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.

Ignition Interlock Laws Reduce Alcohol-Involved Fatal Crashes

--Estimated 1,250 alcohol-involved fatal crashes were prevented in 21 states where mandatory interlock laws have been implemented

Newswise, February 13, 2017 — State laws requiring ignition interlocks for all drunk driving offenders appear to reduce the number of fatal drunk driving crashes, a new study by Johns Hopkins Bloomberg School of Public Health and Colorado School of Public Health researchers suggests.

The study — published Jan. 5 in the American Journal of Preventive Medicine — found that mandatory interlock laws were associated with a seven percent decrease in the rate of fatal crashes with at least one driver with a blood alcohol content over the legal limit.

The decrease translates into an estimated 1,250 prevented fatal crashes in states with mandatory interlock laws since states first started passing such laws in 1993.

An ignition interlock is an alcohol-sensing device, connected to the ignition of a vehicle, which detects alcohol in the driver’s breath. If alcohol in excess of a preset limit is detected by the sensor, the vehicle will not start.

While all 50 states have some type of ignition interlock laws, 26 have mandatory laws requiring all individuals convicted of a DUI offense to use an interlock in order to drive legally, as of March 2016.

This is the first study to look at all the different types of interlock laws across all 50 states.

The researchers found that interlock laws which are mandatory for all DUI offenders were much more effective than those applicable to only some offenders, such as only repeat offenders or those with a very high blood alcohol content.

In the United States in 2014, alcohol-involved fatal motor vehicle crashes caused approximately 10,000 deaths, about one-third of all motor vehicle crash deaths.

“Our study demonstrates the value of mandatory ignition interlock laws across the United States,” says study leader Emma E. “Beth” McGinty, PhD, MS, deputy director at the Johns Hopkins Center for Mental Health and Addiction Policy Research at the Bloomberg School.

“We already know that alcohol plays a tragic role in the number of motor vehicle crash fatalities each year. Interlock laws which are mandatory for all DUI offenders save lives. "

To estimate the effects of existing ignition interlock laws, the researchers studied the effects of interlock laws on trends in alcohol-involved fatal crashes over a 32-year period, 1982 to 2013, and controlled for other motor vehicle safety laws and trends in crashes over time.

The team assessed changes in pre- and post-interlock law rates of alcohol-involved fatal crashes with crash data obtained from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS), and measured them against the different categories of interlock laws: permissive (at the discretion of a judge), partial (applicable to only some DUI offenders), and mandatory for all.

The researchers used two measures based on FARS data: alcohol-involved fatal crashes with a driver having a blood alcohol level of 0.08—the legal limit—and a second data set with a driver with a blood alcohol level greater than 0.15.

“Until recently, there hasn’t been any evidence on whether these laws prevent alcohol-involved fatal crashes, and specifically whether mandatory/all laws are more effective than permissive and partial laws,” McGinty says.

“Our study suggests that they are effective, and it’s encouraging to see more and more states moving towards this evidence-based policy change. Since 2005, we’ve seen over 20 states adopt interlock laws for all drunk-driving offenses. We’d like to see the remaining states follow suit.”

“Ignition Interlock Laws: Effects on Fatal Motor Vehicle Crashes, 1982–2013” was written by Emma E. McGinty, PhD, MS; Gregory Tung, PhD, MPH,; Juliana Shulman-Laniel, MPH; Rose Hardy, MPH; Lainie Rutkow, JD, PhD, MPH; Shannon Frattaroli, PhD, MPH; and Jon S. Vernick, JD, MPH.

The study was supported by the Centers for Disease Control and Prevention (#1R49CE002466-01).