Stress modulates illness-course of substance use disorders: a translational review

Childhood trauma and post-childhood chronic/repeated stress could increase the risk of a substance use disorder by affecting 5 stages of addiction illness-course: (a) initial experimentation with substances; (b) shifting from experimental to regular use; (c) escalation from regular use to abuse or d...

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Main Authors: Marijn eLijffijt, Kesong eHu, Alan eSwann
Format: Article
Language:English
Published: Frontiers Media S.A. 2014-07-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fpsyt.2014.00083/full
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author Marijn eLijffijt
Kesong eHu
Alan eSwann
author_facet Marijn eLijffijt
Kesong eHu
Alan eSwann
author_sort Marijn eLijffijt
collection DOAJ
description Childhood trauma and post-childhood chronic/repeated stress could increase the risk of a substance use disorder by affecting 5 stages of addiction illness-course: (a) initial experimentation with substances; (b) shifting from experimental to regular use; (c) escalation from regular use to abuse or dependence; (d) motivation to quit; (e) risk of (re-)lapse. We reviewed the human literature on relationships between stress and addiction illness-course. We explored per illness-course stage (i) whether childhood trauma and post-childhood chronic/repeated stress have comparable effects, and (ii) whether effects cut across classes of substances of abuse. We further discuss potential underlying mechanisms by which stressors may affect illness-course stages for which we relied on evidence from studies in animals and humans. Stress and substances of abuse both activate stress and dopaminergic motivation systems, and childhood trauma and post-childhood stressful events are more chronic and occur more frequently in people who use substances. Stressors increase risk to initiate early use potentially by affecting trait-like factors of risk-taking, decision making, and behavioral control by diminished prefrontal functioning. Stressors also accelerate transition to regular use, potentially due to prior effects of stress on cross-sensitization of dopaminergic motivation systems with substances of abuse, especially in people with high trait impulsivity who are more prone to sensitization. Finally, stressors increase risk for abuse and dependence, attenuate motivation to quit, and increase relapse risk, potentially by intensified sensitization of motivational systems, by a shift from positive to negative reinforcement due to sensitization of the amygdala by corticotropin releasing factor, and by increased sensitization of noradrenergic systems. Stress generally affects addiction illness-course across childhood stressor types, and across classes of substances of abuse.
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spelling doaj.art-63c60d79c216414f8c19f7b2c1e795142022-12-22T03:09:55ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402014-07-01510.3389/fpsyt.2014.0008397335Stress modulates illness-course of substance use disorders: a translational reviewMarijn eLijffijt0Kesong eHu1Alan eSwann2Baylor College of MedicineCornell UniversityBaylor College of MedicineChildhood trauma and post-childhood chronic/repeated stress could increase the risk of a substance use disorder by affecting 5 stages of addiction illness-course: (a) initial experimentation with substances; (b) shifting from experimental to regular use; (c) escalation from regular use to abuse or dependence; (d) motivation to quit; (e) risk of (re-)lapse. We reviewed the human literature on relationships between stress and addiction illness-course. We explored per illness-course stage (i) whether childhood trauma and post-childhood chronic/repeated stress have comparable effects, and (ii) whether effects cut across classes of substances of abuse. We further discuss potential underlying mechanisms by which stressors may affect illness-course stages for which we relied on evidence from studies in animals and humans. Stress and substances of abuse both activate stress and dopaminergic motivation systems, and childhood trauma and post-childhood stressful events are more chronic and occur more frequently in people who use substances. Stressors increase risk to initiate early use potentially by affecting trait-like factors of risk-taking, decision making, and behavioral control by diminished prefrontal functioning. Stressors also accelerate transition to regular use, potentially due to prior effects of stress on cross-sensitization of dopaminergic motivation systems with substances of abuse, especially in people with high trait impulsivity who are more prone to sensitization. Finally, stressors increase risk for abuse and dependence, attenuate motivation to quit, and increase relapse risk, potentially by intensified sensitization of motivational systems, by a shift from positive to negative reinforcement due to sensitization of the amygdala by corticotropin releasing factor, and by increased sensitization of noradrenergic systems. Stress generally affects addiction illness-course across childhood stressor types, and across classes of substances of abuse.http://journal.frontiersin.org/Journal/10.3389/fpsyt.2014.00083/fullDecision MakingMotivationNorepinephrineAddictioncortisolimpulsivity
spellingShingle Marijn eLijffijt
Kesong eHu
Alan eSwann
Stress modulates illness-course of substance use disorders: a translational review
Frontiers in Psychiatry
Decision Making
Motivation
Norepinephrine
Addiction
cortisol
impulsivity
title Stress modulates illness-course of substance use disorders: a translational review
title_full Stress modulates illness-course of substance use disorders: a translational review
title_fullStr Stress modulates illness-course of substance use disorders: a translational review
title_full_unstemmed Stress modulates illness-course of substance use disorders: a translational review
title_short Stress modulates illness-course of substance use disorders: a translational review
title_sort stress modulates illness course of substance use disorders a translational review
topic Decision Making
Motivation
Norepinephrine
Addiction
cortisol
impulsivity
url http://journal.frontiersin.org/Journal/10.3389/fpsyt.2014.00083/full
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AT alaneswann stressmodulatesillnesscourseofsubstanceusedisordersatranslationalreview