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Repeated psychological stress testing in stimulant-dependent patients
Debra S Harris1, Victor I Reus, Owen M Wolkowitz
1Drug Dependence Research Center, Langley Porter Psychiatric Institute, Department of Psychiatry, University of California, San Francisco, CA, USA. debra.harris@med.va.gov
Summary
Stress imagery tests effectively measure stress-induced craving in substance abuse, showing better replicability than the Trier Social Stress Test (TSST). This aids in evaluating interventions for reducing relapse to drugs.
Area of Science:
- Neuroscience
- Psychology
- Addiction Research
Background:
- Reducing stress reactivity is crucial for interventions targeting substance abuse relapse.
- Repeated laboratory stress tests are needed to evaluate intervention efficacy prior to large-scale trials.
Purpose of the Study:
- To compare the efficacy and replicability of two psychological stress tests: the Trier Social Stress Test (TSST) and a stress imagery test.
- To examine the psychological, physiological, and hormonal responses to repeated stress testing in individuals dependent on cocaine or methamphetamine.
- To investigate the relationship between stress responses, drug craving, and hormonal changes (salivary cortisol and DHEA).
Main Methods:
- Two psychological stress tests (TSST and stress imagery) were administered twice to cocaine- or methamphetamine-dependent individuals.
- Subjective psychological responses, including negative affect and drug craving, were measured.
- Physiological and hormonal responses, specifically salivary cortisol and dehydroepiandrosterone (DHEA), were assessed.
Main Results:
- The stress imagery test demonstrated significant subjective changes and better replicability across sessions compared to the TSST.
- The TSST showed significant effects only in the second session.
- Cocaine and methamphetamine users exhibited different craving responses to stress; methamphetamine users reported smaller increases or decreases in craving.
- Neither stress test significantly altered salivary cortisol or DHEA levels, and hormonal changes were not correlated with subjective responses.
Conclusions:
- Stress imagery testing appears to be a promising tool for assessing stress-induced affect and stimulant drug craving in laboratory settings.
- The findings suggest that the hypothalamic-pituitary-adrenal (HPA) axis responsivity may not be directly linked to acute stress-induced stimulant craving or affective responses in this population.
- The study highlights the potential utility of stress imagery for evaluating interventions aimed at reducing stress reactivity in substance abuse treatment.