The effects of stress and coping on daily alcohol use in women

doi:10.1016/0306-4603(94)00055-7

Addictive Behaviors

Volume 20, Issue 2, March–April 1995, Pages 141-147

https://doi.org/10.1016/0306-4603(94)00055-7 Get rights and content

Abstract

To evaluate the notion that perceived stress and drinking covary over time, daily logs were periodically collected over a 6-month period from 32 middle-aged women. Results indicated that significantly less alcohol was consumed on high-stress weeks than low-stress weeks. Problem-focused (P-F) coping preference moderated this relationship, with low P-F copers consuming more alcohol per occasion than did high P-F copers but only during low-stress weeks. These findings support a model of stress and alcohol use that includes coping preference as an important moderator of women's drinking. In addition, our data are consistent with the notion that stress can influence alcohol consumption but that low P-F women regulate their use, preferring to delay their drinking until after the termination of the stressor.

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Adrenocortical sensitivity, moderated by ongoing stress, predicts drinking intensity in alcohol-dependent men
2017, Psychoneuroendocrinology
Citation Excerpt :
Environmental stress, an allostatic stressor, has also long been posited as a precipitant for alcohol ingestion (Conger, 1956; Cooper et al., 1988; Hull, 1981; Pohorecky, 1991; Sher and Levenson, 1982; Wilson, 1983). Nevertheless, while multiple studies have shown a positive relationship between alcohol use and general life stress (Keyes et al., 2012), several prospective studies in non-alcohol dependent populations have reported either an inverse, null, or limited relationship between daily stressors and alcohol intake (Breslin et al., 1995; Helzer et al., 2006; Rohsenow, 1982; Schroder and Perrine, 2007). Equally tenuous is the relevance of ongoing stress to drinking severity in individuals with an active alcohol use disorder.
Allostatic load from both environmental stressors and persistent glucocorticoid secretion has been associated with disease severity in alcohol dependence. Heightened relapse risk and/or drinking severity, in particular, may be a reaction to alcohol- and withdrawal-induced changes in physiological stress response systems coupled with ongoing life stress, although their shared contributions upon drinking severity have not been assessed. To investigate the combined contribution of hypothalamic-pituitary-adrenal (HPA) reactivity and environmental stressors (e.g., ongoing life stress) to relapse severity in alcohol-dependent men following treatment, plasma adrenocorticotropin (ACTH) and cortisol were obtained in 4–6 weeks abstinent alcohol-dependent men (n = 41) following a psychosocial stressor [the Trier Social Stress Test (TSST)] and two pharmacological provocations [ovine corticotropin releasing factor (oCRH) and cosyntropin]. Following treatment discharge, drinking outcomes (primary outcome: drinks per drinking day (DDD); secondary outcomes: total drinks and drinking days) were assessed weekly and ongoing life stress was assessed biweekly for 24 weeks following treatment discharge. Generalized estimating equation models of drinking severity were fit with basal and stimulated ACTH and cortisol concentrations as predictors and ongoing life stress as the moderator. Greater levels of life stress were independently associated with greater drinking intensity (DDD and total drinks) but not frequency (days drinking). Higher basal cortisol:ACTH or provoked cortisol:ACTH ratios were strongly associated with greater post-treatment DDD in individuals who experienced higher levels of ongoing stress. In conclusion, ongoing life stress is associated with post-treatment drinking intensity in alcohol dependent men; stress also strengthens the relationship between adrenocortical sensitivity and post-treatment drinking. Physiological measures of allostatic load and environmental stressors conjointly increase relapse intensity.
The Potential Role of Glucocorticoids and the HPA Axis in Alcohol Dependence
2014, Neurobiology of Alcohol Dependence
The hypothalamic–pituitary–adrenal (HPA) axis is an important component of the stress-response system. The HPA axis carefully orchestrates a rapid hormonal stress response and subsequent return to homeostasis once the stressor has passed. However, HPA axis dysregulation that results in hypo- or hyperresponsive production of the stress hormone cortisol has been associated with hazardous alcohol use and dependence. Cortisol interacts with the brain’s reward system, may contribute to habit formation and promote habit-based learning, and may trigger important epigenetic events to potentially increase risk for, development of, and maintenance of alcohol use disorders. Further, cortisol levels during initial alcohol abstinence may indicate relapse vulnerability. Therapeutic advances currently include compounds that target brain stress systems that theoretically can reduce cortisol levels or block the effects of cortisol in the body. The implications of HPA axis dysregulation associated with alcohol use disorders are discussed.
Drinking and stress: An examination of sex and stressor differences using IVR-based daily data
2011, Drug and Alcohol Dependence
Citation Excerpt :
In addition, sample size has varied, from 15 (Andersson et al., 2007) to 802 (Grzywacz and Almeida, 2008). Sex distribution (i.e., proportion of men and women) is also inconsistent, with some studies focusing on women only (Breslin et al., 1995), some on men (Helzer et al., 2006; Rohsenow et al., 1985), and others with varying proportions of men and women (Armeli et al., 2003; Flynn, 2000; Steptoe and Wardle, 1999). Importantly, many of these samples excluded alcohol-dependent participants (Armeli et al., 2007; Carney et al., 2000), or did not assess dependency (Andersson et al., 2007; Grzywacz and Almeida, 2008).
Research on the relation of stress to alcohol consumption is inconsistent regarding the direction of effects, and this association has been shown to vary by sex and type of stress. We sought to build upon the stress–drinking literature by examining the direction of the stress–drinking association over time as well as sex and stressor differences using daily data.
246 heavy drinking adults (67% men) aged 21–82 reported daily stress levels and alcohol consumption over 180 days using Interactive Voice Response (IVR). Baseline daily hassles were examined as an alternative measure of stress. Generalized estimating equations (GEEs) were conducted to test the stress–drinking association accounting for alcohol dependency at baseline and sex and stressor type as moderators.
IVR daily stress predicted increased alcohol consumption the following day, whereas baseline level of daily hassles did not. Examining the opposite direction of effects, IVR ratings of daily alcohol consumption predicted decreased next-day stress. Stress predicted higher alcohol consumption the next day for men but there was no significant association for women. For both sexes, drinking predicted decreased stress the next day, but this effect was stronger for women.
This study generally supported the drinking to cope and self-medication hypotheses, with findings that increased stress led to increased drinking. The time-varying relation between stress and alcohol appears to be sex- and measure-specific, however. Therefore, interventions targeted at stress management found to be effective for one sex should not be presumed to be applicable to the other.
Stress and coping in subjects consulting for drinking problems
2008, Journal de Therapie Comportementale et Cognitive
Cette étude a pour objectifs d’analyser les stratégies de coping mises en place en situation de stress et d’étudier leurs liens avec la consommation d’alcool, l’anxiété et la dépression. Trente-deux patients alcoolodépendants ont été évalués à l’aide de questionnaires d’autoévaluation mesurant la consommation d’alcool (alcohol use disorders identification test AUDIT), la symptomatologie dépressive (BDI-13), l’anxiété trait et état (state and trait anxiety inventory , STAI E-T) et les stratégies de coping en situation de stress (CISS). Les résultats indiquent, de manière significative, que les sujets utilisent préférentiellement un coping centré sur l’émotion face au stress. Ce type de coping est corrélé positivement à l’anxiété trait et état, à l’intensité des symptômes dépressifs et au degré de consommation d’alcool. Les résultats témoignent de la nécessité d’aider les patients à développer de meilleures stratégies d’adaptation face au stress en utilisant des techniques issues des thérapies cognitivocomportementales telles que la gestion du stress, des émotions, et la résolution de problème.
The aims of the current investigation were to study adaptation strategies used by subjects to cope with various stress situations, and to examine the link between adaptation strategy and alcohol consumption. Thirty-two out patients, addicted to alcohol were given standardized self-rating scales: anxiety scale (STAI), depression scale (BDI), alcohol drinking questionnaire (AUDIT), and coping questionnaire (CISS). The results show that subjects mainly use coping strategies focused on emotion in stressful situations. This kind of coping is linked to a high level of depression, anxiety (trait and state) and alcohol drinking. These results prove the need to help patients to develop better adaptation strategies to cope with stressful situations, by using techniques stemming from behavioural and cognitive therapy, such as stress or emotions management and problem solving.
Coping styles of type I and type II alcohol-dependent men undergoing treatment
2006, Comprehensive Psychiatry
Citation Excerpt :
Beyond this, coping styles can influence the course of drinking problems. In this regard, the use of negative (eg, “avoidant”) coping styles has been found to be associated with greater levels of alcohol consumption; the use of positive (eg, “active”) coping styles, with lower levels of alcohol use and problems [18-21] (cited by Johnson and Pandina [22]). In a study of stress, drinking, and the adverse consequences of drinking, it was found that people who used more coping or problem-solving strategies and were satisfied with their degree of social support experienced fewer adverse consequences [23].
The purpose of this study was to investigate the ways by which individuals with alcohol dependence, who were subgrouped into type I and type II according to the typology criteria of von Knorring et al, (J. Study Alcohol. 1987;48:523-527), cope with life events. One hundred male alcohol-dependent individuals participating in a therapeutic program composed the study sample. Of the 100, 61 subjects were categorized as type I and 39 subjects as type II. Coping styles were measured using a self-administered questionnaire that includes 8 subscales of coping styles. The type II subgroup scored significantly lower on the suppression subscale and significantly higher on the replacement, mapping, and substitution subscales as compared with the type I subgroup, of which the latter difference was at a tendency level. As regards the remaining 4 coping style subscales, minimization, help seeking, blame, and reversal, no significant differences were found between the 2 patient subgroups. The differences found may be taken into account in the development of therapeutic programs for the 2 subgroups.
Stressful events, personality, and mood disturbance: Gender differences in alcoholics and problem drinkers
2003, Addictive Behaviors
The present study examined relationships among stressful events, personality characteristics, and affective status in males and females of various alcohol drinking patterns. We examined a total of 154 participants from three distinct alcohol subgroups: alcohol dependent, problem drinker, and light social drinker. These subjects did not meet criteria for any concurrent nonalcohol comorbid psychiatric disorder. The study included an alcohol quantity–frequency interview and self-report questionnaires on stressful life events, depressive symptoms, trait anxiety, and personality characteristics. Results showed female alcoholics reported significantly greater depression, anxiety, and neuroticism compared to their male counterparts (and all other drinking groups). Female problem drinkers reported significantly greater depressive symptoms and health-related stressful events compared to male problem drinkers and the light drinkers. In contrast, male problem drinkers did not show elevations on these dimensions and more closely resembled light drinkers, of whom no gender differences were found. The findings support theories suggesting a “telescoping” of complications, health-related stress, and mood dysfunction in women at a lower threshold level of alcohol consumption compared to their male counterparts.

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^☆: This research was supported by a grant from the Uniformed Services University of the Health Sciences (C07205). The opinions or assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of Defense or the Uniformed Services University of the Health Sciences. Do not quote without permission.

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The effects of stress and coping on daily alcohol use in women☆

Abstract

Drug and Alcohol Dependence

Addictive Behavior

Understanding relapse and recovery in alcohol abuse

Annals of Behavioral Medicine

Stress as a psychophysiological process

Alcohol and tension reduction: An update on research and theory

A global measure of perceived stress

Journal of Health and Social Behavior

Reinforcement theory and the dynamics of alcoholism

Quarterly Journal of Studies on Alcohol

Occupational stress and variation in cigarette, coffee, and alcohol consumption

Journal of Health and Social Behavior

Coping, expectancies, and alcohol abuse: A test of social learning formulations

Journal of Abnormal Psychology

Stress and alcohol use: Moderating effects of gender, coping, and alcohol expectancies

Journal of Abnormal Psychology

The role of predisposing and moderating factors in the stressillness relationship

Journal of Health and Social Behavior

Analysis of coping in a middle-aged community sample

Journal of Health and Social Behavior