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Rewarding, stimulant, and sedative alcohol responses and relationship to future binge drinking.
Arch Gen Psychiatry. 2011 Apr; 68(4):389-99.AG

Abstract

CONTEXT

Excessive consumption of alcohol is a major problem in the United States and abroad. Despite many years of study, it is unclear why some individuals drink alcohol excessively while others do not. It has been postulated that either lower or greater acute responses to alcohol, or both, depending on the limb of the breath alcohol concentration curve, contribute to propensity for alcohol misuse.

OBJECTIVE

To prospectively assess the relationship of acute alcohol responses to future binge drinking.

DESIGN

Within-subject, double-blind, placebo-controlled, multidose laboratory alcohol challenge study with intensive follow-up. Each participant completed 3 randomized sessions examining responses to a high (0.8 g/kg) and low (0.4 g/kg) alcohol dose and placebo, followed by quarterly assessments for 2 years examining drinking behaviors and alcohol diagnoses.

SETTING

Participants recruited from the community.

PARTICIPANTS

High-risk heavy social drinkers aged 21 to 35 years who habitually engage in weekly binge drinking (n = 104) and light drinker controls (n = 86).

INTERVENTION

We conducted 570 laboratory sessions with a subsequent 99.1% follow-up (1506 of 1520).

MAIN OUTCOME MEASURES

Biphasic Alcohol Effects Scale, Drug Effects Questionnaire, cortisol response, Timeline Follow-Back, Drinker Inventory of Consequences-Recent, and DSM-IV alcohol abuse and dependence.

RESULTS

Alcohol produced greater stimulant and rewarding (liking and wanting) responses and lower sedative and cortisol responses in heavy vs light drinkers. Among the heavy drinkers, greater positive effects and lower sedative effects after alcohol consumption predicted increased binge drinking frequency during follow-up. In turn, greater frequency of binge drinking during follow-up was associated with greater likelihood of meeting diagnostic criteria for alcohol abuse and dependence.

CONCLUSIONS

The widely held low level response theory and differentiator model should be revised: in high-risk drinkers, stimulant and rewarding alcohol responses even at peak breath alcohol concentrations are important predictors of future alcohol problems.

TRIAL REGISTRATION

clinicaltrials.gov Identifier: NCT00961792.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL 60637, USA. aking@bsd.uchicago.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21464363

Citation

King, Andrea C., et al. "Rewarding, Stimulant, and Sedative Alcohol Responses and Relationship to Future Binge Drinking." Archives of General Psychiatry, vol. 68, no. 4, 2011, pp. 389-99.
King AC, de Wit H, McNamara PJ, et al. Rewarding, stimulant, and sedative alcohol responses and relationship to future binge drinking. Arch Gen Psychiatry. 2011;68(4):389-99.
King, A. C., de Wit, H., McNamara, P. J., & Cao, D. (2011). Rewarding, stimulant, and sedative alcohol responses and relationship to future binge drinking. Archives of General Psychiatry, 68(4), 389-99. https://doi.org/10.1001/archgenpsychiatry.2011.26
King AC, et al. Rewarding, Stimulant, and Sedative Alcohol Responses and Relationship to Future Binge Drinking. Arch Gen Psychiatry. 2011;68(4):389-99. PubMed PMID: 21464363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rewarding, stimulant, and sedative alcohol responses and relationship to future binge drinking. AU - King,Andrea C, AU - de Wit,Harriet, AU - McNamara,Patrick J, AU - Cao,Dingcai, PY - 2011/4/6/entrez PY - 2011/4/6/pubmed PY - 2011/6/7/medline SP - 389 EP - 99 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 68 IS - 4 N2 - CONTEXT: Excessive consumption of alcohol is a major problem in the United States and abroad. Despite many years of study, it is unclear why some individuals drink alcohol excessively while others do not. It has been postulated that either lower or greater acute responses to alcohol, or both, depending on the limb of the breath alcohol concentration curve, contribute to propensity for alcohol misuse. OBJECTIVE: To prospectively assess the relationship of acute alcohol responses to future binge drinking. DESIGN: Within-subject, double-blind, placebo-controlled, multidose laboratory alcohol challenge study with intensive follow-up. Each participant completed 3 randomized sessions examining responses to a high (0.8 g/kg) and low (0.4 g/kg) alcohol dose and placebo, followed by quarterly assessments for 2 years examining drinking behaviors and alcohol diagnoses. SETTING: Participants recruited from the community. PARTICIPANTS: High-risk heavy social drinkers aged 21 to 35 years who habitually engage in weekly binge drinking (n = 104) and light drinker controls (n = 86). INTERVENTION: We conducted 570 laboratory sessions with a subsequent 99.1% follow-up (1506 of 1520). MAIN OUTCOME MEASURES: Biphasic Alcohol Effects Scale, Drug Effects Questionnaire, cortisol response, Timeline Follow-Back, Drinker Inventory of Consequences-Recent, and DSM-IV alcohol abuse and dependence. RESULTS: Alcohol produced greater stimulant and rewarding (liking and wanting) responses and lower sedative and cortisol responses in heavy vs light drinkers. Among the heavy drinkers, greater positive effects and lower sedative effects after alcohol consumption predicted increased binge drinking frequency during follow-up. In turn, greater frequency of binge drinking during follow-up was associated with greater likelihood of meeting diagnostic criteria for alcohol abuse and dependence. CONCLUSIONS: The widely held low level response theory and differentiator model should be revised: in high-risk drinkers, stimulant and rewarding alcohol responses even at peak breath alcohol concentrations are important predictors of future alcohol problems. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00961792. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/21464363/Rewarding_stimulant_and_sedative_alcohol_responses_and_relationship_to_future_binge_drinking_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archgenpsychiatry.2011.26 DB - PRIME DP - Unbound Medicine ER -