Childhood Trauma, Adolescent Alcohol Binge Drinking, and Reward Functioning Among Young Adult Drinkers

Despite evidence suggesting that childhood trauma (CT) and adolescent binge drinking may have a considerable impact on alcohol and non-alcohol reward functioning and contribute to increased alcohol use disorder (AUD) risk, studies addressing the nature of the relationship between CT, adolescent binge drinking, and reward indices are lacking. The current study evaluated associations among CT, adolescent binge drinking, subjective reward responses, and psychiatric risk among a sample of young adult drinkers. Participants were recruited and enrolled on the basis of meeting criteria for CT and adolescent binge exposure, CT and no adolescent binge exposure, no CT and adolescent binge exposure, and no history of CT or adolescent binge exposure (i.e., controls). It was hypothesized that individuals with a history of both CT and adolescent binge would exhibit the lowest non-alcohol reward and greatest alcohol reward responses compared to either condition alone, and that a history of (a) CT and (b) adolescent binge drinking would predict dampened non-alcohol reward and elevated alcohol reward responses compared to controls. A series of one-way 2 X 2 between-subjects ANCOVAs were conducted to examine the influence of CT and adolescent binge drinking on measures of reward and psychiatric risk. Contrary to expectation, there were no main or interactive effects of CT or adolescent binge history on non-alcohol reward outcomes. Adolescent binge history was associated with greater intensity of alcohol demand, suggesting higher consummatory alcohol reward. Adolescent binge history was not associated with elevated motivational alcohol reward, AUD risk, or psychiatric risk. CT related to more frequent binge drinking, depression, and alcohol coping and conformity motives. Future studies employing longitudinal methods with multi-modal reward assessments are required to illuminate patterns of reward response and alcohol use as a consequence of CT and adolescent binge drinking

Influences of Major Depression and Posttraumatic Stress Disorder on Trauma and Alcohol Cue Reactivity

Despite established support for the development of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) comorbidity by way of self-medication alcohol use, models of PTSD-AUD etiology rarely account for the role of other common comorbidities in risk processes, namely major depressive disorder (MDD). Past studies indicate that approximately 50.0% of individuals with PTSD and 40.3% of individuals with AUD meet criteria for current MDD. Importantly, MDD may interact with PTSD to influence AUD risk by enhancing incentive for self-medication and/or by increasing motivation for alcohol-related reward. Laboratory models of trauma and alcohol cue reactivity are well suited to evaluate how depression and PTSD may work together on risk for AUD. The trauma and alcohol cue reactivity paradigm assesses craving in response to four combinations of narrative (trauma vs. neutral) and beverage (alcohol vs. water) cues. The current study examined the main and interactive effects of PTSD (Clinician Administered PTSD scale for DSM-5; CAPS) and depression symptoms (Center for Epidemiologic Studies Depression Scale-Revised; CESD-R) on trauma and alcohol cue reactivity. Forward-fitted linear mixed effects models with deviance testing were conducted to ascertain the impact of the within-subjects factors (narrative cue and beverage cue) and covariates (PTSD symptoms and depressive symptoms) on self-reported and physiological (salivation, in grams) alcohol craving after controlling for cumulative trauma exposure. For craving, there was a main effect of total depressive symptoms on self-reported craving, after accounting for the interaction between PTSD symptoms and narrative cue, B = 0.418, p = .028, and improved model fit above an initial base model, X2 = 4.74, p .05. Further, depression did not exhibit main or interactive effects on salivation, p’s > .05. These results suggest that depressive symptoms may increase subjective craving for alcohol, regardless of trauma or alcohol contextual cues. Further research is needed to explain the role of MDD in PTSD-AUD etiology and maintenance