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Increasing ecological validity in neuropsychopharmacology research on the relationship between alcohol use and uncertain stressors

Neuropsychopharmacology volume 49, pages 353–354 (2024)Cite this article

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We enthusiastically read Gorka et al. [1]. Earlier laboratory work from both their group and authors of this letter (e.g., refs. [2, 3]) highlight stressor uncertainty as a key moderator of alcohol’s long reported but inconsistently observed stress response dampening effects. Importantly, this research identifies exaggerated stress reactivity to uncertain stressors as either a consequent “disease marker” of repeated alcohol use (i.e., drug induced neuroadaptation; [3]) or, as suggested by Gorka et al. [1], a pre-morbid risk factor for alcohol use disorder. Gorka et al. [1] provided critical adjudication between these competing hypotheses using a rigorous longitudinal approach and a well-validated psychophysiological task. Though the sample’s preexisting alcohol exposure limits evidence for premorbidity, Gorka et al.’s [1] study provides intriguing data for the premorbid risk factor hypothesis which may inform intervention efforts for excessive alcohol use.

Gorka et al. [1] speculated that those “hyper-reactive to [uncertain threat] express vulnerability to coping oriented motives, or ‘self-medication,’” and, “The subjective… relief gained from intoxication can contribute to [alcohol] expectancies … and promote coping-motives for alcohol use.” Although speculation about potential clinical implications of basic research is common, empirical confirmation of even a tenuous connection between implicit measures (e.g., fMRI & startle) with drinkers’ subjective perceptions, cognitions, and subsequent drinking is sparse. Therefore, we agree with Gorka et al. [1] that reactions to uncertainty “can be captured at multiple units of analysis and similarly relate to real-world drinking behaviors.” and we propose this relationship will only be established if the units of analysis include subjective expectations and experience ([2, 4]). This will not only better connect neurobiology to real-world behavior, but also inform research in related sub-fields (e.g., expectancy).

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Fig. 1: Effects of stressor certainty and imagined intoxication.

References

  1. Gorka SM, Radoman M, Jimmy J, Kreutzer KA, Manzler C, Culp S. Behavioral and brain reactivity to uncertain stress prospectively predicts binge drinking in youth. Neuropsychopharmacol. 2023;48:1194–1200.

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Authors and Affiliations

  1. School of Psychological Science, Oregon State University, Corvallis, OR, USA

    Daniel E. Bradford, Angelica DeFalco & Freya Whittaker

  2. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Amelia S. Dev & Kiara R. Timpano

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  1. Daniel E. Bradford
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  2. Amelia S. Dev
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  3. Angelica DeFalco
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  4. Freya Whittaker
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  5. Kiara R. Timpano
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Contributions

DEB, ASD, & KRT developed the study concept and design, Data collection was performed by ASD & KRT. DEB, ASD, & KRT performed the data analysis and interpretation, DEB, AD, and FW drafted the letter. ASD & KRT provided critical revisions. All authors approved the final letter.

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Correspondence to Daniel E. Bradford.

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Bradford, D.E., Dev, A.S., DeFalco, A. et al. Increasing ecological validity in neuropsychopharmacology research on the relationship between alcohol use and uncertain stressors. Neuropsychopharmacol. 49, 353–354 (2024). https://doi.org/10.1038/s41386-023-01672-7

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