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Stress-related salivary alpha-amylase (sAA) activity in alcohol dependent patients with and without a history of childhood maltreatment

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Abstract

Rationale

Alcohol-dependent (AD) patients with a history of childhood maltreatment (CM) have shown a more severe clinical profile and a higher risk of relapse than those without CM. It was hypothesized that stress responsivity plays an important role in moderating the relationship between CM and AD. Surprisingly, systematic investigations about the stress responsivity in AD patients with CM are rare.

Objective

This study compared physiological and subjective stress responses in AD patients with and without CM as well as in healthy controls with and without CM.

Methods

A total of 130 participants performed the Trier Social Stress Test (TSST). Physiological stress reactivity related to the noradrenergic system was assessed by salivary alpha-amylase (sAA) activity. Subjective ratings of anxiety, nervousness, distress, and mood were rated on visual analogue scales.

Results

AD patients showed significantly lower stress-related sAA activity than healthy controls (p ≤ 0.024; z ≥ 1.97). A different pattern was found in the subjective ratings. In particular, anticipatory anxiety revealed a clear effect of CM (p ≤ 0.005; z ≥ 2.43) but no difference between AD patients and healthy controls (p > 0.05). After the TSST, distress ratings differed between AD patients with CM and AD patients without CM (p ≤ 0.009; z ≥ 2.61).

Conclusion

The discrepancy between physiological responsivity and subjective stress experiences may account for an increased inability to cope with stressful situations, which in turn might explain the enhanced risk of relapse in AD patients with a history of CM during early abstinence.

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Acknowledgments

This research was supported by the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung): Grant No. 01KR1203A. We would like to thank Kirsten Huwald, Sandra Schwentesius, and Iris Remmlinger-Marten for their lab assistance.

CANSAS study group: Schäfer I. (coordinator), Barnow S., Bullinger M., Driessen M., Härter M., Hiller P., Hillemacher T., Klein M., Muhtz C., Muehlhan M., Ravens-Sieberer U., Scherbaum N., Thomasius R., M. Schäfer, Schneider B., Wegscheider K., and Pawils S.

Authors’ contribution

MM is responsible for the study concept and design, conducted the statistical analyses, and wrote the paper. AH performed the data acquisition and contributed substantially to the interpretation of the data, MH guided the statistical analyses and contributed substantially to the interpretation of the data, KW performed the biochemical analyses and contributed substantially to the interpretation of the data, SB contributed substantially to the interpretation of the data, IS is the principal investigator, responsible for the study design, and contributed substantially to the interpretation of the data. All authors approved the final version of the manuscript.

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Authors and Affiliations

  1. Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany

    Markus Muehlhan & Michael Höfler

  2. Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany

    Markus Muehlhan

  3. Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany

    Anja Höcker, Klaus Wiedemann & Ingo Schäfer

  4. Department of Clinical Psychology and Psychotherapy, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany

    Sven Barnow

  5. Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany

    Ingo Schäfer

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  1. Markus Muehlhan
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Correspondence to Markus Muehlhan.

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Muehlhan, M., Höcker, A., Höfler, M. et al. Stress-related salivary alpha-amylase (sAA) activity in alcohol dependent patients with and without a history of childhood maltreatment. Psychopharmacology 234, 1901–1909 (2017). https://doi.org/10.1007/s00213-017-4595-8

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