic PressNew York143168
    Google Scholar
  53. Sinha, R, Fuse, T, Aubin, LR, O’Malley, SS 2000Psychological stress, drug-related cues and cocaine cravingPsychopharmacol152140148CrossRefGoogle Scholar
  54. Stasiewicz, PR, Gulliver, SB, Bradizza, CM, Rohsenow, DJ, Torrisi, R, Monti, PM 1997Exposure to negative emotional cues and alcohol cue reactivity with alcoholics: a preliminary investigationBehav Res Ther3511431149PubMedCrossRefGoogle Scholar
  55. Stewart, J, de Wit, H, Eikelboom, R 1984Role of unconditioned and conditioned drug effects on the self-administration of opiates and stimulantsPsychol Rev91251268PubMedCrossRefGoogle Scholar
  56. Stockwell, T, Hodgson, R, Edwards, G, Taylor, C, Rankin, H 1979The development of a questionnaire to measure severity of alcohol dependenceBr J Addict747987CrossRefGoogle Scholar
  57. Stormark, KM, Laberg, JC, Bjerland, T, Nordby, H, Hugdahl, K 1995Autonomic cued reactivity in alcoholics: the effect of olfactory stimuliAddict Behav20571584PubMedCrossRefGoogle Scholar
  58. Streeter, CC, Gulliver, SB, Baker, E, Blank, SR, Meyer, AA, Ciraulo, DA, Renshaw, PF 2002Videotaped cue for urge to drink alcoholAlcohol Clin Exp Res26627634PubMedCrossRefGoogle Scholar
  59. Sullivan, JT, Sykora, K, Schneiderman, J, Naranjo, CA, Sellers, EM 1989Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)Br J Addict8413531357PubMedCrossRefGoogle Scholar
  60. Szegedi, A, Lorch, B, Scheurich, A, Ruppe, A, Hautzinger, M, Wetzel, H 2000Cue exposure in alcohol dependent patients: preliminary evidence for different types of cue reactivityJ Neural Transm107721730PubMedCrossRefGoogle Scholar
  61. Tiffany, ST, Carter, BL, Singleton, EG 2000Challenges in manipulation, assessment and interpretation of craving relevant variablesAddiction95S177S187PubMedCrossRefGoogle Scholar
  62. Turkkan, JS, McCaul, ME, Stitzer, ML 1989Psychophysiological effects of alcohol-related stimuli. II. Enhancement with alcohol availabilityAlcohol Clin Exp Res13392398PubMedCrossRefGoogle Scholar
  63. Westerberg, VS 2000Constituents of craving in a clinical alcohol sampleJ Subst Abuse12415423PubMedCrossRefGoogle Scholar
  64. Wikler, A 1965

    Conditioning factors in opiate addiction and relapse

    Wiher, DIKassebaum, G eds. NarcoticsMcGraw HillNew York
    Google Scholar
  65. Wrase, J, Grusser, SM, Klein, S, Diener, C, Hermann, D, Flor, H, Mann, K, Braus, DF, Heinz, A 2002Development of alcohol-associated cues and cue-induced brain activation in alcoholicsEur Psychiatry17287291PubMedCrossRefGoogle Scholar
  66. Verheul, R, Van den Brink, W, Geerlings, P 1999A three-way psychobiological model of craving for alcoholAlcohol Alcoholism34197222CrossRefGoogle Scholar
  67. Zack, M, Toneatto, T, MacLeod, CM 2002Anxiety and explicit alcohol-related memory in problem drinkersAddict Behav27331343PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • M. S. Reid
    • 1
  • F. Flammino
    • 1
  • A. Starosta
    • 1
  • J. Palamar
    • 1
  • J. Franck
    • 2
  1. 1.Department of PsychiatryNew York University School of MedicineNew YorkUSA
  2. 2.Department of Clinical NeuroscienceKarolinska InstituteStockholmSweden

Personalised recommendations