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Alewel DI, Kodavanti UP. Neuroendocrine contribution to sex-related variations in adverse air pollution health effects. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2024; 27:287-314. [PMID: 39075643 DOI: 10.1080/10937404.2024.2383637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
Air pollution exposure is ranked as a leading environmental risk factor for not only cardiopulmonary diseases but also for systemic health ailments including diabetes, reproductive abnormalities, and neuropsychiatric disorders, likely mediated by central neural stress mechanisms. Current experimental evidence links many air pollution health outcomes with activation of neuroendocrine sympathetic-adrenal-medullary and hypothalamic-pituitary-adrenal (HPA) stress axes associated with resultant increases in adrenal-derived hormone levels acting as circulating mediators of multi-organ stress reactions. Epidemiological and experimental investigations also demonstrated sex-specific responses to air pollutant inhalation, which may be attributed to hormonal interactions within the stress and reproductive axes. Sex hormones (androgens and estrogens) interact with neuroendocrine functions to influence hypothalamic responses, subsequently augmenting stress-mediated metabolic and immune changes. These neurohormonal interactions may contribute to innate sex-specific responses to inhaled irritants, inducing differing individual susceptibility. The aim of this review was to: (1) examine neuroendocrine co-regulation of the HPA axis by gonadal hormones, (2) provide experimental evidence demonstrating sex-specific respiratory and systemic effects attributed to air pollutant inhalation exposure, and (3) postulate proposed mechanisms of stress and sex hormone interactions during air pollution-related stress.
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Affiliation(s)
- Devin I Alewel
- Oak Ridge Institute for Science and Education Research Participation Program, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Urmila P Kodavanti
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
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Fox HC, Milivojevic V, Sinha R. Therapeutics for Substance-Using Women: The Need to Elucidate Sex-Specific Targets for Better-Tailored Treatments. Handb Exp Pharmacol 2023; 282:127-161. [PMID: 37592081 DOI: 10.1007/164_2023_687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
In the last decade, alcohol consumption in the US has risen by 84% in women compared with 35% in men. Furthermore, research has shown that sex- and gender-related differences may disadvantage women in terms of developing a range of psychological, cognitive, and medical problems considerably earlier in their drinking history than men, and despite consuming a similar quantity of substances. While this "telescoping" process has been acknowledged in the literature, a concomitant understanding of the underlying biobehavioral mechanisms, and an increase in the development of specific treatments tailored to women, has not occurred. In the current chapter we focus on understanding why the need for personalized, sex-specific medications is imperative, and highlight some of the potential sex-specific gonadal and stress-related adaptations underpinning the accelerated progress from controlled to compulsive drug and alcohol seeking in women. We additionally discuss the efficacy of these mechanisms as novel targets for medications development, using exogenous progesterone and guanfacine as examples. Finally, we assess some of the challenges faced and progress made in terms of developing innovative medications in women. We suggest that agents such as exogenous progesterone and adrenergic medications, such as guanfacine, may provide some efficacy in terms of attenuating stress-induced craving for several substances, as well as improving the ability to emotionally regulate in the face of stress, preferentially in women. However, to fully leverage the potential of these therapeutics in substance-using women, greater focus needs to the placed on reducing barriers to treatment and research by encouraging women into clinical trials.
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Affiliation(s)
- Helen C Fox
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - Verica Milivojevic
- The Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rajita Sinha
- The Yale Stress Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Tsumura H, Fukuda M, Kanda H. Blunted cortisol and normal sympathetic nervous system responses to an acute psychosocial stressor in internet addiction. Heliyon 2022; 8:e12142. [PMID: 36582718 PMCID: PMC9792755 DOI: 10.1016/j.heliyon.2022.e12142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/25/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Studies have demonstrated that addiction leads to blunted responses of cortisol and sympathetic nervous system (SNS) to acute stressors; however, limited studies have examined the neuroendocrine and SNS stress responses in Internet addiction (IA). To examine acute stress responses in IA, the current study recruited a total of 76 Japanese university students and staff members (51 females and 25 males, mean age = 22.4 years, SD = 4.7), and measured the salivary cortisol, salivary alpha-amylase (sAA), and blood pressure (BP) responses to an acute stressor under stress or a nonstress placebo conditions in IA and non-IA groups. The results revealed that patients with IA showed a blunted cortisol response to a stressor. In contrast, no differences were found in the sAA and BP responses between the IA and non-IA groups. These results suggest that IA may be characterized by blunted cortisol responses in acute stress settings.
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Affiliation(s)
- Hideki Tsumura
- Graduate School of Technology, Industrial and Social Sciences, Tokushima University, 1-1, Minamijosanjima, Tokushima, 770-8502, Japan,Corresponding author.
| | - Mari Fukuda
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Hideyuki Kanda
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Wang B, Shi H, Ren L, Miao Z, Wan B, Yang H, Fan X, Gustafsson JA, Sun M, Xu X. Ahi1 regulates serotonin production by the GR/ERβ/TPH2 pathway involving sexual differences in depressive behaviors. Cell Commun Signal 2022; 20:74. [PMID: 35643536 PMCID: PMC9148486 DOI: 10.1186/s12964-022-00894-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is one of the most common psychiatric diseases. The monoamine transmitter theory suggests that neurotransmitters are involved in the mechanism of depression; however, the regulation on serotonin production is still unclear. We previously showed that Ahi1 knockout (KO) mice exhibited depression-like behavior accompanied by a significant decrease in brain serotonin. METHODS In the present study, western blot, gene knockdown, immunofluorescence, dual-luciferase reporter assay, and rescue assay were used to detect changes in the Ahi1/GR/ERβ/TPH2 pathway in the brains of male stressed mice and male Ahi1 KO mice to explain the pathogenesis of depression-like behaviors. In addition, E2 levels in the blood and brain of male and female mice were measured to investigate the effect on the ERβ/TPH2 pathway and to reveal the mechanisms for the phenomenon of gender differences in depression-like behaviors. RESULTS We found that the serotonin-producing pathway-the ERβ/TPH2 pathway was inhibited in male stressed mice and male Ahi1 KO mice. We further demonstrated that glucocorticoid receptor (GR) as a transcription factor bound to the promoter of ERβ that contains glucocorticoid response elements and inhibited the transcription of ERβ. Our recent study had indicated that Ahi1 regulates the nuclear translocation of GR upon stress, thus proposing the Ahi1/GR/ERβ/TPH2 pathway for serotonin production. Interestingly, female Ahi1 KO mice did not exhibit depressive behaviors, indicating sexual differences in depressive behaviors compared with male mice. Furthermore, we found that serum 17β-estradiol (E2) level was not changed in male and female mice; however, brain E2 level significantly decreased in male but not female Ahi1 KO mice. Further, ERβ agonist LY-500307 increased TPH2 expression and 5-HT production. Therefore, both Ahi1 and E2 regulate the ERβ/TPH2 pathway and involve sexual differences in brain serotonin production and depressive behaviors. CONCLUSIONS In conclusion, although it is unclear how Ahi1 controls E2 secretion in the brain, our findings demonstrate that Ahi1 regulates serotonin production by the GR/ERβ/TPH2 pathway in the brain and possibly involves the regulation on sex differences in depressive behaviors. Video Abstract.
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Affiliation(s)
- Bin Wang
- Department of Fetology, the First Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China
- Institute of Neuroscience, Soochow University, Suzhou, 215123, People's Republic of China
| | - Haixia Shi
- Institute of Neuroscience, Soochow University, Suzhou, 215123, People's Republic of China
| | - Liyan Ren
- Institute of Neuroscience, Soochow University, Suzhou, 215123, People's Republic of China
| | - Zhigang Miao
- Institute of Neuroscience, Soochow University, Suzhou, 215123, People's Republic of China
| | - Bo Wan
- Institute of Neuroscience, Soochow University, Suzhou, 215123, People's Republic of China
| | - Hao Yang
- Department of Fetology, the First Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China
| | - Xiaotang Fan
- Department of Developmental Neuropsychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Jan-Ake Gustafsson
- Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden
- Center for Nuclear Receptors and Cell Signaling, Department of Biology and Biochemistry, University of Houston, Houston, TX, USA
| | - Miao Sun
- Department of Fetology, the First Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China.
| | - Xingshun Xu
- Institute of Neuroscience, Soochow University, Suzhou, 215123, People's Republic of China.
- Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China.
- Jiangsu Key Laboratory of Neuropsychiatric Diseases, Soochow University, Suzhou, 215123, Jiangsu, People's Republic of China.
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, People's Republic of China.
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Howard S, Keogh TM, Hughes BM, Gallagher S. Smokers show an altered hemodynamic profile to active stress: Evidence of a dysregulated stress response in young adults. Psychophysiology 2022; 59:e14081. [PMID: 35499979 PMCID: PMC9541945 DOI: 10.1111/psyp.14081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 03/03/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Siobhán Howard
- SASHLab, Centre for Social Issues Research, Department of Psychology, Faculty of Education and Health Sciences University of Limerick Limerick Ireland
- Health Research Institute University of Limerick Limerick Ireland
| | - Tracey M. Keogh
- SASHLab, Centre for Social Issues Research, Department of Psychology, Faculty of Education and Health Sciences University of Limerick Limerick Ireland
- Health Research Institute University of Limerick Limerick Ireland
| | - Brian M. Hughes
- School of Psychology National University of Ireland, Galway Galway Ireland
| | - Stephen Gallagher
- SASHLab, Centre for Social Issues Research, Department of Psychology, Faculty of Education and Health Sciences University of Limerick Limerick Ireland
- Health Research Institute University of Limerick Limerick Ireland
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Abstract
BACKGROUND Aspects of the canonical stress response differ in stimulant, opioid, and alcohol users relative to controls, and dysregulated responses to stress may contribute to continued use of these drugs. Little prior research has focused on stress responses in regular cannabis smokers. We assessed responses to a standardized laboratory social stress assay (the Trier Social Stress Task; TSST) in regular cannabis smokers (CANs) compared with controls (CONs). METHODS Healthy, non-treatment-seeking adult CANs (⩾4×/week; smoking cannabis as usual) and demographically matched CONs completed the TSST. Outcome measures were subjective mood, heart rate, and salivary cortisol. RESULTS Nineteen CANs (1 female) and 20 CONs (2 female) participated; groups were matched on trauma exposure, sex, race, and age. CANs smoked cannabis 6.4 ± 1.1 days/week. Eight CANs and one CON smoked tobacco cigarettes daily. Overall, the TSST produced expected increases in anxiety, negative mood states, cortisol, and heart rate. CANs had blunted subjective response to stress relative to CONs, but they did not differ in physiological (cortisol and cardiovascular) stress responding. CONCLUSION These results indicate that CANs have blunted mood responses to social stress, but normative physiological stress responding. Observed differences could be due to residual effects of cannabis, reluctance to endorse negative mood states, or to issues related to identifying (i.e., emotional identification) or feeling (i.e., interoception) stress-related affective states. Further research is warranted to characterize the mechanisms of these differences and assess implications for daily functioning and treatment outcomes.
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Affiliation(s)
- Richard J Xia
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northshore University Hospital/Long Island Jewish Medical Center, New York
| | - Thomas Chao
- Department of Psychology, The New School for Social Research, New York
| | - Divya Patel
- Department of Medicine, New York University School of Medicine, New York
| | - Gillinder Bedi
- New York State Psychiatric Institute, New York,Centre for Youth Mental Health, University of Melbourne, and Orygen Melbourne, Australia
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The Impact of Smoking on Clinical Outcomes after Percutaneous Coronary Intervention in Women Compared to Men. J Interv Cardiol 2021; 2021:6619503. [PMID: 33815003 PMCID: PMC7987447 DOI: 10.1155/2021/6619503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/24/2021] [Accepted: 03/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background For decades, cardiovascular diseases (CVD) have been known as men's disease. However, recent research studies showed that they have become more common in women. Smoking is a strong risk factor for CVD especially that of coronary artery disease (CAD). Several studies reported that women are more susceptible to drastic sequels of smoking than men. There is limited data regarding the impact of smoking on post-revascularization clinical events stratified by gender. This study aimed to investigate if gender significantly changes the incidence of adverse clinical outcomes after percutaneous coronary intervention (PCI) among those with history of smoking. Methods Participants were selected from two hospitals from 2003 to 2019. Among patients who had PCI (index PCI), those with stable CAD who underwent elective PCI were included. Exclusion criteria were defined as primary PCI and those with multiple prior revascularizations. Participants were followed up seeking for major adverse cardiac events (MACE) including revascularization (PCI or coronary artery bypass grafting), myocardial infarction, and coronary death in three time intervals according to the time of index PCI (short term: up to 24 hours, mid-term: 24 hours to less than 6 months, and long term: more than 6 months). Results Of the 1799 patients, 61% were men and 47.08% had history of smoking (75% of the smokers were men). At the time of index PCI, smokers were significantly younger than nonsmokers. Also, MACE were significantly higher in smokers than nonsmokers, which was particularly pronounced at the long-term interval. In the nonsmokers group, there was no difference in MACE occurrence between men and women. However, of the smokers, women showed significantly higher MACE rate compared with men peers. Conclusion Smoking makes women more prone to MACE in comparison to men among patients with stable CAD after PCI with drug-eluting stent.
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Tomioka K, Shima M, Saeki K. Association between heaviness of cigarette smoking and serious psychological distress is stronger in women than in men: a nationally representative cross-sectional survey in Japan. Harm Reduct J 2021; 18:27. [PMID: 33663543 PMCID: PMC7931554 DOI: 10.1186/s12954-021-00469-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/11/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Higher smoking prevalence in people with serious psychological distress (SPD) is well-recognized. However, gender and age differences in the association between heaviness of cigarette smoking and SPD have not been fully investigated. METHODS We used anonymized data from a nationally representative survey in Japan (33,925 men and 37,257 women). SPD was measured using the Kessler 6-item Psychological Distress Scale and defined as ≥ 13 points. Multiple logistic regression analyses stratified by gender and age-groups (20-44 years, 45-64 years, and ≥ 65 years) were used to estimate adjusted odds ratio (aOR) and 95% confidence interval (CI) for SPD. RESULTS After adjusting for sociodemographic confounders including education, equivalent household expenditures, and employment contract, women had a significant association between heavier smoking and more frequent SPD: compared to never-smokers, aORs (95% CIs) of ex-smokers, current light smokers who smoked 1-10 cigarettes per day (CPD), current moderate smokers 11-20 CPD, and current heavy smokers ≥ 21 CPD were 1.22 (0.92-1.63), 1.52 (1.25-1.84), 1.75 (1.46-2.09), and 2.22 (1.59-3.10), respectively (P-trend < 0.001). A significant positive association among women was consistent across all age-groups. Among men, there was no association between heaviness of cigarette smoking and SPD in all age-groups, and only current heavy smokers aged 20-44 years had a significantly higher OR for SPD (aOR, 1.37 [95% CI, 1.02-1.85]) than never-smokers. CONCLUSIONS There was a positive association between heaviness of cigarette smoking and SPD only among women, but not among men. For female smokers experiencing mental disorders, there is a need not only to improve mental health services but also to improve smoking-cessation support.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
| | - Midori Shima
- Nara Prefectural Health Research Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
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Abstract
Purpose of Review Substance use disorders (SUD) affect differentially women and men. Although the prevalence has been reported higher in men, those women with addictive disorders present a more vulnerable profile and are less likely to enter treatment than men. The aim of this paper is to present an overview of how sex and gender may influence epidemiology, clinical manifestations, social impact, and the neurobiological basis of these differences of women with SUD, based on human research. Recent Findings The differences in prevalence rates between genders are getting narrower; also, women tend to increase the amount of consumption more rapidly than men, showing an accelerated onset of the SUD (telescoping effect). In respect to clinical features, the most important differences are related to the risk of experience psychiatric comorbidity, the exposure to intimate partner violence, and the associated high risks in sexual and reproductive health; and those who are mothers and addicted to substances are at risk of losing the custody of children accumulating more adverse life events. Some of these differences can be based on neurobiological differences: pharmacokinetic response to substances, sensitivity to gonadal hormones, differences in neurobiological systems as glutamate, endocannabinoids, and genetic differences. Summary Specific research in women who use drugs is very scarce and treatments are not gender-sensitive oriented. For these reasons, it is important to guarantee access to the appropriate treatment of women who use drugs and a need for a gender perspective in the treatment and research of substance use disorders.
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Examining sex, adverse childhood experiences, and oxytocin on neuroendocrine reactivity in smokers. Psychoneuroendocrinology 2020; 120:104752. [PMID: 32634745 PMCID: PMC7502468 DOI: 10.1016/j.psyneuen.2020.104752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 05/12/2020] [Accepted: 05/29/2020] [Indexed: 11/21/2022]
Abstract
Adverse childhood experiences (ACE) are associated with greater neuroendocrine responses to social stress in substance users. The neuropeptide oxytocin might attenuate this relationship. Given sex differences in ACE exposure and neuroendocrine stress reactivity, it is unknown whether this association is similar for males and females. Therefore, this secondary analysis evaluated the interactive effect of sex, ACE, and acute oxytocin administration on neuroendocrine stress responses in adult cigarette smokers (N = 144). Participants completed the Adverse Childhood Experiences Questionnaire at screening and were randomized to receive intranasal oxytocin or placebo before undergoing the Trier Social Stress Task (TSST). Cortisol levels were assessed at pre- and post-medication administration and at 20 and 40 min following the TSST. Generalized linear mixed models were developed to predict post-TSST cortisol levels. Predictors included treatment assignment (placebo vs. oxytocin), sex (male vs. female), ACE (0-10 total score), pre-medication cortisol levels, and minutes since medication administration. The hypothesized three-way interaction between sex, oxytocin, and ACE scores was significant. Linear associations between ACE scores and cortisol reactivity indicated higher ACE scores were associated with attenuated cortisol response in females, regardless of treatment condition. For males, higher ACE scores were associated with heightened cortisol response, an effect that was attenuated by oxytocin. Results indicate that the association between ACE and neuroendocrine reactivity to social stress, as well as the attenuating effect of oxytocin, is differentially impacted by sex. Males with greater childhood adversity may be more likely to benefit from oxytocin's anxiolytic properties.
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Airagnes G. Stress au travail et usage chronique de benzodiazépines. Med Sci (Paris) 2020; 36:216-218. [DOI: 10.1051/medsci/2020035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yang C, Feng Y, Wang S, Han M, Wang S, Kang F, Huang X, Li J. Effect of sex differences in remifentanil requirements for inhibiting the response to a CO 2 pneumoperitoneum during propofol anesthesia: an up-and-down sequential allocation trial. BMC Anesthesiol 2020; 20:35. [PMID: 32013877 PMCID: PMC6998344 DOI: 10.1186/s12871-020-0951-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 01/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background A CO2 pneumoperitoneum during a laparoscopic procedure causes violent hemodynamic changes. However, the remifentanil required to inhibit the cardiovascular response to a CO2 pneumoperitoneum combined with propofol remains unknown. Moreover, the sex of the patient may influence the response to opioids, which can affect this requirement. The main objective of this study was to compare the required median effective concentration (EC50) of remifentanil for inhibiting the cardiovascular response to a CO2 pneumoperitoneum between female and male patients during propofol anesthesia. Methods The current study is an up-and-down sequential allocation trial. Forty-six patients with American Society of Anesthesiologists physical status I or II, a body mass index 18 to 30 kg/m2, aged 20 to 60 years, and scheduled for laparoscopic surgery were enrolled. Induction of anesthesia was performed by target-controlled infusion. The effective effect-site concentration (Ce) of propofol was 4 μg/ml. The Ce of remifentanil was initially 4 ng/ml and then adjusted to a predetermined level after I-gel laryngeal mask airway insertion. The Ce of remifentanil for each patient was determined by the response of the previous patient using the modified Dixon “up-and-down” method. The first patient received remifentanil at 5.0 ng/ml Ce, and the step size between patients was 0.5 ng/ml. Results Patients characteristics including age, body mass index, American Society of Anesthesiologists physical status, type of surgery and surgery duration, were comparable between male and female patients. The EC50 of remifentanil required to inhibit the response to a CO2 pneumoperitoneum based on the Dixon “up-and-down” method in women (4.17 ± 0.38 ng/ml) was significantly lower than that in men (5.00 ± 0.52 ng/ml) during propofol anesthesia (P = 0.01). Conclusions The EC50 of remifentanil required to inhibit the response to a CO2 pneumoperitoneum was lower in women than in men during propofol anesthesia. Trial registration The study was registered at http://www.chictr.org.cn (ChiCTR-IOR-17011906, 8th, July, 2017).
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Affiliation(s)
- Chengwei Yang
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Yuanyuan Feng
- Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230031, China
| | - Sheng Wang
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Mingming Han
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Song Wang
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Fang Kang
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Xiang Huang
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Juan Li
- Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China.
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McClure EA, Baker NL, Gray KM, Hood CO, Tomko RL, Carpenter MJ, Ramakrishnan VR, Buchanan CJ, Saladin ME. The influence of gender and oxytocin on stress reactivity, cigarette craving, and smoking in a randomized, placebo-controlled laboratory relapse paradigm. Psychopharmacology (Berl) 2020; 237:543-555. [PMID: 31792646 PMCID: PMC7024045 DOI: 10.1007/s00213-019-05392-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/04/2019] [Indexed: 12/11/2022]
Abstract
RATIONALE Female cigarette smokers tend to show greater cessation failure compared with males. Variables that contribute to the maintenance of smoking, including stress and craving, may differentially impact male and female smokers. Novel pharmacotherapies, such as oxytocin, may attenuate stress reactivity and craving in smokers, but work in this area is limited. OBJECTIVES This study assessed the influence of gender and oxytocin on stress reactivity, craving, and smoking in a randomized, placebo-controlled laboratory relapse paradigm. METHODS Male and female adult cigarette smokers (ages 18-45) were enrolled (women oversampled 2:1) and completed a laboratory session, in which intranasal oxytocin or placebo was administered followed by a laboratory social stress task. The role of gender and oxytocin were assessed on measures of stress reactivity, cigarette craving, latency to smoke in a resistance task, subjective responses to smoking, and ad-libitum smoking. RESULTS Participants (N = 144) had a mean age of 31 were 63% female and 56% White. Following stress induction, female smokers evidenced greater subjective stress than males, though males demonstrated greater neuroendocrine reactivity and smoking intensity than females. No gender differences were demonstrated for craving. Oxytocin did not attenuate any aspect of stress reactivity, craving, smoking, or subjective responses to smoking compared with placebo. CONCLUSIONS Gender differences in stress reactivity were shown in the hypothesized direction, but oxytocin appeared to exert little impact on subjective or behavioral metrics. Results highlight the complex relationship between gender, stress, and smoking, as well as the implications for oxytocin as a potential pharmacotherapy for smoking cessation.
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Affiliation(s)
- Erin A McClure
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Nathaniel L Baker
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Caitlyn O Hood
- Department of Psychology, College of Arts & Sciences, University of Kentucky, Lexington, KY, USA
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Viswanathan R Ramakrishnan
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Cole J Buchanan
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michael E Saladin
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
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Kan Y, Duan H, Chen X, Wang X, Xue W, Hu W. Attentional blink affected by acute stress in women: The role of affective stimuli and attentional resources. Conscious Cogn 2019; 75:102796. [PMID: 31374428 DOI: 10.1016/j.concog.2019.102796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/15/2019] [Accepted: 07/21/2019] [Indexed: 12/27/2022]
Abstract
The role of attentional resources and affective stimuli on temporal selective attention in the rapid serial visual presentation (RSVP) paradigm under acute stress was explored among women. Seventy-three female undergraduates were randomly assigned to the Trier Social Stress Test (TSST) group or control group. We found that when the first target was negative, stress increased its accuracy. Stress promoted the recognition of neutral target two (T2) only at lag2, and there was no interaction with theemotionality of target one (T1). In addition, the accumulated effect of stress enhanced temporal selective attention, predominately 20-40 min after the TSST task; cortisol concentration during this time period could significantly predict AB task performance. In summary, when attentional resources were severely insufficient, individuals under stress were more able to focus on the current target; that is, stress facilitated selective attention. A novel result was that participants were exempt from the affective influence of previous targets, which may have been caused by activation of the autonomic nervous system and gender differences.
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Affiliation(s)
- Yuecui Kan
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China; School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Haijun Duan
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China.
| | - Xitong Chen
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China
| | - Xuewei Wang
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China
| | - Wenlong Xue
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China
| | - Weiping Hu
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China; Collaborative Innovation Center of Assessment Towards Basic Education Quality, Beijing Normal University, Beijing, China
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Cortisol stress response in psychosis from the high-risk to the chronic stage: a systematic review. Ir J Psychol Med 2019; 36:305-315. [PMID: 31317845 DOI: 10.1017/ipm.2019.27] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We review studies of whether cortisol levels following psychosocial stress exposure differ between patients with psychosis and healthy control subjects. METHODS Original research published between 1993 and February 2019 was included in the literature search. Studies that used experimentally induced psychosocial stress and reported stress response measures of plasma or saliva cortisol levels in patients at any stage of illness (i.e. high risk, first episode and chronic phase) were included. RESULTS A total of 17 studies were included. Although there was evidence of inconsistencies in measures, we observed moderate evidence of an association with stress-induced cortisol blunting response across studies. CONCLUSIONS This review highlights recent evidence of blunting of cortisol response following experimentally induced psychosocial stress. While there was some evidence of this blunted response across illness types and stages, the strongest evidence was observed for those with chronic schizophrenia. Due to the low number of studies, in particular in bipolar disorder, much work is still needed to accurately characterise the biological effects of stress in psychosis.
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Schweinhart A, Cargill V, Brady K, Hall K, Spencer E, Clayton J. Addressing Health Challenges of Women Across the Life Course: Summary of the Women's Health 2018 Preconference Symposium. J Womens Health (Larchmt) 2019; 28:741-746. [PMID: 31219766 DOI: 10.1089/jwh.2019.29027.pcss] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although the United States is often ahead in both research and health care fields, it lags behind peer countries in many population health indicators. To address these complex health problems that often reflect the intersection of many socioeconomic and health issues, it is essential that scientists work collaboratively across distinct disciplines. Women's health is but one area which can benefit from such an approach given the multifaceted and complex issues underlying the different aspects of women's health research. The National Institutes of Health (NIH) Office of Research on Women's Health (ORWH) and the Office of Women's Health of the U.S. Food and Drug Administration (FDA) cosponsored a preconference symposium at the Women's Health 2018 Conference, held in May in Arlington, VA, to highlight interdisciplinary approaches to research, how researchers can work collaboratively, and how to apply multifaceted approaches to complex real-world problems. Three speakers presented information on a range of subjects related to the health of women across the life course, including the distinction between multidisciplinary, interdisciplinary, and transdisciplinary approaches; the science behind Team Science and how its findings apply to working collaboratively; and gender inequalities in the opioid epidemic. This article summarizes the major points of the presentations and the subsequent discussions.
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Affiliation(s)
- April Schweinhart
- 1 PIRE Louisville Center, Pacific Institute for Research and Evaluation, Louisville, Kentucky
| | - Victoria Cargill
- 2 Office of Research on Women's Health, National Institutes of Health, Bethesda, Maryland
| | - Kathleen Brady
- 3 Office of Research, Medical University of South Carolina, Charleston, South Carolina
| | - Kara Hall
- 4 National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Elizabeth Spencer
- 2 Office of Research on Women's Health, National Institutes of Health, Bethesda, Maryland
| | - Janine Clayton
- 2 Office of Research on Women's Health, National Institutes of Health, Bethesda, Maryland
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Gilmore AK, Guille C, Baker NL, Brady KT, Hahn CK, Davis CM, McCauley JL, Back SE. Gender differences in subjective stress and neuroendocrine response to a stress task among individuals with opioid dependence: A pilot study. Addict Behav 2019; 92:148-154. [PMID: 30640146 PMCID: PMC6499664 DOI: 10.1016/j.addbeh.2018.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Opioid dependence is a significant public health problem in the United States and the number of opioid overdose deaths among women has increased dramatically in comparison to men in the last few years. In this context, understanding the biological mechanisms underlying gender differences in vulnerability to opioid dependence is essential. METHODS The current pilot study examined gender differences in subjective stress, heart rate (HR), and cortisol/dephydroepiandrosterone (DHEA) response to a laboratory stressor (Trier Social Stress Test; TSST) or a no-stress condition, and drug cue paradigm among men (n = 21) and women (n = 18) with opioid dependence. RESULTS Significant group (TSST vs. no stress) differences emerged in self-reported stress [F(1,35) = 23.8, p < .001], HR [F(1,31) = 12.3; p = .001] and cortisol (F1,34 = 5.0; p = .032) response, such that the TSST group was more reactive than the no-stress group. Women reported greater subjective stress [F(1,35) = 6.5, p <= .015] in response to the TSST compared to men. However, men evidenced marginally greater cortisol and DHEA responses to the TSST compared to women [F(1,34) = 2.7; p = .113 and F(1,31) = 3.4; p = .073, respectively]. CONCLUSIONS Although women with opioid dependence reported greater subjective stress when exposed to a laboratory stress paradigm as compared to men, the neuroendocrine response was more robust in men. This pattern was similar to gender findings in men and women with cocaine and tobacco use disorders. The blunted cortisol combined with an increased subjective response among women may be a sign of HPA axis dysregulation which could increase vulnerability to relapse in women.
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Affiliation(s)
- Amanda K Gilmore
- College of Nursing, Medical University of South Carolina, United States; Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States.
| | - Constance Guille
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Nathaniel L Baker
- Department of Public Health Sciences, Medical University of South Carolina, United States
| | - Kathleen T Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Christine K Hahn
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Callah M Davis
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Jenna L McCauley
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Sudie E Back
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
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18
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Moran LM, Kowalczyk WJ, Phillips KA, Vahabzadeh M, Lin JL, Mezghanni M, Epstein DH, Preston KL. Sex differences in daily life stress and craving in opioid-dependent patients. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 44:512-523. [PMID: 29641291 DOI: 10.1080/00952990.2018.1454934] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Responses to stress and drug craving differ between men and women. Differences in the momentary experience of stress in relation to craving are less well-understood. OBJECTIVES Using ecological momentary assessment (EMA), we examined sex differences in real-time in two areas: (1) causes and contexts associated with stress, and (2) the extent to which stress and drug cues are associated with craving. METHODS Outpatients on opioid-agonist treatment (135 males, 47 females) reported stress, craving, and behavior on smartphones for 16 weeks. They initiated an entry each time they felt more stressed than usual (stress event) and made randomly prompted entries 3 times/day. In stress-event entries, they identified the causes and context (location, activity, companions), and rated stress and craving severity. RESULTS The causes reported for stress events did not differ significantly by sex. Women reported arguing and being in a store more often during stress events, and men reported working more often during stress events, compared to base rates (assessed via random prompts). Women showed a greater increase in opioid craving as a function of stress (p < 0.0001) and had higher stress ratings in the presence of both stress and drug cues relative to men (p < 0.01). Similar effects were found for cocaine craving in men (p < 0.0001). CONCLUSION EMA methods provide evidence based on real-time activities and moods that opioid-dependent men and women experience similar contexts and causes for stress but differ in stress- and cue-induced craving. These findings support sex-based tailoring of treatment, but because not all participants conformed to the overall pattern of sex differences, any such tailoring should also consider person-level differences.
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Affiliation(s)
- Landhing M Moran
- a Clinical Pharmacology and Therapeutics Research Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA
| | - William J Kowalczyk
- a Clinical Pharmacology and Therapeutics Research Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA.,b Department of Psychology , Hartwick College , Oneonta , NY , USA
| | - Karran A Phillips
- a Clinical Pharmacology and Therapeutics Research Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA
| | - Massoud Vahabzadeh
- c Biomedical Informatics Section, Administrative Management Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA
| | - Jia-Ling Lin
- c Biomedical Informatics Section, Administrative Management Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA
| | - Mustapha Mezghanni
- c Biomedical Informatics Section, Administrative Management Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA
| | - David H Epstein
- a Clinical Pharmacology and Therapeutics Research Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA
| | - Kenzie L Preston
- a Clinical Pharmacology and Therapeutics Research Branch , National Institute on Drug Abuse, Intramural Research Center , Baltimore , MD , USA
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19
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Carlson SC, Allen AM, Allen SS, al’Absi M. Differences in mood and cortisol by menstrual phase during acute smoking abstinence: A within-subject comparison. Exp Clin Psychopharmacol 2017; 25:338-345. [PMID: 29048182 PMCID: PMC5687826 DOI: 10.1037/pha0000142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is evidence that smoking-cessation success differs by menstrual phase and sex hormone levels; however, the biological mechanisms underlying these differences are not clear. One possibility is that variation in cortisol throughout the menstrual cycle and early smoking abstinence may be partly responsible. The goal of this secondary-data analysis was to conduct a within-subject examination of the effects of menstrual phase and smoking abstinence on salivary cortisol and mood. Data are from a controlled crossover trial, in which participants completed 2 testing weeks during their follicular and luteal phases. During each testing week, they smoked ad libitum during the first 2 days and then abstained from smoking during the next 4 days. Salivary cortisol and self-reported mood were collected 5 times on the day before abstinence (D0) and the first (D1) and third (D3) days of abstinence. Participants (n = 125) were, on average (mean ± SE), 29.4 ± 0.6 years old and smoked 12.6 ± 0.5 cigarettes/day. Whereas salivary cortisol varied significantly by time of day (p < .0001) and smoking abstinence (D0 to D1: β = -0.06 ± 0.02 log[ng/ml], p = .0074 and D3: β = -0.05 ± 0.02 log[ng/ml], p = .0117). no significant differences by menstrual phase were observed. Craving increased from D0 to D1 during the follicular phase but decreased in the luteal phase (+0.31 vs. -0.15, β = 0.46 ± 0.19, p = .0162). This work builds on prior observations in demonstrating a decrease in cortisol in acute smoking abstinence and menstrual phase differences in craving. The results provide further evidence that cortisol levels do not vary by menstrual phase in the first few days of abstinence. (PsycINFO Database Record
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Affiliation(s)
- Samantha C. Carlson
- Department of Family Medicine & Community Health, Medical
School, University of Minnesota, 717 Delaware Street SE, Suite 454,
Minneapolis, MN 55414
| | - Alicia M. Allen
- Department of Family & Community Medicine, College of
Medicine, University of Arizona, 3950 South Country Club Drive, Suite 330,
Tucson, AZ 85742
| | - Sharon S. Allen
- Department of Family Medicine & Community Health, Medical
School, University of Minnesota, 420 Delaware Street SE, Room A682,
Minneapolis, MN 55455
| | - Mustafa al’Absi
- Department of Behavioral Sciences, Medical School, University of
Minnesota, Duluth, 1035 University Drive, 236 SMed, D601A, Duluth, MN
55812
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20
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Kotlyar M, Lindgren BR, Vuchetich JP, Le C, Mills AM, Amiot E, Hatsukami DK. Timing of nicotine lozenge administration to minimize trigger induced craving and withdrawal symptoms. Addict Behav 2017; 71:18-24. [PMID: 28235705 DOI: 10.1016/j.addbeh.2017.02.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/03/2017] [Accepted: 02/09/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Smokers are often advised to use nicotine lozenge when craving or withdrawal symptoms occur. This may be too late to prevent lapses. This study assessed if nicotine lozenge use prior to a common smoking trigger can minimize trigger induced increases in craving and withdrawal symptoms. METHODS Eighty-four smokers completed two laboratory sessions in random order. At one session, nicotine lozenge was given immediately after a stressor (to approximate current recommended use - i.e., after craving and withdrawal symptoms occur); at the other session subjects were randomized to receive nicotine lozenge at time points ranging from immediately to 30min prior to the stressor. Withdrawal symptoms and urge to smoke were measured using the Minnesota Nicotine Withdrawal Scale and the Questionnaire of Smoking Urges (QSU). RESULTS Relative to receiving lozenge after the stressor, a smaller increase in pre-stressor to post-stressor withdrawal symptom scores occurred when lozenge was used immediately (p=0.03) and 10min prior (p=0.044) to the stressor. Results were similar for factors 1 and 2 of the QSU when lozenge was used immediately prior to the stressor (p<0.03) and for factor 1 of the QSU when lozenge was used 10min prior to the stressor (p=0.028). Absolute levels of post-stressor withdrawal symptom and urge to smoke severity were lower when lozenge was given prior to versus after a stressor. CONCLUSIONS Administering the nicotine lozenge prior to a smoking trigger can decrease trigger induced craving and withdrawal symptoms. Future studies are needed to determine if such use would increase cessation rates. Clinicaltrials.gov # NCT01522963.
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Affiliation(s)
- Michael Kotlyar
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-153 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, United States; Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, United States.
| | - Bruce R Lindgren
- Masonic Cancer Center, University of Minnesota, Mayo Mail Code 806 420 Delaware Street SE, Minneapolis, MN 55455, United States
| | - John P Vuchetich
- Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, United States
| | - Chap Le
- Masonic Cancer Center, University of Minnesota, Mayo Mail Code 806 420 Delaware Street SE, Minneapolis, MN 55455, United States
| | - Anne M Mills
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-153 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, United States
| | - Elizabeth Amiot
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-153 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, United States
| | - Dorothy K Hatsukami
- Department of Psychiatry, University of Minnesota, 2450 Riverside Ave, Minneapolis, MN 55454, United States; Tobacco Research Programs, University of Minnesota, 717 Delaware Street SE, Minnneapolis, MN 55414, United States
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Kotlyar M, Thuras P, Hatsukami DK, al'Absi M. Sex differences in physiological response to the combination of stress and smoking. Int J Psychophysiol 2017; 118:27-31. [PMID: 28549539 DOI: 10.1016/j.ijpsycho.2017.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/29/2017] [Accepted: 05/22/2017] [Indexed: 11/16/2022]
Abstract
Stressful situations are among the most commonly cited smoking triggers. Smoking and stress exposure each individually increase cardiovascular and hypothalamic-pituitary-adrenal measures with larger increases occurring when stress and smoking are combined. In this analysis, sex differences in the physiological response to the combination of stress and smoking are examined. Smokers (36 males; 34 females) completed a laboratory session in which systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), plasma epinephrine (Epi), norepinephrine and cortisol concentrations were measured at rest, while smoking a cigarette, during a speech task occurring immediately after smoking and at several time-points following the stressor. Significant period by sex effects were observed for HR, SBP, DBP and Epi but not for cortisol or norepinephrine concentrations. For SBP (p=0.002), the increase between resting and speech were larger in men than in women, primarily due to a larger increase between smoking and speech occurring in men. A similar pattern was observed for DBP and Epi with a significantly larger Epi increase from smoking to speech observed in men than in women (p=0.016). A different pattern emerged for HR - the total increase was larger in women (p<0.001), due to a larger rest to smoking increase (p<0.001). In most measures therefore, overall increases were greater in men than women, primarily due to larger smoking to speech increases. Additional research is needed to determine the clinical implications of these results as they apply to sex difference in smoking cessation success rates and in the cardiovascular risks of smoking.
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Affiliation(s)
- Michael Kotlyar
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Twin Cities, Minneapolis, MN, United States; Department of Psychiatry, University of Minnesota, Twin Cities. Minneapolis, MN, United States.
| | - Paul Thuras
- Department of Psychiatry, University of Minnesota, Twin Cities. Minneapolis, MN, United States
| | - Dorothy K Hatsukami
- Department of Psychiatry, University of Minnesota, Twin Cities. Minneapolis, MN, United States
| | - Mustafa al'Absi
- Department of Biobehavioral Health and Family Medicine, University of Minnesota Medical School, Duluth, United States
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22
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Kim K, Park H. Gender differences in the association between self-reported stress and cigarette smoking in Korean adolescents. Tob Induc Dis 2016; 14:19. [PMID: 27274720 PMCID: PMC4891905 DOI: 10.1186/s12971-016-0084-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 05/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to examine the relationship between stress and smoking among Korean adolescents, as well as the influence of gender on this relationship. Methods A cross-sectional study was conducted using data from 3930 adolescents aged 12–18 years, collected in the 2007–2012 Korea National Health and Nutrition Examination Surveys. Results An increased level of self-reported stress was positively associated with increasing levels of smoking in both girls and boys (p for trend < 0.001). After adjusting for age, the odds ratios of smoking among girls and boys reporting very high levels of stress were 15.99 (95 % confidence interval (CI), 4.17–61.30) and 2.34 (95 % CI, 1.07–5.11), respectively, compared with those who reported low levels of stress. Conclusions This study found a statistically significant association between stress and smoking among Korean adolescents and this association was stronger in girls than boys. Further research is needed to understand more fully the link between stress and smoking in adolescents, with particular attention to sex differences.
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Affiliation(s)
- Kisok Kim
- College of Pharmacy, Keimyung University, Daegu, 42601 Republic of Korea
| | - Hyejin Park
- Department of International Medical Management, Catholic University of Daegu, Kyungbuk, 38430 Republic of Korea
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Herbison CE, Henley D, Marsh J, Atkinson H, Newnham JP, Matthews SG, Lye SJ, Pennell CE. Characterization and novel analyses of acute stress response patterns in a population-based cohort of young adults: influence of gender, smoking, and BMI. Stress 2016; 19:139-50. [PMID: 26809721 DOI: 10.3109/10253890.2016.1146672] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dysregulation of the biological stress response system has been implicated in the development of psychological, metabolic, and cardiovascular disease. Whilst changes in stress response are often quantified as an increase or decrease in cortisol levels, three different patterns of stress response have been reported in the literature for the Trier Social Stress Test (TSST) (reactive-responders (RR), anticipatory-responders (AR) and non-responders (NR)). However, these have never been systematically analyzed in a large population-based cohort. The aims of this study were to examine factors that contribute to TSST variation (gender, oral contraceptive use, menstrual cycle phase, smoking, and BMI) using traditional methods and novel analyses of stress response patterns. We analyzed the acute stress response of 798, 18-year-old participants from a community-based cohort using the TSST. Plasma adrenocorticotrophic hormone, plasma cortisol, and salivary cortisol levels were quantified. RR, AR, and NR patterns comprised 56.6%, 26.2%, and 17.2% of the cohort, respectively. Smokers were more likely to be NR than (RR or AR; adjusted, p < 0.05). Overweight and obese subjects were less likely to be NR than the other patterns (adjusted, p < 0.05). Males were more likely to be RR than NR (adjusted, p = 0.05). In addition, we present a novel AUC measure (AUCR), for use when the TSST baseline concentration is higher than later time points. These results show that in a young adult cohort, stress-response patterns, in addition to other parameters vary with gender, smoking, and BMI. The distribution of these patterns has the potential to vary with adult health and disease and may represent a biomarker for future investigation.
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Affiliation(s)
- Carly E Herbison
- a School of Women's and Infants' Health, The University of Western Australia , Perth , WA , Australia
| | - David Henley
- b School of Medicine and Pharmacology, The University of Western Australia , Perth , WA , Australia
- c Department of Endocrinology and Diabetes , Sir Charles Gairdner Hospital , Perth , WA , Australia
| | - Julie Marsh
- a School of Women's and Infants' Health, The University of Western Australia , Perth , WA , Australia
| | - Helen Atkinson
- a School of Women's and Infants' Health, The University of Western Australia , Perth , WA , Australia
| | - John P Newnham
- a School of Women's and Infants' Health, The University of Western Australia , Perth , WA , Australia
| | - Stephen G Matthews
- d Department of Physiology , Department of Obstetrics and Gynecology & Department of Medicine, University of Toronto , Toronto , ON , Canada , and
| | - Stephen J Lye
- e Mount Sinai Hospital, The Lunenfeld-Tanenbaum Research Institute , Toronto , ON , Canada
| | - Craig E Pennell
- a School of Women's and Infants' Health, The University of Western Australia , Perth , WA , Australia
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24
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Back SE, Gros DF, Price M, LaRowe S, Flanagan J, Brady KT, Davis C, Jaconis M, McCauley JL. Laboratory-induced stress and craving among individuals with prescription opioid dependence. Drug Alcohol Depend 2015; 155:60-7. [PMID: 26342626 PMCID: PMC4582004 DOI: 10.1016/j.drugalcdep.2015.08.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 07/10/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Stress and conditioned drug cues have been implicated in the initiation, maintenance and relapse to substances of abuse. Although stress and drug cues are often encountered together, little research exists on whether stress potentiates the response to drug cues. METHOD Participants (N=75) were 39 community recruited individuals with current prescription opioid (PO) dependence and 36 healthy controls. Participants stayed overnight in the hospital for one night and then completed laboratory testing the following morning. During laboratory testing, participants were randomly assigned to a stress task (Trier Social Stress Task; TSST) or a no-stress condition. Following the stress manipulation, all participants completed a PO cue paradigm. Immediately before and after the stress and cue tasks, the following were assessed: subjective (stress, craving, anger, sadness, happiness), physiological (heart rate, blood pressure, galvanic skin response), and neuroendocrine responses (cortisol and dehydroepiandrosterone). RESULTS Internal validity of the stress task was demonstrated, as evidenced by significantly higher subjective stress, as well as cortisol, heart rate and blood pressure in the TSST compared to the no-stress group. Individuals with PO dependence evidenced significantly greater reactivity to the stress task than controls. Craving increased significantly in response to the drug cue task among PO participants. No stress×cue interaction was observed. CONCLUSIONS In this study, heightened stress reactivity was observed among individuals with PO dependence. Exposure to acute stress, however, did not potentiate craving in response to conditioned drug cues.
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Affiliation(s)
- Sudie E. Back
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC,Corresponding Author: Sudie E. Back Ph.D., Department of Psychiatry and Behavioral Sciences, Clinical Neuroscience Division, Medical University of South Carolina, 67 President St., P.O. Box 250861, Charleston, SC 29425. Telephone (843) 792-9383, Fax (843) 792-3514.
| | - Daniel F. Gros
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Matthew Price
- Department of Psychology, University of Vermont, Burlington, VT
| | - Steve LaRowe
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Julianne Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Kathleen T. Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Charles Davis
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Maryanne Jaconis
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Jenna L. McCauley
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
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Abstract
Alcohol and substance use, until recently, were believed to be a predominantly male phenomenon. Only in the last few decades, attention has shifted to female drug use and its repercussions in women. As the numbers of female drug users continue to rise, studies attempt to understand gender-specific etiological factors, phenomenology, course and outcome, and issues related to treatment with the aim to develop more effective treatment programs. Research has primarily focused on alcohol and tobacco in women, and most of the literature is from the Western countries with data from developing countries like India being sparse. This review highlights the issues pertinent to alcohol and substance use in women with a special focus to the situation in India.
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Affiliation(s)
- Rakesh Lal
- Department of Psychiatry and National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - Koushik Sinha Deb
- Department of Psychiatry and National Drug Dependence Treatment Centre, AIIMS, New Delhi, India
| | - Swati Kedia
- Centre for Addiction Medicine, NIMHANS, Bengaluru, Karnataka, India
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McKee SA, Weinberger AH. Innovations in translational sex and gender-sensitive tobacco research. Nicotine Tob Res 2015; 17:379-81. [PMID: 25762746 PMCID: PMC4481708 DOI: 10.1093/ntr/ntu335] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sherry A McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT;
| | - Andrea H Weinberger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT; Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
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Carr AR, Scully A, Webb M, Felmingham KL. Gender differences in salivary alpha-amylase and attentional bias towards negative facial expressions following acute stress induction. Cogn Emot 2015; 30:315-24. [DOI: 10.1080/02699931.2014.999748] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sex differences in the stress response in SD rats. Behav Brain Res 2015; 284:231-7. [PMID: 25687843 DOI: 10.1016/j.bbr.2015.02.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 12/16/2022]
Abstract
Sex differences play an important role in depression, the basis of which is an excessive stress response. We aimed at revealing the neurobiological sex differences in the same study in acute- and chronically-stressed rats. Female Sprague-Dawley (SD) rats were randomly divided into 6 groups: chronic unpredictable mild stress (CUMS), acute foot shock (FS) and controls, animals in all 3 groups were sacrificed in proestrus or diestrus. Male SD rats were randomly divided into 3 groups: CUMS, FS and controls. Comparisons were made of behavioral changes in CUMS and control rats, plasma levels of corticosterone (CORT), testosterone (T) and estradiol (E2), and of the hypothalamic mRNA-expression of stress-related molecules, i.e. estrogen receptor α and β, androgen receptor, aromatase, mineralocorticoid receptor, glucocorticoid receptor, corticotropin-releasing hormone, arginine vasopressin and oxytocin. CUMS resulted in disordered estrus cycles, more behavioral and hypothalamic stress-related molecules changes and a stronger CORT response in female rats compared with male rats. Female rats also showed decreased E2 and T levels after FS and CUMS, while male FS rats showed increased E2 and male CUMS rats showed decreased T levels. Stress affects the behavioral, endocrine and the molecular response of the stress systems in the hypothalamus of SD rats in a clear sexual dimorphic way, which has parallels in human data on stress and depression.
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Ginty AT, Jones A, Carroll D, Roseboom TJ, Phillips AC, Painter R, de Rooij SR. Neuroendocrine and cardiovascular reactions to acute psychological stress are attenuated in smokers. Psychoneuroendocrinology 2014; 48:87-97. [PMID: 24997350 DOI: 10.1016/j.psyneuen.2014.05.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 05/09/2014] [Accepted: 05/30/2014] [Indexed: 02/07/2023]
Abstract
A number of studies have now examined the association between smoking and the magnitude of physiological reactions to acute psychological stress. However, no large-scale study has demonstrated this association incorporating neuroendocrine in addition to cardiovascular reactions to stress. The present study compared neuroendocrine and cardiovascular reactions to acute stress exposure in current smokers, ex-smokers, and those who had never smoked in a large community sample. Salivary cortisol, systolic and diastolic blood pressure, heart rate and frequency components of systolic blood pressure and heart rate variability were measured at rest and during exposure to a battery of three standardized stress tasks in 480 male and female participants from the Dutch Famine Birth Cohort Study. Current smokers had significantly lower cortisol, systolic and diastolic blood pressure, and heart rate reactions to stress. They also exhibited smaller changes in the low frequency band of blood pressure variability compared to ex- and never smokers. There were no group differences in stress related changes in overall heart rate variability as measured by the root mean square of successive interbeat interval differences or in the high frequency band of heart rate variability. In all cases, effects remained significant following statistical adjustment for a host of variables likely to be associated with reactivity and/or smoking. In secondary analyses, there were no significant associations between lifetime cigarette consumption or current consumption and stress reactivity. In conclusion, compared to non-smokers and ex-smokers, current smokers exhibited attenuated neuroendocrine and cardiovascular reactions to acute psychological stress. Among smokers and ex-smokers, there is no evidence that lifetime exposure was associated with physiological reactions to acute stress, nor that current levels of cigarette consumption were associated with reactivity. It is possible, then, that attenuated stress reactivity may be a marker for an increased susceptibility to take up and/or maintain smoking behaviour once initiated.
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Affiliation(s)
- Annie T Ginty
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
| | - Alexander Jones
- University College London Institute of Cardiovascular Science, London, United Kingdom
| | - Douglas Carroll
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Tessa J Roseboom
- Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna C Phillips
- School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Rebecca Painter
- Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Smith PH, Rose JS, Mazure CM, Giovino GA, McKee SA. What is the evidence for hardening in the cigarette smoking population? Trends in nicotine dependence in the U.S., 2002-2012. Drug Alcohol Depend 2014; 142:333-40. [PMID: 25064023 PMCID: PMC4158455 DOI: 10.1016/j.drugalcdep.2014.07.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 06/23/2014] [Accepted: 07/04/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND It is unclear whether declines in cigarette smoking in the U.S. have resulted in a hardened population of "hardcore" smokers. We studied changes in nicotine dependence severity from 2002 to 2012, using data from the National Survey on Drug Use and Health. METHODS We used generalized non-linear factor analysis to examine whether individual Nicotine Dependence Syndrome Scale (NDSS) items functioned differently over time, and whether average NDSS scores changed in a sample of 130,637 current smokers. We also examined trends for individual NDSS sub-scales and whether trends were moderated by tobacco consumption and socio-demographic factors. RESULTS Consumption levels and dependence severity both declined over the study period. This decline was driven by priority (e.g., avoiding smoke-free locations) and tolerance dimensions of dependence, while drive (e.g., craving and smoking to relieve negative affect) and continuity (e.g., stability) of smoking did not change. Declines for tolerance were greatest among those without serious psychological distress and among middle-aged smokers. Drive and continuity increased among women and low income smokers. CONCLUSIONS We did not find evidence of hardening at the population level for smokers in the U.S., 2002-2012. However, there is evidence of hardening when considering drive and continuity-related nicotine dependence among women and low-income smokers, suggesting these sub-groups are experiencing greater severity of craving, smoking to relieve negative affect, and regularity of smoking despite reduced consumption.
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Affiliation(s)
- Philip H. Smith
- Department of Psychiatry, Yale University, 2 Church Street South, Suite 109, New Haven, CT 06519, United States
| | - Jennifer S. Rose
- Department of Psychology, Wesleyan University, 207 High St., Middletown, CT 06459
| | - Carolyn M. Mazure
- Department of Psychiatry, Yale University, 2 Church Street South, Suite 109, New Haven, CT 06519, United States,Women’s Health Research at Yale
| | - Gary A. Giovino
- Community Health and Health Behavior, University at Buffalo, SUNY, Buffalo, NY 14214
| | - Sherry A. McKee
- Department of Psychiatry, Yale University, 2 Church Street South, Suite 109, New Haven, CT 06519, United States,Women’s Health Research at Yale
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Dutra LM, Williams DR, Kawachi I, Okechukwu CA. Racial and non-racial discrimination and smoking status among South African adults 10 years after apartheid. Tob Control 2014; 23:e114-21. [PMID: 24789604 DOI: 10.1136/tobaccocontrol-2013-051478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Despite a long history of discrimination and persisting racial disparities in smoking prevalence, little research exists on the relationship between discrimination and smoking in South Africa. METHODS This analysis examined chronic (day-to-day) and acute (lifetime) experiences of racial and non-racial (eg, age, gender or physical appearance) discrimination and smoking status among respondents to the South Africa Stress and Health study. Logistic regression models were constructed using SAS-Callable SUDAAN. RESULTS Both chronic racial discrimination (RR=1.45, 95% CI 1.14 to 1.85) and chronic non-racial discrimination (RR=1.69, 95% CI 1.37 to 2.08) predicted a higher risk of smoking, but neither type of acute discrimination did. Total (sum of racial and non-racial) chronic discrimination (RR=1.46, 95% CI 1.20 to 1.78) and total acute discrimination (RR=1.28, 95% CI 1.01 to 1.60) predicted a higher risk of current smoking. CONCLUSIONS Racial and non-racial discrimination may be related to South African adults' smoking behaviour, but this relationship likely varies by the timing and frequency of these experiences. Future research should use longitudinal data to identify the temporal ordering of the relationships studied, include areas outside of South Africa to increase generalisability and consider the implications of these findings for smoking cessation approaches in South Africa.
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Affiliation(s)
- Lauren M Dutra
- The Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Cassandra A Okechukwu
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
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Hammond CJ, Mayes LC, Potenza MN. Neurobiology of adolescent substance use and addictive behaviors: treatment implications. ADOLESCENT MEDICINE: STATE OF THE ART REVIEWS 2014; 25:15-32. [PMID: 25022184 PMCID: PMC4446977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Psychoactive substance and nonsubstance/behavioral addictions are major public health concerns associated with significant societal cost. Adolescence is a period of dynamic biologic, psychological, and behavioral changes. Adolescence is also associated with an increased risk for substance use and addictive disorders. During adolescence, developmental changes in neural circuitry of reward processing, motivation, cognitive control, and stress may contribute to vulnerability for increased levels of engagement in substance use and nonsubstance addictive behaviors. Current biologic models of adolescent vulnerability for addictions incorporate existing data on allostatic changes in function and structure of the midbrain dopaminergic system, stress-associated neuroplasticity, and maturational imbalances between cognitive control and reward reactivity. When characterizing adolescent vulnerability, identifying subgroups of adolescents at high risk for addictive behaviors is a major goal of the addiction field. Genetics, epigenetics, and intermediate phenotypes/endophenotypes may assist in characterizing children and adolescents at risk. Improved understanding of the neurobiology of adolescence and addiction vulnerability has the potential to refine screening, enhance prevention and intervention strategies, and inform public policy.
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Affiliation(s)
- Christopher J. Hammond
- Child Study Center, Yale University, School of Medicine, New Haven, Connecticut
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut
| | - Linda C. Mayes
- Child Study Center, Yale University, School of Medicine, New Haven, Connecticut
| | - Marc N. Potenza
- Child Study Center, Yale University, School of Medicine, New Haven, Connecticut
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut
- Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut
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Li S, Zou S, Coen K, Funk D, Shram MJ, Lê A. Sex differences in yohimbine-induced increases in the reinforcing efficacy of nicotine in adolescent rats. Addict Biol 2014; 19:156-64. [PMID: 22784103 DOI: 10.1111/j.1369-1600.2012.00473.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Stress is an important factor in the initiation and maintenance of smoking in adolescents. Women are more vulnerable to the development of addiction to smoking and have more difficulty quitting than men. Women also showe enhanced responses to stress. Despite these differences, no work has been done examining the effects of stress on the reinforcing efficacy of self-administered nicotine in adolescent rats, or if there are sex differences. Male and female adolescent Long Evans rats were trained to self-administer one of three different intravenous doses of nicotine (7.5, 15, 30 μg/kg/infusion) first on fixed ratio, and then on a progressive ratio (PR) schedule beginning on postnatal day 33. The effect of the pharmacological stressor yohimbine (0.3, 0.6 mg/kg, i.p.) on the reinforcing efficacy of nicotine was then determined using the PR schedule. Yohimbine stimulated nicotine intake and increased PR breakpoints and numbers of infusions received in both male and female adolescent rats. The infusion dose of nicotine was positively associated with yohimbine-induced increases in responding. Female rats showed significantly increased breakpoints at yohimbine doses and nicotine infusion doses at which males did not. The effects of the pharmacological stressor, yohimbine on the reinforcing efficacy of nicotine are therefore linked to sex and nicotine infusion dose. Female rats are more sensitive to stress-induced potentiation of nicotine self-administration.
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Affiliation(s)
- Sophia Li
- Neurobiology of Alcohol Laboratory; Centre for Addiction and Mental Health; Toronto ON Canada
| | - Sheng Zou
- Neurobiology of Alcohol Laboratory; Centre for Addiction and Mental Health; Toronto ON Canada
| | - Kathleen Coen
- Neurobiology of Alcohol Laboratory; Centre for Addiction and Mental Health; Toronto ON Canada
| | - Douglas Funk
- Neurobiology of Alcohol Laboratory; Centre for Addiction and Mental Health; Toronto ON Canada
| | - Megan J. Shram
- Department of Pharmacology and Toxicology; University of Toronto; Toronto ON Canada
- INC Research Early Stage; Toronto ON Canada
| | - A.D. Lê
- Neurobiology of Alcohol Laboratory; Centre for Addiction and Mental Health; Toronto ON Canada
- Department of Pharmacology and Toxicology; University of Toronto; Toronto ON Canada
- Department of Psychiatry; University of Toronto; Toronto ON Canada
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34
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Dutra LM, Williams DR, Gupta J, Kawachi I, Okechukwu CA. Human rights violations and smoking status among South African adults enrolled in the South Africa Stress and Health (SASH) study. Soc Sci Med 2014; 105:103-11. [PMID: 24509050 DOI: 10.1016/j.socscimed.2014.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 09/26/2013] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
Despite South Africa's history of violent political conflict, and the link between stressful experiences and smoking in the literature, no public health study has examined South Africans' experiences of human rights violations and smoking. Using data from participants in the nationally representative cross-sectional South Africa Stress and Health study (SASH), this analysis examined the association between respondent smoking status and both human rights violations experienced by the respondent and violations experienced by the respondents' close friends and family members. SAS-Callable SUDAAN was used to construct separate log-binomial models by political affiliation during apartheid (government or liberation supporters). In comparison to those who reported no violations, in adjusted analyses, government supporters who reported violations of themselves but not others (RR = 1.76, 95% CI: 1.25-2.46) had a significantly higher smoking prevalence. In comparison to liberation supporters who reported no violations, those who reported violations of self only (RR = 1.56, 95%CI: 1.07-2.29), close others only (RR = 1.97, 95%CI: 1.12-3.47), or violations of self and close others due to close others' political beliefs and the respondent's political beliefs (RR = 2.86, 95%CI: 1.70-4.82) had a significantly higher prevalence of smoking. The results of this analysis suggest that a relationship may exist between human rights violations and smoking among South Africa adults. Future research should use longitudinal data to assess causality, test the generalizability of these findings, and consider how to apply these findings to smoking cessation interventions.
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Affiliation(s)
- Lauren M Dutra
- Harvard University, USA; University of California San Francisco, USA.
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35
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Evans BE, Greaves-Lord K, Euser AS, Tulen JHM, Franken IHA, Huizink AC. Alcohol and tobacco use and heart rate reactivity to a psychosocial stressor in an adolescent population. Drug Alcohol Depend 2012; 126:296-303. [PMID: 22726913 DOI: 10.1016/j.drugalcdep.2012.05.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/17/2012] [Accepted: 05/24/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Few studies have investigated physiological stress (re)activity in relation to substance use, especially in adolescents. Using substances is one way to stimulate physiological arousal, therefore inherent hypo-arousal may be associated with substance use in adolescents. The purpose of this study was to examine the relation of autonomic nervous system (ANS) activity with alcohol and tobacco use in adolescents. METHODS ANS activity and perceived stress during a social stress procedure were examined in relation to substance use. 275 Dutch adolescents from a general population study provided complete data. Heart rate was recorded continuously during a pre-task rest period, a stressful task period and a post-task recovery period. Alcohol and tobacco use were self-reported. RESULTS Adolescents who consumed a medium and high number of alcoholic drinks per week (more than two) exhibited lower heart rates during the entire stress procedure as compared to those who consumed a low number of alcoholic drinks. Adolescents who smoked every day portrayed blunted heart rate reactivity to stress as compared to adolescents who smoked less frequently or not at all. Perceived stress was not related to alcohol or tobacco use. CONCLUSIONS Overall lower heart rate in adolescents who drank more and blunted heart rate reactivity to stress in those who used tobacco every day may indicate inherent hypo-arousal of the ANS system in those vulnerable to use substances more often. These adolescents may actively seek out substances in order to achieve a more normalized state of arousal.
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Affiliation(s)
- Brittany E Evans
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands.
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Sumin AN, Sumina LY, Barbarash NA. Stress-related hemodynamic response in healthy young individuals with Type D personality. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2012. [DOI: 10.15829/1728-8800-2012-3-70-76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To investigate the association between the stress-related hemodynamic response during the mental calculation test (MCT) and the presence of Type D personality in healthy young individuals. Material and methods. The study included 80 healthy individuals (19 men and 61 women; mean age 18,8±0,2 years). Psychological status examination included the DS-14 scale, depression scale, and Spielberger-Khanin scale. MCT was performed with simultaneous assessment of hemodynamic response. Results. Type D personality (distressed type) was observed in 32,5% of the participants. Among young students, Type D personality was associated with higher levels of trait and state anxiety (TA and SA), as well as higher depression scale scores, compared to students without Type D personality. Type D personality was also linked to a more pronounced response of systolic blood pressure (SBP) during MCT (p=0,05). There was a strong correlation between social inhibition levels and maximal heart rate (HR) during MCT (r=-0,238; p=0,034). Young men demonstrated a moderate correlation between Type D personality and HR response (r=-0,508; p=0,026), as well as between negative affectivity levels and HR response during MCT (r=0,469; p=0,043). Conclusion. Distressed personality type was observed in one-third of healthy young participants of the study. Type D personality and its subscales correlated with the hemodynamic response during MCT, with some gender-specific features observed. These findings clarify potential mechanisms of Type D personality effects on the development and prognosis of cardiovascular disease.
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Affiliation(s)
- A. N. Sumin
- Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
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DUŠKOVÁ M, ŠIMŮNKOVÁ K, HILL M, VELÍKOVÁ M, KUBÁTOVÁ J, KANCHEVA L, KAZIHNITKOVÁ H, HRUŠKOVIČOVÁ H, POSPÍŠILOVÁ H, RÁCZ B, SALÁTOVÁ M, CIRMANOVÁ V, KRÁLÍKOVÁ E, STÁRKA L, PAŘÍZEK A. Chronic Cigarette Smoking Alters Circulating Sex Hormones and Neuroactive Steroids in Premenopausal Women. Physiol Res 2012; 61:97-111. [DOI: 10.33549/physiolres.932164] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Chronic smoking alters the circulating levels of sex hormones and possibly also the neuroactive steroids. However, the data available is limited. Therefore, a broad spectrum of free and conjugated steroids and related substances was quantified by GC-MS and RIA in premenopausal smokers and in age-matched (38.9±7.3 years of age) non-smokers in the follicular (FP) and luteal phases (LP) of menstrual cycle (10 non-smokers and 10 smokers, in the FP, and 10 non-smokers and 8 smokers in the LP). Smokers in both phases of the menstrual cycle showed higher levels of conjugated 17-hydroxypregnenolone, 5α-dihydroprogesterone, conjugated isopregnanolone, conjugated 5α-pregnane-3β,20α-diol, conjugated androstenediol, androstenedione, testosterone, free testosterone, conjugated 5α-androstane-3α/β,17β-diols, and higher free testosterone index. In the FP, the smokers exhibited higher levels of conjugated pregnenolone, progesterone, conjugated pregnanolone, lutropin, and a higher lutropin/follitropin ratio, but lower levels of cortisol, allopregnanolone, and pregnanolone. In the LP, the smokers exhibited higher levels of free and conjugated 20α-dihydropregnenolone, free and conjugated dehydroepiandrosterone, free androstenediol, 5α-dihydro-testosterone, free and conjugated androsterone, free and conjugated epiandrosterone, free and conjugated etiocholanolone, 7α/β-hydroxy-dehydroepiandrosterone isomers, and follitropin but lower levels of estradiol and sex hormone binding globulin (SHBG) and lower values of the lutropin/follitropin ratio. In conclusion, chronic cigarette smoking augments serum androgens and their 5α/β-reduced metabolites (including GABAergic substances) but suppresses the levels of estradiol in the LP and SHBG and may induce hyperandrogenism in female smokers. The female smokers had pronouncedly increased serum progestogens but paradoxically suppressed levels of their GABA-ergic metabolites. Further investigation is needed concerning these effects.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - A. PAŘÍZEK
- Department of Obstetrics and Gynecology of the First Faculty of Medicine, Charles University, Prague, Czech Republic
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Howe M, Leidal A, Montgomery D, Jackson E. Role of cigarette smoking and gender in acute coronary syndrome events. Am J Cardiol 2011; 108:1382-6. [PMID: 21924390 DOI: 10.1016/j.amjcard.2011.06.059] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 06/28/2011] [Accepted: 06/28/2011] [Indexed: 10/17/2022]
Abstract
Cigarette smoking has been associated with lower mortality after an acute coronary event. We hypothesized that the improved survival in smokers is related to demographic differences and sought to further evaluate the gender disparities in smokers after an acute coronary event. A prospective cohort of 3,588 patients hospitalized at a single center from 1999 to 2006 was identified. Smoking status, in-hospital and 6-month follow-up death, and cardiovascular events (i.e., myocardial infarction, stroke, cardiac-related rehospitalization, and unscheduled revascularization) were assessed. The prevalence of smoking in men increased over time. The smokers were younger at presentation with fewer co-morbidities than nonsmokers. Male smokers had lower mortality (3.2% vs 5.4%, p = 0.04) and fewer cardiovascular events (33.1% vs 42.4%, p = 0.003) at 6 months than nonsmokers. However, after adjusting for age and co-morbidities, smoking was not an independent predictor of events (odds ratio 0.88, 95% confidence interval 0.67 to 1.17). Female smokers had mortality (5.6% vs 8.4%, p = 0.15) and cardiovascular events (54.5% vs 49.7%, p = 0.28) at 6 months similar to that of nonsmokers, with a nonsignificant trend toward increased risk after adjustment (odds ratio 1.31, 95% confidence interval 0.90 to 1.93). Among smokers, female gender remained a significant risk factor for cardiovascular events at 6 months (odds ratio 2.35, 95% confidence interval 1.58 to 3.50), even after adjustment for age and co-morbidities. In conclusion, smokers experienced acute coronary event events earlier than did nonsmokers. Younger age and fewer co-morbidities likely account for most observed survival benefit in smokers, although female smokers are more likely to experience cardiovascular complications by 6 months than male smokers.
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Buffalari DM, Baldwin CK, Feltenstein MW, See RE. Corticotrophin releasing factor (CRF) induced reinstatement of cocaine seeking in male and female rats. Physiol Behav 2011; 105:209-14. [PMID: 21889522 DOI: 10.1016/j.physbeh.2011.08.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 07/26/2011] [Accepted: 08/17/2011] [Indexed: 11/30/2022]
Abstract
Significant sex differences have been demonstrated in clinical and preclinical studies of cocaine addiction, with some of the most consistent differences noted in regard to the role of stress and craving. The current study examined stress-induced reinstatement of cocaine seeking in male and female rats in an animal model of relapse using corticotropin-releasing factor (CRF) administration. Both male and female rats demonstrated increased cocaine seeking in response to CRF. CRF-induced reinstatement was highly variable across both male and female rats, and further analysis revealed a subpopulation that was particularly sensitive to CRF (high responders). Female high responders displayed significantly increased responding to CRF compared to males. Individual differences in stress responsivity could thus contribute to the likelihood of relapse, with females showing greater heterogeneity to stress-induced relapse.
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Affiliation(s)
- Deanne M Buffalari
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA
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40
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Richards JM, Stipelman BA, Bornovalova MA, Daughters SB, Sinha R, Lejuez CW. Biological mechanisms underlying the relationship between stress and smoking: state of the science and directions for future work. Biol Psychol 2011; 88:1-12. [PMID: 21741435 DOI: 10.1016/j.biopsycho.2011.06.009] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 03/07/2011] [Accepted: 06/22/2011] [Indexed: 01/01/2023]
Abstract
Theories of addiction implicate stress as a crucial mechanism underlying initiation, maintenance, and relapse to cigarette smoking. Examinations of the biological stress systems, including functioning of the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), have provided additional insights into the relationship between stress and smoking. To date, convergent data suggests that chronic cigarette smoking is associated with alterations in HPA and ANS functioning; however, less is known about the role of HPA and ANS functioning in smoking initiation and relapse following cessation. In order to organize existing findings and stimulate future research, the current paper summarizes the available literature on the roles of HPA axis and ANS functioning in the relationship between stress and cigarette smoking, highlights limitations within the existing literature, and suggests directions for future research to address unanswered questions in the extant literature on the biological mechanisms underlying the relationship between stress and smoking.
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Affiliation(s)
- Jessica M Richards
- Department of Psychology, Center for Addictions, Personality, and Emotion Research (CAPER), University of Maryland, 2103 Cole Activities Building, College Park, MD 20742, USA.
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Bouma EMC, Riese H, Ormel J, Verhulst FC, Oldehinkel AJ. Self-assessed parental depressive problems are associated with blunted cortisol responses to a social stress test in daughters. The TRAILS Study. Psychoneuroendocrinology 2011; 36:854-63. [PMID: 21185125 DOI: 10.1016/j.psyneuen.2010.11.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 11/18/2010] [Accepted: 11/24/2010] [Indexed: 11/28/2022]
Abstract
Depression runs in families and is considered a stress-related disorder. Familial risk for depression may be transmitted via deregulated psychophysiological stress responses from parent to child. In this study, we examined the association between self-assessed lifetime parental depressive problems (PDP) and adolescent offspring' cortisol responses to a social stress test. Data were collected as part of the third assessment wave of TRAILS (TRacking Adolescents' Individual Lives Survey), a large prospective population study of Dutch adolescents. Data of 330 adolescents (mean age 16.04; 40.9% girls) who participated in a laboratory session, including a standardized performance-related social stress task (public speaking and mental arithmetic) were examined. Four saliva cortisol samples were collected before, during and after the social stress task which were analyzed with repeated measures Analysis of Variance. Lifetime parental depressive problems were assessed by self-reports from both biological parents. PDP was associated with daughter' cortisol responses (F(3,133)=3.90, p=.02), but no association was found in sons (F(3,193)=0.27, p=.78). Girls whose parents ever experienced depressive symptoms displayed a blunted cortisol response to the standardized social stress test, while girls whose parents never had such problems displayed the characteristic curvilinear response pattern. This effect was not mediated by offspring stress history (age 0-16). Analyses were corrected for smoking behaviour and adolescent depressed mood. The fact that PDP were measured by self-report questionnaires and did not reflect clinical DSM-IV diagnosis could be considered a limitation of the study.
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Affiliation(s)
- Esther M C Bouma
- Interdisciplinary Center for Psychiatric Epidemiology and Graduate Schools for Behavioral and Cognitive Neurosciences and for Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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DeSantis SM, Bandyopadhyay D. Hidden Markov models for zero-inflated Poisson counts with an application to substance use. Stat Med 2011; 30:1678-94. [PMID: 21538455 DOI: 10.1002/sim.4207] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Accepted: 01/03/2011] [Indexed: 11/10/2022]
Abstract
Paradigms for substance abuse cue-reactivity research involve pharmacological or stressful stimulation designed to elicit stress and craving responses in cocaine-dependent subjects. It is unclear as to whether stress induced from participation in such studies increases drug-seeking behavior. We propose a 2-state Hidden Markov model to model the number of cocaine abuses per week before and after participation in a stress-and cue-reactivity study. The hypothesized latent state corresponds to 'high' or 'low' use. To account for a preponderance of zeros, we assume a zero-inflated Poisson model for the count data. Transition probabilities depend on the prior week's state, fixed demographic variables, and time-varying covariates. We adopt a Bayesian approach to model fitting, and use the conditional predictive ordinate statistic to demonstrate that the zero-inflated Poisson hidden Markov model outperforms other models for longitudinal count data.
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Affiliation(s)
- Stacia M DeSantis
- Division of Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC 29425, USA.
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Zatu MC, Van Rooyen JM, Schutte AE. Smoking and vascular dysfunction in Africans and Caucasians from South Africa. Cardiovasc J Afr 2011; 22:18-24. [PMID: 21298201 PMCID: PMC4650927 DOI: 10.5830/cvja-2010-034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 03/14/2010] [Indexed: 11/21/2022] Open
Abstract
Background Smoking is an important modifiable risk factor for cardiovascular disease, with limited research having been done in Africans. We aimed to determine the association between smoking and measurements of vascular function in Africans and Caucasians. Methods We determined anthropometric and cardiovascular variables, serum cotinine and C-reactive protein (CRP) in African and Caucasian participants from South Africa (n = 630). Results Africans had significantly lower body mass index (BMI), higher blood pressure and lower socio-economic status (SES) than Caucasians. Only African smokers showed increased arterial stiffness and a significant correlation between smoking and arterial stiffness. African smokers had increased and Caucasian smokers decreased high-density lipoprotein cholesterol (HDL-C) than the non-smokers. After adjusting for confounders, smoking showed few correlations, mainly with heart rate and CRP. In Africans, smoking also correlated positively with HDL-C, with the opposite result in Caucasians. Conclusion African smokers had significantly increased arterial stiffness, which was not found in Caucasian smokers. Africans generally demonstrated more associations between smoking and cardiovascular dysfunction than Caucasians.
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Affiliation(s)
- M C Zatu
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
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McKee SA, Sinha R, Weinberger AH, Sofuoglu M, Harrison EL, Lavery M, Wanzer J. Stress decreases the ability to resist smoking and potentiates smoking intensity and reward. J Psychopharmacol 2011; 25:490-502. [PMID: 20817750 PMCID: PMC3637660 DOI: 10.1177/0269881110376694] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We have developed a novel human laboratory model to examine two primary aspects of stress-precipitated tobacco relapse: (1) Does stress reduce the ability to resist the first cigarette? (2) Once the first cigarette is initiated, does stress facilitate subsequent smoking? Using a within-subject design, daily smokers (n = 37) who were nicotine deprived overnight received a personalized imagery induction (stress or neutral) on two separate days, and then had the option of initiating a tobacco self-administration session or delaying initiation for up to 50 min in exchange for three levels of monetary reinforcement. Subsequently, the tobacco self-administration session entailed a 1-hour period in which subjects could choose to smoke using a smoking topography system. Following the stress induction, subjects were less able to resist smoking, smoked more intensely (increased puffs, shorter inter-puff interval, and greater peak puff velocity), and perceived greater satisfaction and reward from smoking. Stress significantly increased hypothalamus-pituitary-adrenal (HPA) axis reactivity, tobacco craving, negative emotion, and physiologic reactivity relative to the neutral condition. In addition, increased cortisol, ACTH, and tobacco craving were associated with reduced ability to resist smoking following stress. These findings have implications for understanding the impact of stress on smoking relapse and model development to assess smoking lapse behavior.
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Affiliation(s)
- Sherry A. McKee
- CORRESPONDING AUTHOR: Sherry A. McKee, Ph.D., Department of Psychiatry, Yale University School of Medicine, 2 Church St. South, Suite 109, New Haven, CT, USA, 06519. Phone: (203) 737-3529, Fax (203) 737-4243,
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Moran-Santa Maria MM, McRae-Clark AL, Back SE, DeSantis SM, Baker NL, Spratt EG, Simpson AN, Brady KT. Influence of cocaine dependence and early life stress on pituitary-adrenal axis responses to CRH and the Trier social stressor. Psychoneuroendocrinology 2010; 35:1492-500. [PMID: 20570051 PMCID: PMC2945624 DOI: 10.1016/j.psyneuen.2010.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 04/12/2010] [Accepted: 05/05/2010] [Indexed: 11/19/2022]
Abstract
Long-term changes in the hypothalamic-pituitary-adrenal (HPA) axis as a result of early life stress could be related to the development of substance use disorders during adulthood. In this study, the neuroendocrine, physiologic (HR), and subjective responses to corticotropin releasing hormone (CRH) and the Trier Social Stress Task (TSST) in individuals with cocaine dependence, with (n=21)/without early life stress (n=21), non-dependent individuals with early life stress (n=22), and a control group were examined (n=21). CRH increased cortisol and ACTH levels in all groups. However, a significant effect of early life stress on ACTH was observed indicating that the increase in ACTH was greatest in subjects with a history of childhood stress. Post hoc analysis indicated the early life stress/non-cocaine dependent individuals exhibited significantly higher levels of ACTH as compared to the early life stress/cocaine-dependent group. Despite the elevated ACTH response there was no difference between the groups in the cortisol response to CRH. The TSST produced a significant elevation in ACTH and cortisol all study groups. No significant group differences were observed. The subjective stress and peak heart rate responses to the TSST were greatest in cocaine-dependent subjects without early life stress. In response to CRH, subjective stress and craving were positively correlated in cocaine-dependent subjects regardless of early life stress history, while stress and craving following the TSST were correlated only in cocaine-dependent subjects without a history of early life stress. Findings support previous studies demonstrating that subjects with a history of childhood adversity exhibit elevated ACTH and blunted cortisol levels in response to stress. In contrast, HR and subjective stress in response to the TSST were greatest in cocaine-dependent subjects without a history of early life stress, suggesting that childhood adversity may desensitize autonomic and subjective responding to social stress in adults with cocaine dependence.
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Affiliation(s)
- Megan M Moran-Santa Maria
- Department of Psychiatry and Behavioral Sciences, Clinical Neuroscience Division, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States.
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Waldrop AE, Price KL, DeSantis SM, Simpson AN, Back SE, McRae AL, Spratt EG, Kreek MJ, Brady KT. Community-dwelling cocaine-dependent men and women respond differently to social stressors versus cocaine cues. Psychoneuroendocrinology 2010; 35:798-806. [PMID: 20004523 PMCID: PMC2875320 DOI: 10.1016/j.psyneuen.2009.11.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 11/03/2009] [Accepted: 11/03/2009] [Indexed: 12/19/2022]
Abstract
UNLABELLED There are likely to be gender differences in determinants of relapse to drug use following abstinence in cocaine-dependent individuals. Cocaine-dependent women are more likely to attribute relapse to negative emotional states and interpersonal conflict. Cocaine dependence has also been linked to dysregulation of stress response and the hypothalamic pituitary adrenal (HPA) axis which may differ between genders. Subjective and HPA-axis responses to a social evaluative stressor, the Trier Social Stress Test (TRIER), and in vivo cocaine-related cues were examined in the present study. RESULTS There were no gender differences in magnitude of craving responses to the TRIER or the CUE. Both genders had a greater craving response to the CUE than to the TRIER, but the magnitude of the difference was greater for men than women (p=0.04). Cocaine-dependent subjects, compared to the control group, had significantly higher response throughout the TRIER (p<0.0001) and CUE (p<0.0001) testing sessions. There were no gender differences and no gender by cocaine interaction for ACTH responses to the TRIER, although women had lower baseline ACTH (p=0.049). On the CUE task, in contrast, female cocaine-dependent subjects had a more blunted ACTH response than did the other three groups (p=0.02). Female cocaine-dependent subjects also had a lower odds of a positive cortisol response to the TRIER as compared to the other three groups (OR=0.84, 95% CI=[0.02, 1.01]). During the CUE task, cocaine-dependent subjects had overall higher mean cortisol levels (p=0.0001), and higher odds of demonstrating a positive cortisol response to the CUE (OR=2.61, 95% CI=[1.11, 6.11]). No gender differences were found in ACTH responses to the CUE. The results are reviewed in the context of the existing literature on gender differences in cocaine dependence and potential implications for treatment are discussed.
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Affiliation(s)
- Angela E. Waldrop
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403,Corresponding Author: Dr. Waldrop is now at the University of California, San Francisco and the San Francisco VA Medical Center, 4150 Clement St, San Francisco, CA 94121; phone (415) 221-4810; fax (415) 751-2297;
| | - Kimber L. Price
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403
| | - Stacia M. DeSantis
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403
| | - Annie N. Simpson
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403
| | - Sudie E. Back
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403
| | - Aimee L. McRae
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403
| | - Eve G. Spratt
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403
| | - Mary Jeanne Kreek
- The Rockefeller University, Laboratory of Biology of Addictive Diseases, 1230 York Ave, New York, NY, 10062
| | - Kathleen T. Brady
- Medical University of South Carolina, 67 President St, Charleston, SC, 29403
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Abstract
Gender differences in substance use disorders (SUDs) and treatment outcomes for women with SUDs have been a focus of research in the last 15 years. This article reviews gender differences in the epidemiology of SUDs, highlighting the convergence of male/female prevalence ratios of SUDs in the last 20 years. The telescoping course of SUDs, recent research on the role of neuroactive gonadal steroid hormones in craving and relapse, and sex differences in stress reactivity and relapse to substance abuse are described. The role of co-occurring mood and anxiety, eating, and posttraumatic stress disorders is considered in the epidemiology, natural history, and treatment of women with SUDs. Women's use of alcohol, stimulants, opioids, cannabis, and nicotine are examined in terms of recent epidemiology, biologic and psychosocial effects, and treatment. Although women may be less likely to enter substance abuse treatment than men over the course of the lifetime, once they enter treatment, gender itself is not a predictor of treatment retention, completion, or outcome. Research on gender-specific treatments for women with SUDs and behavioral couples treatment has yielded promising results for substance abuse treatment outcomes in women.
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Affiliation(s)
- Shelly F. Greenfield
- Alcohol and Drug Abuse Treatment Program, McLean Hospital, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA
| | - Sudie E. Back
- Clinical Neuroscience Division, Department of Psychiatry, Medical University of South Carolina, 67 President Street/PO Box 250861, Charleston, SC 29425, USA
| | - Katie Lawson
- Clinical Neuroscience Division, Department of Psychiatry, Medical University of South Carolina, 67 President Street/PO Box 250861, Charleston, SC 29425, USA
| | - Kathleen T. Brady
- Clinical Neuroscience Division, Department of Psychiatry, Medical University of South Carolina, 67 President Street/PO Box 250861, Charleston, SC 29425, USA
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Garcia-Leal C, Del-Ben CM, Leal FM, Graeff FG, Guimarães FS. Escitalopram prolonged fear induced by simulated public speaking and released hypothalamic-pituitary-adrenal axis activation. J Psychopharmacol 2010; 24:683-94. [PMID: 19251828 DOI: 10.1177/0269881108101782] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Simulated public speaking (SPS) test is sensitive to drugs that interfere with serotonin-mediated neurotransmission and is supposed to recruit neural systems involved in panic disorder. The study was aimed at evaluating the effects of escitalopram, the most selective serotonin-selective reuptake inhibitor available, in SPS. Healthy males received, in a double-blind, randomized design, placebo (n = 12), 10 (n = 17) or 20 (n = 14) mg of escitalopram 2 hours before the test. Behavioural, autonomic and neuroendocrine measures were assessed. Both doses of escitalopram did not produce any effect before or during the speech but prolonged the fear induced by SPS. The test itself did not significantly change cortisol and prolactin levels but under the higher dose of escitalopram, cortisol and prolactin increased immediately after SPS. This fear-enhancing effect of escitalopram agrees with previously reported results with less selective serotonin reuptake inhibitors and the receptor antagonist ritanserin, indicating that serotonin inhibits the fear of speaking in public.
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Affiliation(s)
- C Garcia-Leal
- Department of Neurology, Psychiatry and Medical Psychology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
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Habituation–sensitization of cardiovascular reactivity to repeated stress in smokers and non-smokers: An anthropometrically matched trial. Int J Psychophysiol 2010; 76:34-9. [DOI: 10.1016/j.ijpsycho.2010.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 01/28/2010] [Accepted: 02/01/2010] [Indexed: 11/20/2022]
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Brewer JA, Sinha R, Chen JA, Michalsen RN, Babuscio TA, Nich C, Grier A, Bergquist KL, Reis DL, Potenza MN, Carroll KM, Rounsaville BJ. Mindfulness training and stress reactivity in substance abuse: results from a randomized, controlled stage I pilot study. Subst Abus 2010; 30:306-17. [PMID: 19904666 DOI: 10.1080/08897070903250241] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Stress is important in substance use disorders (SUDs). Mindfulness training (MT) has shown promise for stress-related maladies. No studies have compared MT to empirically validated treatments for SUDs. The goals of this study were to assess MT compared to cognitive behavioral therapy (CBT) in substance use and treatment acceptability, and specificity of MT compared to CBT in targeting stress reactivity. Thirty-six individuals with alcohol and/or cocaine use disorders were randomly assigned to receive group MT or CBT in an outpatient setting. Drug use was assessed weekly. After treatment, responses to personalized stress provocation were measured. Fourteen individuals completed treatment. There were no differences in treatment satisfaction or drug use between groups. The laboratory paradigm suggested reduced psychological and physiological indices of stress during provocation in MT compared to CBT. This pilot study provides evidence of the feasibility of MT in treating SUDs and suggests that MT may be efficacious in targeting stress.
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Affiliation(s)
- Judson A Brewer
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
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