AUD, Depression May Not Dampen Alcohol’s Pleasurable Effects

Individuals with alcohol use disorder (AUD) and comorbid depression still experience high levels of pleasure when drinking, according to a study appearing in the February issue of The American Journal of Psychiatry.

These findings run counter to the allostasis model of addiction, which posits that excessive alcohol use changes brain responses so that people drink more to relieve negative feelings rather than for pleasure or reward.

Yet as Andrea C. King, Ph.D., and colleagues at the University of Chicago, wrote: “Debate remains whether excessive drinking reflects overall acute alcohol tolerance, desire for relief from negative mood states (e.g., depression), or heightened sensitivity to alcohol’s pleasurable effects.”

King and colleagues examined data from 221 adults ages 21 to 35 across the United States who completed a one-week assessment of drinking behavior. This group included 120 adults with AUD (of whom 64 also had a depressive disorder within the past year) and 101 adults without AUD (of whom 45 had past-year depression).

All participants completed daily mood surveys along a detailed survey of a typical drinking session and a typical non-drinking session during the week; for these surveys, participants reported how they felt both while drinking (or not) and the following morning.

As anticipated, individuals with AUD on average drank more during a typical drinking session than those without AUD (8.5 standard drinks versus 3.7 standard drinks, respectively). Individuals with AUD also reported more pleasurable feelings such as stimulation and wanting more than those without, both initially and across the three-hour monitoring period. The researchers identified no significant differences in pleasure levels between individuals with or without depression.

Adults in all groups reported less negative affect during drinking, though the changes were smaller in magnitude and showed no significant difference based on AUD or depression status.

“In the present study’s real-time assessment of naturalistic drinking episodes, we found evidence of sensitivity to alcohol’s desirable subjective effects, rather than tolerance to these effects … in persons with AUD, regardless of depression status,” the researchers wrote. They suggested that the pathway from early drinking to addiction may be better viewed as a coexistence of positive and negative reinforcement, rather than progression from one to the other.

For related information, see the Psychiatric News article “NIAAA Director Hopeful About Growing Awareness of Risks, Harms of Alcohol.”

(Image: Getty Images/iStock/Shutter2U)

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Fathers’ Depression May Affect Children’s Behavior

Kindergarten-age children who have fathers with depression are more likely than children not exposed to paternal depression to have behavioral problems and poor social skills several years later, a study in the American Journal of Preventive Medicine has found.

Kristine Schmitz, M.D., of Robert Wood Johnson Medical School, and colleagues examined data from 1,422 children enrolled in the Future of Families and Child Wellbeing study. This ongoing study is following a cohort of individuals born in one of 20 large U.S. cities between 1998 and 2000 as well as their families. More than 75% of mothers in the study were unmarried at the time of their children’s birth. Paternal depression was assessed using the World Health Organization’s Composite International Diagnostic Interview Short Form when the children were 5 years old, at which time 9% of fathers screened positive for depression.

When the children were 9 years old, their teachers reported the children’s behavior via the Conners’ Teacher Rating Scale—Revised Short form and the Social Skills Rating Scale. These assessments measure externalizing behaviors, internalizing behaviors, attention problems, and social problems.

After adjusting for numerous child and family variables, including maternal depression and whether the father lived with the child, the researchers found that paternal depression was associated with a 36% higher oppositional score, 37% higher hyperactive score, and 25% higher attention-deficit/hyperactivity disorder score at age 9. Paternal depression was also associated with an 11% lower positive social skills score and a 25% higher problematic behavior score. There were no associations between paternal depression and cognitive problems/inattention.

“Several potential mechanisms could underlie the findings,” the researchers wrote. “Depression can lead to suboptimal parenting and less emotional support for the child. Paternal depression has been associated with fewer positive and more negative parenting behaviors, including harsher parenting and physical punishment.”

The researchers added that the findings support the need to identify fathers at risk for depression beyond the perinatal period and link them to interventions to support their children’s well-being.

“[The findings] also suggest the need for interventions supporting school-aged children exposed to paternal depression,” the researchers wrote. “Pediatricians, with their frequent contact with families, are well-positioned to address these important needs.”

For related information, see the Psychiatric News article “One-Third of Teens Have Parent With Anxiety or Depression.”

(Image: Getty Images/iStock/Miljan Živković)

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