Adverse effects of excessive drinking are widespread in society. Understanding the factors that contribute to excessive alcohol consumption is crucial for improved prevention, education, and intervention. The goal of the Chicago Social Drinking Project (CSDP) is to evaluate the role of subjective and physiologic responses to alcohol in the escalation and maintenance of excessive drinking in adults. Our paradigm integrates human laboratory alcohol challenge with longitudinal assessment of drinking and related behaviors to discern whether alcohol responses predict future drinking problems and alcohol use disorder (AUD) symptoms. The CSDP has demonstrated that heightened sensitivity to alcohol stimulation and reward (liking, wanting) characterize young adult heavy drinkers (HD) versus light drinkers (LD) and these responses are primary predictors of future drinking progression and development of AUD over a decade later. This alcohol response phenotype is also evident in a newly-tested cohort of young adult AUD drinkers. Contrary to prevailing models of addiction propensity, our findings show a pervasive and sustained heightened sensitivity to alcohol stimulation and reward in excessive drinkers, and not low reward and negative reinforcement. In this award phase, we propose to further advance new discoveries and challenge existing paradigms by continuing to examine our high- retention cohorts in CSDP as well as enroll new cohorts.
In Aim 1, we will extend a final follow-up wave in our existing HD and LD as well as extend follow-up in our ongoing young adult AUD cohort (N=398; >98% retention) to discern binge drinking severity, AUD symptoms, and drinking consequences during middle adulthood to evaluate the role of early-adult stimulating, rewarding, and sedating alcohol responses in predicting these behaviors.
In Aims 2 and 3, we will enroll two new cohorts historically excluded from alcohol challenge research to provide potentially the most robust tests on the role of alcohol responses in excessive drinking. These include young adult HD with affective disorder (n=100) and older, chronic AUD drinkers (n=100; non-treatment-seeking), and their respective control groups (n=70 each), to determine if their alcohol response phenotype is characterized primarily by stimulation and reward sensitivity or by reward insensitivity and relief of negative affect or withdrawal states, as commonly theorized. These participants will undergo similar alcohol and placebo laboratory sessions and follow-up on drinking behaviors and AUD symptoms, as in established cohorts. As well-controlled research examining biphasic alcohol responses in clinically-relevant subgroups of comorbid and older AUD drinkers is lacking, determining their alcohol response phenotype offers a unique opportunity to test current theories of incentive-sensitization, reward sensitivity, and positive/negative reinforcement models of the development and maintenance of addictive behavior.

Public Health Relevance

Understanding the factors contributing to development and persistence of excessive alcohol consumption is crucial for improved prevention, education and intervention strategies. Our unique integration of human laboratory alcohol challenge and longitudinal assessment of drinking behaviors and consequences over time will provide critical tests of the prospective role of stimulating, rewarding, and sedating alcohol responses to escalations and maintenance of excessive drinking.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA013746-18
Application #
10087455
Study Section
Addiction Risks and Mechanisms Study Section (ARM)
Program Officer
Matochik, John A
Project Start
2003-06-05
Project End
2024-01-31
Budget Start
2021-02-01
Budget End
2022-01-31
Support Year
18
Fiscal Year
2021
Total Cost
Indirect Cost
Name
University of Chicago
Department
Psychiatry
Type
Schools of Medicine
DUNS #
005421136
City
Chicago
State
IL
Country
United States
Zip Code
60637
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Smith, Lia J; McNamara, Patrick J; King, Andrea C (2017) Optimizing follow-up and study retention in the 21st century: Advances from the front line in alcohol and tobacco research. Drug Alcohol Depend 175:171-178
Fridberg, Daniel J; Rueger, Sandra Y; Smith, Patrick et al. (2017) Association of Anticipated and Laboratory-Derived Alcohol Stimulation, Sedation, and Reward. Alcohol Clin Exp Res 41:1361-1369
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King, Andrea C; Hasin, Deborah; O'Connor, Sean J et al. (2016) A Prospective 5-Year Re-examination of Alcohol Response in Heavy Drinkers Progressing in Alcohol Use Disorder. Biol Psychiatry 79:489-98
Cao, Dingcai; Zhuang, Xiaohua; Kang, Para et al. (2016) Acute Alcohol Drinking Promotes Piecemeal Percepts during Binocular Rivalry. Front Psychol 7:489
Fridberg, Daniel J; Cao, Dingcai; King, Andrea C (2015) Integrating alcohol response feedback in a brief intervention for young adult heavy drinkers who smoke: A pilot study. Drug Alcohol Depend 155:293-7
Rueger, Sandra Y; Hu, Hongxing; McNamara, Patrick et al. (2015) Differences in subjective response to alcohol in heavy- and light-drinking Chinese men versus Caucasian American men. Addiction 110:91-9

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