This component consists of two separate studies that deal with alcohol dependence as a psychobiological process. The first study (cue reactivity) is the continuation of an ongoing project designed to evaluate the effect of cue exposure treatment on urges to drink and relapse in abstinent alcoholics. Seventy inpatient alcoholics are being randomly assigned to six sessions of individual therapy involving either alcohol cue exposure plus coping skills training or coping skills alone. Changes in reactivity to alcohol-related cues are assessed in the laboratory. Follow-up interviews are conducted to assess treatment outcome at 3 and 6 months after discharge from inpatient treatment. Subjects repeatedly exposed to alcohol cues are expected to show a decrease in cue reactivity and be less likely to relapse. After this research is completed in the second grant year, a different group of investigators will initiate a three-year study of vulnerability factors that may contribute to the development of alcohol dependence through the mechanism of stress dampening. Eighty moderate to heavy drinkers (40 males, 40 females), half with a history of familial alcoholism, will be studied in the natural environment using an intensive daily process methodology during a 50-day observational period. The study will examine family history of alcoholism (FH+), gender, and affective reactions to daily events as predictors of alcohol use. It is hypothesized that FH+ individuals compared to FH- individuals will be more extreme in their affective reactions to negative events; exhibit greater dampening of these responses when alcohol is consumed prior to a stressful event; and report more alcohol use after experiencing such events. These hypotheses, if confirmed, will provide valuable evidence for a theoretical model that implicates the interaction between genetic vulnerability and psychological reinforcement as basic mechanisms in the development of alcohol dependence.
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