Social Rejection by Those Closest to You Can Lead to Subsequent Drinking

Newswise, June 6, 2017 — The need to belong and experience social connections is a fundamental human characteristic. Prior research has shown that social rejection is linked to increases in negative emotions, distress, and hostility.

This study examined the impact of social rejection on alcohol use, and whether the impact differed when the social rejection was by close others, such as friends, spouses or family members, or by strangers or acquaintances.

Researchers gathered data from 77 community participants (41 women, 36 men) who used their smartphones to record their social interactions and alcohol use for 14 consecutive days. The analysis examined associations between rejection experiences and daily alcohol use.

Findings indicated that the type of relationship may be a key factor in whether or not social rejection leads to drinking. More specifically, on days characterized by rejection by close others, the likelihood of drinking significantly increased.

In contrast, on days characterized by rejection by acquaintances, there was no increase in the likelihood of drinking. This finding contrasts with laboratory studies of rejection that emphasize rejection and ostracism by strangers rather than known others.

Anxiety Is a Stronger Harbinger of Alcohol Problems Than Stress

Newswise, March 20, 2017 — Stress and anxiety are widely believed to contribute to drinking. Alcohol is thought to reduce tension caused by stress (the “flight or fight” response) as well as alleviate the unpleasant symptoms of anxiety (anticipation of the unpredictable, impending threats).

Prior research, however, has yielded inconsistent findings as to the unique relations between stress and anxiety, on the one hand, and alcohol consumption and alcohol use disorders, on the other hand.

This study was designed to examine how differences in self-reported levels of anxiety, anxiety sensitivity, and perceived stress impact the frequency and intensity of drinking, alcohol craving during early withdrawal, and alcohol craving and stress reactivity.

Recent drinking was assessed in 87 individuals (70 men, 17 women) with alcohol use disorders (AUDs). Three distinct measures were used to evaluate anxiety, anxiety sensitivity, and perceived stress.

A subset of 30 subjects was admitted to a medical center to ensure alcohol abstinence for one week: measures of alcohol craving were collected twice daily. On day 4, subjects participated in a public speaking/math challenge, before and after which measures of cortisol and alcohol craving were collected.

In these heavy drinkers, measures of anxiety as compared with perceived stress were more strongly associated with a variety of alcohol-related measures.

While alcohol studies often use the terms anxiety, anxiety sensitivity, and stress interchangeably, this study showed the importance of differentiating among the three terms given their unique relationships with drinking, craving, and stress reactivity among individuals with AUDs.

Gambling Addiction Triggers the Same Brain Areas as Drug and Alcohol Cravings

Newswise, February 13, 2017 — Gambling addiction activates the same brain pathways as drug and alcohol cravings, suggests new research.

The study, by international scientists including researchers from Imperial College London, suggests targeting these brain pathways may lead to future treatments for the condition.

The findings, published in the journal Translational Psychiatry, also suggest connections between the parts of the brain that control our impulses may be weakened in people with gambling addiction.

This work provides vital clues into the biology of gambling addiction, which is still largely unknown, explained Dr Henrietta Bowden-Jones, co-author from the Department of Medicine at Imperial, and director of the National Problem Gambling Clinic, at Central and North West London NHS Foundation Trust.

"Gambling addiction can have a devastating effect not just on patients, but also their families. It can result in people losing their job, and leave families and children homeless.

"We know the condition may have a genetic component - and that the children of gambling addicts are at higher risk of gambling addiction themselves - but we still don't know the exact parts of the brain involved. This research identifies key brain areas, and opens avenues for targeted treatments that prevent cravings and relapse."

The study, funded by the UK Medical Research Council, found that two brain areas, called the insula and nucleus accumbens, are highly active when people with gambling addiction experience cravings.

Activity in these areas, which are found deep in the centre of the brain and involved in decision-making, reward and impulse control, has been previously linked to drug and alcohol cravings.

Problem gambling may affect up to 593,000 people in the UK. The condition can be treated by talking therapies, such as cognitive behavioural therapy, or medications that combat cravings.

In the research, which was conducted between Imperial and the National Problem Gambling Clinic, scientists studied 19 patients with gambling addiction, and 19 healthy volunteers.

The most commonly reported problematic forms of gambling among the patients were electronic roulette and sports gambling.

Each volunteer went into a magnetic resonance imaging scanner - which uses a powerful electromagnet to monitor brain activity - and were shown various images. These included pictures of gambling scenes, such as a roulette wheel or a betting shop.

All participants were asked to rate their level of craving when they saw the images.

The team, which included scientists from the University of British Columbia and the University of Cambridge, then assessed which brain areas were activated when the volunteers experienced cravings.

They found that, in problem gamblers, the insula and nucleus accumbens were highly active when they were shown an image associated with gambling, and experienced a craving.

Interestingly, the team also found that weaker connections between the nucleus accumbens and an area called the frontal lobe in problem gamblers were associated with greater craving.

The frontal lobe, which is involved in decision-making, may help keep the insula in-check by controlling impulses, explained Professor Anne Lingford-Hughes, co-author from the Department of Medicine at Imperial.

"Weak connections between these regions have also been identified in drug addiction. The frontal lobe can help control impulsivity, therefore a weak link may contribute to people being unable to stop gambling, and ignoring the negative consequences of their actions. The connections may also be affected by mood - and be further weakened by stress, which may be why gambling addicts relapse during difficult periods in their life."

Professor Lingford-Hughes added that monitoring activity and connections in the insula and nucleus accumbens in gambling addicts may not only help medics assess effectiveness of a treatment, but may also help prevent relapse - a common problem in addiction.

The group are now investigating which treatments may reduce activity in these areas, in an attempt to reduce cravings.

They would also like to compare the brain activity of problem gamblers with people who gamble but do not have an addiction, to investigate why the addiction escalates in some but not others.

Problem Drinking in Older Adults

Newswise, January 14, 2017 – Older adults suffering from multiple chronic health conditions and depression are nearly five times as likely to be problem drinkers as older adults with the same conditions and no depression, according to researchers at the University of Georgia. Their study is the first to document the connection between multiple chronic illnesses, depression and alcohol use in seniors.

This information could help health care providers identify which older adults are most likely to experience problem drinking and lead to better preventive care for this segment of society.

The study, conducted by researchers from the UGA School of Social Work, utilized data from the National Social Life, Health and Aging Project, a nationwide survey of older adults that is funded by the National Institutes of Health. Researchers looked at more than 1,600 individuals aged 57 to 85 who identified as active alcohol consumers.

Among problem drinkers, or individuals who reported a high amount of negative consequences associated with alcohol use, the researchers found that more than half—66 percent—reported having multiple chronic health conditions, or MCC, and 28 percent reported having symptoms of depression.

The researchers also found that older adults who experienced MCC combined with depression were those who experienced the highest likelihood of problem drinking.

“These findings suggest that effective training in screening and referral for mental health and alcohol use issues for health care providers of older adults may better serve the approximate 4 million older adults who currently experience problem drinking in the U.S.,” said Orion Mowbray, assistant professor at the UGA School of Social Work and lead author of the study.

Previous efforts to prevent and manage disease in older adults have focused on a single disease at a time, said Mowbray. Few physicians consider the combination of multiple chronic conditions in connection with depression as a potential sign for increased alcohol misuse, although screening and follow-up counseling for behavioral problems is known to help.

“There is sufficient evidence that even brief interventions delivered in medical-related settings can have a positive influence on reducing problem drinking among most older adults,” said Mowbray.

“These interventions can include screening for signs of depression in individuals with long-term health problems, engaging the individual in a conversation about the risks of problem drinking, and providing a referral for brief alcohol-related treatment.”

Other contributors to the paper include Tiffany Washington, assistant professor of social work, social work doctoral student Greg Purser and Jay O’Shields.

The study, “Problem drinking and depression in older adults with multiple chronic health conditions,” was published in the October issue of the Journal of the American Geriatrics Society, and will be presented this month at the Society for Social Work and Research’s annual conference in New Orleans. It is available online at http://onlinelibrary.wiley.com/doi/10.1111/jgs.14479/full