Stress and Addiction (eBook)

Front Cover 1
Stress and Addiction: Biological and Psychological Mechanisms 4
Copyright Page 5
Contents 6
Contributors 12
Foreword 16
Preface 18
Acknowledgments 20
SECTION I: NEUROBIOLOGY OF STRESS AND ADDICTION 22
Chapter 1. Biological Bases of the Stress Response 24
I. Introduction 24
II. Physiological Stress Research 25
III. Major Components of the Biological Stress Response System 28
IV. Other Stress-Responsive Hormone Axes 31
V. Other Stress-Responsive Systems 33
VI. Final Remarks 36
References 36
Chapter 2. The Hypothalamic-Pituitary-Adrenal Axis and Addiction 42
I. Introduction 42
II. Stress and the HPA Axis 43
III. Stress, the HPA Axis, and the Acquisition of Drug Taking 44
IV. Stress and Vulnerability to Addiction in Humans 46
V. The HPA Axis and the Maintenance of Drug Taking 47
VI. Relapse to Addiction 49
VII. Inconsistencies 51
VIII. Conclusions and Implications for the Treatment of Addiction 54
References 56
Chapter 3. Dopaminergic Reward Pathways and Effects of Stress 62
I. Defining Stress 62
II. The Mesencephalic Dopamine System 63
III. Dopamine and Addiction 69
IV. Dopamine and Stress 73
V. Conclusions 84
References 88
Chapter 4. Endogenous Opiates, Addiction, and the Stress Response 106
I. Introduction 106
II. The Endogenous Opioid System 107
III. The Endogenous Opioid System and Reward and Reinforcement 107
IV. Effect of Alcohol on Endogenous Opioid Activity 108
V. Effect of Alcohol on Endogenous Opioid Receptors 109
VI. Endogenous Opioid Activity and Receptors and Alcohol Preference 109
VII. Opioid Antagonists in the Treatment of Alcohol Addiction 111
VIII. Endogenous Opioid Activity and Receptors and Cocaine Preference 112
IX. Opioid Antagonists in the Treatment of Cocaine Addiction 112
X. Opioids and Risk for Alcoholism 113
XI. The µ-Opioid Receptor Gene 116
XII. Conclusions 118
References 118
Chapter 5. Early Life Stress and Vulnerability to Addiction 126
I. Introduction 126
II. Neurohormonal Mechanisms of Stress Relevant to Cocaine Addiction 127
III. Animal Models 129
IV. Neurohormonal Effects of Neonatal Isolation 131
V. Behavioral Effects of Neonatal Isolation 133
VI. Sex Differences and Estrous Stage Effects of Neonatal Isolation 139
VII. Maternal Care Hypothesis 139
VIII. Conclusions and Translation for Clinical Relevance 140
References 141
Chapter 6. Genetics, Stress, and the Risk for Addiction 148
I. Introduction 148
II. The Extent of the Problem: Prevalence of Addiction 149
III. Heritability of Addiction 149
IV. HPA Axis 151
V. The “Reward” Pathway of Addiction: Interaction with Stress 153
VI. Reward Pathway and Stress Response: Key Neurotransporter Systems 154
VII. Limbic Regulation of Response to Stress 158
VIII. The Locus Coeruleus (LC)-Norepinephrine (NE) System 159
IX. Conclusions 160
References 160
Chapter 7. Neurobiology of Stress and Risk for Relapse 168
I. Overview 168
II. Animal Models for Studying the Effects of Stress on Relapse to Drug Seeking: The Reinstatement Procedure 169
III. The Neurobiology of Stress-Induced Reinstatement of Drug Seeking 173
IV. Long-Lasting Changes in the Responsivity of the Central Nervous System to CRF: Behavioral and Neuroanatomical Studies with Potential Implications for Reinstatement 179
V. Conclusions 182
References 183
SECTION II: PSYCHOSOCIAL PROCESSES RELATED TO STRESS AND ADDICTION 190
Chapter 8. Negative Affect and Addiction 192
I. Introduction 193
II. Precisely What Is Negative Affect? 195
III. Historical Perspectives on the Role of Withdrawal, Negative Affect, and Substance Abuse 197
IV. Drug Expectancy Effects and NA 199
V. Initiation Stage: Drug Use and NA 200
VI. Maintenance Stage: Drug Use and NA 201
VII. Relapse Stage: Drug Use and NA 203
VIII. Conclusions and Future Directions 203
References 205
Chapter 9. Stress and Impulsive Behaviors 212
I. Introduction 212
II. Impulse Control and Substance Use Disorders 213
III. Reward-Seeking Behavior: Pathological Gambling (PG) 213
IV. Habit Behavior: Trichotillomania (TTM) 219
V. Lack of Premeditation: Intermittent Explosive Disorder (IED) 222
VI. Conclusions 226
References 227
Chapter 10. Psychosocial Determinants of the Stress Response 232
I. Introduction 232
II. Sociodemographic Factors and Stress Responses 234
III. Life Stress Exposure 236
IV. Protective Psychosocial Factors 241
V. Conclusions 243
References 243
Chapter 11. Individual Differences in Response to Stress and Risk for Addiction 248
I. Introduction 248
II. Stress and the Brain’s Motivational Systems 249
III. Hedonic Homeostasis in Addiction Risk 251
IV. Affective Regulation and Vulnerability to Addiction 252
V. Addictions and Abnormalities of HPAC Regulation of Cortisol Secretion 253
VI. Risk for Addiction, Central Opioid Function, and Regional Brain Function 256
VII. The VAL158MET Polymorphism and Opioid Function 259
VIII. Addiction, Response to Stress, and Hedonic Dysregulation 262
IX. Life Events, Behavioral Dispositions, and Addiction Risk 264
X. Conclusions 265
References 265
Chapter 12. Addiction and Stress in Adolescents 270
I. Introduction 270
II. Adolescent Development 271
III. Life Stress in Adolescence 273
IV. Adolescent Stress and Addictive Behaviors 275
V. Implications for Adolescent Addiction Interventions 278
VI. Summary 279
References 280
SECTION III: CLINICAL IMPLICATIONS: ASSESSMENT AND INTERVENTION 284
Chapter 13. Assessment of Stress in Research and Clinical Settings 286
I. Introduction 286
II. The Assessment of Stressful Life Events 287
III. The Assessment of Self-Reported Stress 290
IV. Biological and Physiological Assessment 294
V. Hypothalamic-Pituitary-Adrenocortical (HPA) Measures 294
VI. The Sympatho-Adreno-Medullary (SAM) System 296
VII. The Immune Response 298
VIII. Conclusions 299
References 301
Chapter 14. Assessment of Addictions in Clinical and Research Settings 306
I. Introduction 306
II. Addiction Screens 308
III. Diagnostic Measures 311
IV. Symptom Severity Measures 312
V. Behavioral Measures 313
VI. Treatment Planning 314
VII. Conclusions 318
References 319
Chapter 15. Stress, Anxiety, and Addiction: Intervention Strategies 322
I. Introduction 322
II. Stress-Related Substance Use Disorders (SUDs) 324
III. Anxiety Disorders and Substance Use Disorders (SUDs) 325
IV. Moderators of the Anxiety and SUD Association 325
V. Treatment of Comorbid Disorders 326
VI. Anxiety and SUD Treatment Program Concepts 327
VII. Anxiety and SUD Treatment Outcomes 328
VIII. Treatment Studies Reviewed 328
IX. Conclusions 332
References 333
Chapter 16. Post-traumatic Stress Disorder and Substance Use Disorders 336
I. Epidemiology and Course 336
II. Genetics of PTSD and Addiction 340
III. Neurobiology of Stress and Substance Abuse Disorders 342
IV. Treatment Implications 343
V. Summary and Future Directions 347
References 347
Chapter 17. Novel Pharmacologic Treatment of Stress and Addiction: The Role of CRF and Glucocorticoid Antagonists 354
I. General Mechanisms of Addiction 354
II. Behavioral Paradigms 355
III. General Mechanisms of Stress Response 357
IV. Corticotropin-Releasing Factor 357
V. Glucocorticoids 358
VI. CRF Receptors 358
VII. CRF Pharmacology 358
VIII. CRF in Addiction and Stress 359
IX. Corticosteroids and Addiction 362
X. Stress and Addiction: Mechanistic Overview 362
XI. Clinical Trials with CRF Compounds 363
XII. Conclusions 363
Disclosure 364
References 364
Chapter 18. Current and Future Directions of Research on Stress and Addictive Behaviors 370
I. Introduction 370
II. Working Model 371
III. Stress and Vulnerability to Addiction 372
IV. Stress and Ongoing Addiction and Relapse 375
V. Factors Affecting Stress and Addiction Interactions 378
VI. Stress, Poor Behavioral Regulation, and Addiction 381
VII. Coping Resources 382
VIII. Discussions and Future Directions 382
IX. Conclusions 385
References 385
Subject Index 394
Author Index 402