Effects of Drink‐Stress Sequence and Gender on Alcohol Stress Response Dampening in High and Low Anxiety Sensitive Drinkers

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Abstract
Background: This study tested the appraisal disruption hypothesis of alcohol stress response dampening (SRD) in male and female high or low anxiety sensitive (AS) undergraduates. The hypothesis predicts that alcohol SRD will be greater when drinking occurs before versus after stress exposure. High AS males' predominant social‐evaluative concerns further implied that alcohol SRD to a social stressor (i.e., a speech) would be relatively stronger in high AS males than in high AS females.Methods: Male and female (n=90/gender) high and low AS participants (≥70th; ≤30th percentile on Anxiety Sensitivity Index‐Revised) were matched on drinking habits and randomly assigned to 1 of 9 experimental cells. Drink type—alcohol (0.7 g/kg males; 0.63 g/kg females), placebo, soda—was fully crossed with stress condition—drink before stress (DBS), drink after stress (DAS), and no stress control (NSC). Stress was induced by telling participants they would be required to make a self‐revealing speech. Stress response dampening was assessed for state anxiety on the Spielberger scale and Stroop interference to threat‐related words. Subjective desire for alcohol was also assessed.Results: Relative to placebo, alcohol (peak blood alcohol concentration, 0.064%) reliably reduced state anxiety in high AS but not in low AS participants. Alcohol decreased STAI scores and Stroop interference to social threat words significantly more in the DBS than the DAS condition in high AS males; high AS females displayed the exact opposite pattern of effects. In contrast to other participants, high AS males also reported relatively strong desire scores under alcohol.Conclusions: Overall, the results do not support the appraisal disruption hypothesis as a general mechanism of alcohol SRD in undergraduate drinkers. The findings for high AS males do support the hypothesis, while the opposing profile for high AS females implies that the nature of the stressor (i.e., social challenge) may contribute to gender differences in alcohol SRD in high AS individuals.

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