Experimental & Clinical Psychopharmacology

Oxytocin as a treatment for alcohol use disorder and heavy drinking: A narrative review.
Oxytocin is increasingly being studied for treating symptoms of alcohol use disorders and heavy drinking behavior. The neuropeptide oxytocin facilitates social relationships and modulates the body’s stress response by strengthening coping mechanisms and reducing anxiety. Relatedly, oxytocin is also thought to play a role in processes associated with craving and withdrawal from alcohol. This review aims to primarily provide an overview of preclinical and clinical literature on the applications of oxytocin in alcohol use, and additionally discuss a framework for types of trials and the variety of parameters that affect different study designs. A review of the existing literature in this area suggests that while low dosages of oxytocin do not affect drinking behavior and tolerance, higher dosages taken prior to alcohol exposure have varying behavioral and physiological results. Depending on quantity and timing, oxytocin treatments resulted in declines in withdrawal symptoms and alcohol self-administration in preclinical studies and may decrease neural cue reactivity and withdrawal symptoms in clinical studies. Current ongoing trials are expanding on this work to thoroughly explore clinical applications of oxytocin. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Behavioral economic analysis of the comorbidity of alcohol problems and posttraumatic stress: Findings from high-risk young adults and general community adults.
A behavioral economic reinforcer pathology model theorizes that alcohol problems are influenced by steep delay discounting, overvaluation of alcohol reinforcement, and low reinforcement from alcohol-free activities. Extending this account to the comorbidity of alcohol problems and posttraumatic stress disorder (PTSD), the present study tested the hypothesis that alcohol problems and PTSD symptom severity would interact and be positively associated with indicators from these three domains. High-risk emerging adults from North America (Study 1, n = 1,311, Mage = 22.13) and general community adults from Canada (Study 2, n = 1,506, Mage = 36.80) completed measures of alcohol problems, PTSD symptoms, delay discounting, alcohol demand, and proportionate alcohol-related reinforcement. Across studies, regression analyses revealed significant main effects of alcohol problems and PTSD symptoms in relation to selected reinforcer pathology indicators, but no significant interactions were present for delay discounting or proportionate alcohol-related reinforcement. Interactions were observed for alcohol consumption at $0 (intensity) and the rate of change in consumption across the demand curve (elasticity; Study 1) and for elasticity and maximum alcohol expenditure (Omax; Study 2), but not in the predicted directions. Higher synergistic severity was associated with lower alcohol reinforcing value in each case. These findings reveal expected relations between reinforcer pathology indicators and both alcohol problems and PTSD symptomatology in general but did not support the hypothesized synergistic relationship. The relation between alcohol problems and PTSD is more complex than predicted by existing extensions of the reinforcer pathology model, warranting further investigation. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The relations between impulsivity, opioid use, and nonmedical prescription opioid use motives: An examination within three large urban emergency departments.
Impulsivity is a transdiagnostic risk factor for multiple disorders, including opioid use disorders (OUDs). However, scant work has examined if impulsivity facets distinguish individuals reporting nonmedical opioid use from those who use opioids as prescribed, particularly in important settings such as emergency departments (EDs). Further, no studies, to our knowledge, have examined the relations between impulsivity facets and motives for nonmedical prescription opioid use (NMPOU). Using data from EDs, this study examined if impulsivity facets (assessed via the [negative] urgency, premeditation, perseverance, sensation seeking, and positive urgency) related to nonmedical opioid use and if these facets related to OUD severity among individuals reporting past-year opioid use. Among patients reporting past 3-month NMPOU, the relation between motives for use and impulsivity was examined. Results indicated all facets (except lack of perseverance) distinguished patients reporting nonmedical opioid use from individuals abstaining from opioid use and those who used opioids as prescribed, with particularly large effect sizes for positive and negative urgency. Similarly, among patients reporting past 12-month opioid use, all facets (except lack of perseverance) significantly distinguished individuals who were OUD negative from those with severe OUD, with positive and negative urgency showing the strongest relations. Multiple motives were associated with certain UPPS-P facets, particularly positive urgency, negative urgency, and sensation-seeking. Results suggest that the relation between impulsivity and opioid use characteristics varies across facets of impulsivity, with emotion-based impulsivity being the most relevant. Implications for screening and interventions are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Comparing the psychometric properties of reward and relief drinking measures.
Previous work examining the extent to which individuals seek alcohol to enhance positive experiences (reward drinking) or relieve aversive states (relief drinking) has shown that reward/relief drinking predicts response to naltrexone and acamprosate treatment for alcohol use disorder. Yet, various measures of reward/relief drinking have been used in prior research, and the comparative psychometric properties of these measures are unknown. Evaluating and comparing the psychometric properties of these reward/relief drinking measures could identify measures with the most promise for translating precision medicine findings to clinical practice. In a community sample of 65 individuals with heavy/hazardous alcohol use on the Alcohol Use Disorder Identification Test, we showed good internal consistency reliability, test–retest reliability, and concurrent validity for theoretically aligned measures (e.g., reward drinking and reward responsiveness, relief drinking and depression/anxiety symptoms) of the reward and relief subscales across the six measures. We then used ecological momentary assessment to determine whether reward and relief drinking subscales predicted within-person associations between contextual factors of interest (e.g., negative affect, positive affect, distress intolerance, physical pain, hangover symptoms, social drinking situations, alcohol cues) and same-moment alcohol craving. All six measures demonstrated limited predictive validity for alcohol craving contexts in daily life as assessed via ecological momentary assessment. Despite these findings, reward and relief drinking measures show good reliability and concurrent validity and previously demonstrated clinical utility for predicting response to alcohol use disorder treatments, including naltrexone. Future research should aim to elucidate the mechanisms underlying the association between responses to reward/relief drinking measures and pharmacotherapy outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
A cross-sectional examination of race, gender, and intersectionality on protective behavioral strategies and alcohol outcomes among Black and White college students.
College students consistently report problematic alcohol use (e.g., excessive drinking). Protective behavioral strategies (PBS) are behaviors for reducing alcohol use and/or problems and are negatively associated with alcohol misuse among college students. Studies suggest PBS are used more often and/or more effectively by female individuals. Additionally, examinations specifically between Black and White students have yielded mixed findings and are typically underpowered. Scant studies have investigated the intersectionality between race and gender or examined perceived effectiveness of PBS use related to alcohol outcomes. The current cross-sectional study examined if (a) race, (b) gender, and (c) their interaction moderate the associations between perceived effectiveness of PBS use on PBS use (a path) and between PBS use on alcohol outcomes (i.e., alcohol quantity, peak drinks, and problems; b path). A sample size of N = 528 college drinkers ages 18–24 years old (Mage = 19.85; 52.5%, Black, 40.3% White) completed an online survey and were used for analyses. A series of moderated mediation models were conducted. Race did not moderate the a or b paths. The positive association for the a path as well as the indirect effect of PBS perceived effectiveness on lower alcohol outcomes through PBS use were stronger for female students than male students. The intersectionality examination indicated a stronger association between more PBS use and lower consumption, specifically for White male students, and lower problems for Black female students. More attention is needed toward considering intersectionality when identifying at-risk groups and tailoring alcohol intervention efforts. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Anxiety sensitivity is associated with heightened intolerance of uncertainty in individuals with alcohol use disorder.
Alcohol use disorder (AUD) is a highly prevalent, yet heterogenous condition linked to anxiety, reward sensitivity, and cognitive biases. Understanding cognitive mechanisms of specific AUD symptoms is crucial for developing tailored, effective interventions. This pilot study sought to assess whether two potential cognitive correlates of AUD—intolerance of uncertainty and delay discounting—differentially influence the relationship between AUD, anxiety sensitivity, and drinking motives. Individuals with mild-to-moderate AUD (n = 31) and healthy control participants (n = 31) completed a single-session lab study in which they performed a decision making under uncertainty task as a behavioral measure of uncertainty tolerance, completed a delay discounting task as a measure of reward sensitivity, and responded to surveys related to anxiety sensitivity, state and trait anxiety, intolerance of uncertainty, and drinking motives. Hierarchical regression results demonstrated a significant interaction between AUD status (AUD vs. control) on both self-reported (β = 0.687, p = .020) and behavioral (β = 0.777, p = .012) intolerance of uncertainty. Greater anxiety sensitivity was associated with heightened intolerance of uncertainty in those with AUD but not controls. Correlations showed that the coping drinking motive was significantly positively associated with anxiety sensitivity (r = 0.462, p = .010), self-reported (r = 0.535, p = .002), and behavioral intolerance of uncertainty (r = 0.396, p <.027) in participants with AUD but not controls. No significant associations between anxiety sensitivity, drinking motives, and delay discounting were observed in either the AUD or the control group. Intolerance of uncertainty may therefore represent a cognitive bias in which individuals with AUD and anxiety sensitivity drink to cope with environmental and internal uncertainty. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Evaluating the indirect roles of anxiety and depressive symptoms in the relations between negative emotional reactivity to racial/ethnic stress and cigarette smoking among Hispanic adults who smoke.
There has been increased recognition that Hispanic/Latinx (hereinafter Hispanic) persons are a tobacco disparities group in the United States. Although some past work has found greater exposure to racial/ethnic discrimination is associated with indices of smoking among Hispanic persons, research has not explored the degree of negative emotional reactivity to racial/ethnic stress in terms of smoking processes. The present cross-sectional study served to evaluate the indirect effects of depressive and anxiety symptoms in terms of relations between racial/ethnic stress reactivity and cigarette dependence, severity of problems when trying to quit, and perceived barriers for quitting among Hispanic persons who smoke in the United States. Participants included 329 Hispanic adults who smoked cigarettes daily (Mage = 35.5 years; SD = 8.67; 37.4% female). Results indicated that depressive symptoms exerted a statistically significant indirect effect in the association between negative emotional reactivity to racial/ethnic stress and cigarette dependence and severity of problems when trying to quit, whereas anxiety symptoms maintained an indirect effect for perceived barriers for smoking cessation. The current findings help characterize the intricacies by which negative emotional reactivity to racial/ethnic stress is related to smoking behavior and beliefs among Hispanic persons who smoke. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Effects of intranasal oxytocin on cigarette withdrawal and smoking in the laboratory: Differences by sex and social functioning traits.
Intranasal oxytocin (INOT) has received attention as a treatment for substance use disorders including tobacco dependence. However, it is unclear whether INOT-related effects differ by sex and social functioning traits. This study examined the influence of sex and two trait social functioning measures (hostility and rejection sensitivity) on INOT effects on abstinence-related subjective measures and smoking lapse. Adults who smoked cigarettes daily (N = 64; 21–40 years; 39% female) completed trait hostility and rejection sensitivity surveys at baseline followed by three experimental sessions following 12-hr smoking abstinence. Each session, participants received a single INOT dose (placebo, 20, 40 international units [IU]) in counterbalanced order, completed withdrawal, smoking urges and affect questionnaires, and a smoking lapse analog task. Interactive effects between INOT and sex, hostility, or rejection sensitivity on all outcomes were analyzed. INOT produced differential effects as a function of sex, trait hostility, and rejection sensitivity. The 20 IU dose worsened abstinence-related subjective effects for individuals with high trait hostility. Both INOT doses decreased smoking urges for high rejection sensitivity, and the 20 IU dose increased smoking urges for low rejection sensitivity. INOT increased withdrawal symptoms, smoking urges, and feelings of anger in females but not males. INOT did not improve withdrawal symptoms during abstinence and did not affect smoking lapse. While INOT produced some beneficial effects for a subset of participants with high rejection sensitivity, it worsened abstinence-related symptoms for others. Our results suggest that sex and social functioning should be considered when examining the therapeutic potential of INOT for smoking cessation in future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Using eye tracking to evaluate the impact of smartphone-delivered attentional bias modification training for smokers.
Attentional bias modification (ABM) has been proposed to treat tobacco use disorder by reducing attentional bias (AB) to smoking-related cues. We sought to determine the extent to which AB to smoking cues, as measured by eye-tracking technology, was sensitive to multisession ABM among treatment-seeking adult smokers. The participants (N = 203; 74 women) completed 13 days of daily ABM or sham training using a smartphone, followed by 8 weeks of nicotine replacement therapy and cessation counseling. ABM and sham training were administered using the modified dot-probe task (i.e., neutral cues probed 100% of the time) and the unmodified dot-probe task (i.e., cue types probed equally), respectively. Eye gaze dwell time proportions to paired presentations of smoking and neutral cues were measured at baseline, 1 day post-ABM training, and 8 weeks post-ABM training. At baseline, younger, more dependent smokers and those with higher smoking satisfaction scores looked longer at smoking cues than neutral ones. ABM training resulted in greater gaze preference for the smoking cues than sham training at 1 day posttraining. Gaze preference for smoking cues was positively associated with AB to smoking cues as measured by reaction time during the laboratory dot-probe assessment. At 8 weeks posttraining, gaze preference was not associated with any of the smoking outcome measures. These findings suggest that multisession ABM training resulted in changes in AB by increasing time spent looking at neutral compared with smoking cues in the short term. However, this effect was not sustained and was not associated with smoking behavior outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Effects of a fruit-ice combination flavor on appeal and sensory experience of vaping and moderation by preexisting e-cigarette flavor preference.
E-cigarettes with ice flavors, which are products with a cooling agent added to a characterizing flavor (e.g., grape-ice), are widely sold. Whether ice flavors appeal to only those who already use them or a to wider population is not widely understood. This secondary analysis of a clinical laboratory experiment tested effects of experimental exposure to e-cigarettes with fruit-ice versus other flavors on the appeal and sensory attributes of vaping and whether fruit-ice effects are moderated by preexisting e-cigarette flavor preference. In a controlled double-blind within-subject randomized online experiment, adults who currently use e-cigarettes, N = 85, M (SD) = 35.5 (13.2) years, 50% female, 54.3% White, self-administered e-liquids varying in flavors (fruit-ice [grape + menthol], tobacco-only, dessert-only [caramel], and fruit-only [strawberry]). Participants rated each product’s appeal (liking, disliking, willingness to use again) and sensory attributes (sweetness, smoothness, harshness, bitterness, and coolness). In the overall sample, fruit-ice flavor produced (a) higher appeal, sweetness, smoothness, and coolness and lower bitterness and harshness compared to tobacco and dessert-only flavors and (b) higher coolness and lower sweetness than fruit-only flavors. The appeal-enhancing effect of fruit-ice (vs. tobacco and dessert-only flavors) was stronger among those with preexisting preferences for menthol/mint, fruit, and ice flavors, but not for those who typically used tobacco-only flavors. Our findings suggest that restrictions on fruit-ice-flavored e-cigarettes may reduce the appeal of vaping, particularly among vapers with preferences for products with cooling, fruit, and/or sweet sensory attributes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Examination of the effects of cannabidiol on menstrual-related symptoms.
Some individuals attempt to alleviate menstrual-related symptoms (MRS) by using cannabis and report having expectations that cannabis can improve MRS; however, no study has examined the effect of cannabinoids on MRS. The present study is a pre–post, randomized, open-label trial that aimed to examine the effects of oral cannabidiol (CBD) isolate for alleviating MRS. Participants were assigned randomly to one of two open-label dosing groups of CBD softgels (160 mg twice a day, BID, n = 17; 320 mg BID, n = 16) and completed a 1-month baseline period. Following baseline, participants were instructed to consume CBD starting the first day they believed they experienced symptoms each month and to take their assigned dose daily for 5 consecutive days for three CBD-consumption months. We examined differences in MRS and related outcomes between baseline and 3 months of CBD consumption. Results revealed reductions (in both dosing groups) in MRS, irritability, anxiety, global impression of change, stress, and subjective severity scores when comparing baseline to all 3 months of CBD consumption. Depression scores did not change in either dosing group. Findings suggest that CBD may have the potential for managing MRS. Importantly, changes in symptoms appeared in the first month of CBD consumption and persisted over the 3 consumption months. Further research is warranted comparing the effects of CBD to placebo (a limitation of the study) and examining the potential to optimize CBD consumption for reducing MRS (e.g., combining CBD with terpenes; varying routes and timing of administration). (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Experimental and Clinical Psychopharmacology - Vol 32, Iss 6