stress reactivity as a determinant in co-occurring alcohol use and anxiety disorder: diagnosis and alcohol use outcomes

Conditions: Alcohol Use Disorder; Anxiety Disorder/Anxiety State; Stress Disorder; Hypothalamic Pituitary Adrenal; Drinking to Cope

Summary: alcohol dependence is among the most common and costly public health problems affecting the nation. among individuals with alcohol use disorder (aud), those with (vs. without) a co-occurring anxiety disorder (anxd) are as much as twice as likely to relapse in the months following aud treatment. dysregulation of biological stress-mood systems predict and correlate with aud relapse and anxd symptomatology. in contrast, stress system re-regulation correlates with improved aud treatment outcomes but has not been examined with respect to aud recovery and relapse in co-occurring aud+anxd.

the objectives of the proposed research are to 1) evaluate the effect of co-occurring anxd on the severity of biological stress-mood system dysregulations in aud inpatients at pre-treatment, 2) evaluate the effect of co-occurring anxd on the persistence of stress-mood system dysregulations in aud inpatients in the months following treatment, 3) evaluate the effects of treatment on biological stress-mood system re-regulation among aud patients with co-occurring anxd, and 4) evaluate the effect of re-regulation change in biological stress-mood system function on aud clinical outcomes.

Eligibility criteria:
inclusion criteria: * ability to provide informed consent * between the ages of 18 and 65 * diagnostic and statistical manual diagnosis of a panic disorder, generalized anxiety disorder, or social anxiety disorder within the past 30 days (aud+anxd group only). * primary alcohol use disorder diagnosis and alcohol use in the 30 days preceding the study (aud alone and aud+anxd groups only). * inpatient treatment at lodging plus primarily for alcohol (vs. other drug with nicotine accepted) dependence (aud alone and aud+anxd groups only). * a minimum of a sixth-grade reading level. * healthy controls, same criteria absent aud and anxd diagnosis of an alcohol and/or anxiety disorder * lives within proximity to the twin cities (e.g., within about an hour's drive) or willing to drive to fairview for the purpose of attending follow-up visits * willingness to provide contact information to confirm follow-up appointments exclusion criteria: * lifetime history of psychosis or mania * cognitive impairment, physical impairment, or chronic medical illness that precludes study participation * primary ptsd as determined by qualifying assessment * females currently pregnant * exposure to antipsychotic medication for a total duration \>16 weeks. * prior head injury leading to \>30 minutes of unconsciousness. * cognitive impairment that impedes study participation. * healthy controls with a history of any major medical or psychiatric disorders (e.g., schizophrenia, depression, heart disease, or stroke). * suicide intent or attempt in the past 30 days * cardiovascular health issues * thyroid disease * history of severe neurological illness such as chronic seizure disorder (e.g, epilepsy) or stroke * brain tumor and/or implants in the skull cavity (e.g., plate in the skull) * pacemaker