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)
Don't miss out! To learn about newly posted articles in Psychiatric News, please sign up here.