The proposed study involves an investigation of the interrelationship between neuroendocrine, psychophysiological and subjective reactions following the presentation and consumption of alcohol and placebo beverages in individuals with different histories of alcohol dependence. The repeated measures design is intended to examine and characterize the time course and interrelationship of biological (insulin, glucose, glucagon, cortisol, catecholamines), psychophysiological (heart rate, skin conductance) and subjective (desire to drink, anxiety and other measures of affective stage) changes observed in various samples of subjects (inpatient alcoholics, inpatient drug abusers, community light and heavy drinkers) following the presentation and consumption of placebo and alcoholic beverages. A balanced placebo design will permit the assessment of the effects of expected and actual pharmacological effects of ethanol as well as the interaction of these two factors. It is proposed that alcohol dependent individuals will demonstrate both quantitative and qualitative differences in their neuroendocrine response to the presentation and consumption of both alcoholic and placebo beverages, and that this response in the alcoholic sample is important in defining the biological/cognitive/psychophysiological state (craving) associated with and/or mediating abnormal alcohol consumption in alcohol dependent individuals. The underlying mechanism for the expression of such a multidimensional state will be examined in the present study. Particular emphasis will be placed on mechanisms related to both potential conditioned factors (conditioned compensatory response, conditioned abstinence, conditioned reinforcement) as well as the association among subjective and psychophysiological responses with neuroendocrine responses.
