The Relationship Between Stress and Alcohol Use

by National Institute of Health

(Page 4 of 6)

Effects of Alcohol Exposure on the Response to Stress

AOD self-administration in animals, but previous alcohol exposure influences an animal's response to stress. In a study investigating the relationship between alcohol and stress, both alcohol- treated and control rats were repeatedly stressed by restraining their free movement for 2 hours daily for 5 days. The alcohol-treated rats in that study received alcohol in their drinking water for 2 weeks before being exposed to the restraint stress and continued to receive alcohol during the stress period. A single 2-hour restraining period on the first day of the experiment decreased food intake in both the alcohol-treated and the control rats. On the second and third day of the experiment, however, the control rats showed smaller decreases in food intake, and on the fifth day their food intake had returned to normal levels, suggesting that the animals had adapted to the stress. Among the alcohol-treated rats, however, the decrease in food intake was slightly attenuated after the second-day restraint but did not decrease further on the remaining days of the experiment. These findings suggest that alcohol exposure interfered with the rats' ability to adapt to repeated stress.

In summary, researchers have extensively investigated the effects of stress on AOD self-administration in animals. These studies found that stressful experiences - whether acute or chronic and whether physical or psychological in nature - can contribute significantly to the animals' AOD self-administration.

Consistent with the animal studies described in the previous section, clinical studies indicate that both acute and chronic stress may play a role in the development of AOD use disorders, the initiation of AOD abuse treatment, and the precipitation of relapse in recovering alcoholics. These three areas are discussed in the following sections.

Stress and the Development of Alcoholism

Clinical and naturalistic studies have assessed the influence of both acute and chronic stress on drinking behavior and the development of alcoholism. Many of those investigations have focused on occupational stress as an example of chronic stress. For example, Seeman and Seeman found in a survey of more than 500 men that drinking problems were closely related to stressful experiences - whether they resulted from acute and severe stressors (illness or death of a loved one) or from chronic occupational stressors - that were combined with a strong sense of powerlessness. With respect to occupational stress, men in positions combining little freedom in choosing how to fulfill their job obligations (low job latitude) and high job demands reported the highest drinking levels and most alcohol-related problems.

The extent to which job stress influences drinking behavior also depends on the type of stress experienced. Thus, Crum and colleagues found that men employed in high-strain jobs (jobs with high demands and low control) generally had a higher risk of developing alcohol use disorders when compared with men in low-strain occupations (jobs with low demands and high control). However, this increase was greater for men in positions with high physical demands (three to four times higher risk) than for men in positions with high psychological demands (two to three times higher risk). Other studies noted that chronic, low-level, workrelated stressors (uncooperative coworkers or daily parking problems) also were associated with higher drinking levels.

Several studies have focused specifically on the relationship between stress and alcohol consumption in women. Such analyses are of particular interest, because women may be more susceptible than men are to some of alcohol's harmful health effects. Furthermore, women have been reported to be more likely than men to consider stressful events as being associated with the initiation of problem drinking. The latter association was not confirmed, however, in a critical review of stressful life events and drinking behavior in women. In that review, Allan and Cooke found no evidence of a gender-specific relationship between stress and alcohol abuse in women, although the researchers noted a high prevalence of stressful life events (divorce or death of a loved one), particularly among middle-aged women who developed alcohol dependence later in life. Most studies reviewed, however, failed to address the possibility that heavy drinking may be the cause rather than the consequence of life stressors.

Although the general association between stress and drinking behavior in women has remained controversial, some studies have found an important relationship between women's coping styles and stress-related alcohol consumption. In those studies, women who used problem-focused coping strategies (who took specific measures to eliminate or address the source of the stress) consumed less alcohol during stressful periods in their lives than did women who used coping strategies that focused on emotions or which merely served to relieve the immediate negative emotions (were palliative) rather than address the problem. Accordingly, treatment modules teaching problem-focused coping skills may be an important component of effective therapy for some AOD-abusing clients.

Another approach to investigating the role of stress in the development of alcoholism has been to analyze alcohol's stress-response dampening (SRD) effects in different populations. SRD effects are those consequences of alcohol consumption that result in a reduction of both the body's emotional responses (anxiety, tension, and nervousness) and physiological responses (changes in heart rate or sweating) to stress. Sher and Levenson found that alcohol's SRD effects were more pronounced in nonalcoholic people who demonstrated personality traits that have been associated with a risk for the development of alcoholism (aggressiveness, impulsivity, and outgoing than in people without those characteristics. The researchers suggested that because of their enhanced SRD experience, people with those personality traits were likely to find alcohol consumption particularly reinforcing, increasing their risk for alcoholism. More recently, Sinha and colleagues determined that women with a family history of alcoholism or anxiety disorders, who are at increased risk for alcoholism, exhibit a greater SRD effect of alcohol than do women without such a family history. Again, it is an intriguing notion that this population has an increased risk of alcoholism, because alcohol may be particularly reinforcing as the result of its potent SRD effect. Thus, these studies suggest that an enhanced sensitivity to alcohol's SRD effect may contribute to an increased vulnerability of people with anxiety disorders for initiating and escalating alcohol use.

About the Author

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