Stress Often to Blame for Alcohol Use Disorder
Life events that can seriously challenge the built-in human capacity for coping with stress include such things as the death of a close relative or loved one, going through a divorce, losing your job, having a potentially life-threatening illness, being the victim of a physical or sexual assault, experiencing or witnessing combat, experiencing or witnessing acts of terrorism and going through a natural disaster. Most people live through these kinds of events without experiencing lasting mental health consequences. However, exposure to major stress leads to the onset of diagnosable problems in a sizable minority of the total population. Two mental health diagnoses specifically cover the effects of psychological trauma stemming from stressful events that pose a life-threatening risk or appear to pose such a risk: acute stress disorder and post-traumatic stress disorder. Acute stress disorder (ASD) is characterized by impairing stress-related symptoms that manifest within 30 days of a triggering event. Doctors diagnose post-traumatic stress disorder (PTSD) 30 days or longer after the occurrence of a triggering event.
Alcohol Use Disorder
Alcohol use disorder is a diagnosis created by the American Psychiatric Association in 2013 as a replacement for two conditions previously classified separately: the physical dependence-related disorder called alcoholism and the non-physical dependence-related disorder called alcohol abuse. This switchover was made, in part, because a person affected by alcoholism often has symptoms normally ascribed to alcohol abuse; similarly, a person affected by alcohol abuse may have symptoms normally ascribed to alcoholism. Previously, a diagnosis of alcohol abuse required the presence of at least one out of four possible symptoms, while the diagnosis of alcoholism required the presence of at least three out of seven symptoms. The alcohol use disorder diagnosis requires the presence of at least two of 11 combined alcohol abuse/alcoholism symptoms.
Impact on the Odds
In the study slated for publication in Drug and Alcohol Dependence, researchers from New Zealand’s University of Otago used data from a long-term project to assess the impact that stressful life events have on the odds that a young adult will develop alcohol use disorder. The researchers used the criteria for separately defined alcohol abuse and alcoholism rather than the joint criteria for alcohol use disorder. In most respects, the symptom lists involved are the same. A total of about 1,000 people took part in the study. Over the course of 10 years, the researchers looked at each participant’s experiences with diagnosable alcohol problems in three distinct time frames between the ages of 20 and 30. They also looked at each participant’s history of major stress exposure over a 12-year period that began at age 18.
The researchers concluded that exposure to highly stressful life events does indeed increase the chances that a young adult will develop alcohol use disorder. Compared to individuals with minimal exposure to such events, those with the most exposure were roughly 124 percent more likely to develop alcohol-related symptoms. The researchers compared the outcomes of the men taking part in the study to the outcomes of the women. When they completed this comparison, they additionally concluded that the connection between major stress and alcohol use disorder is stronger in women.
The raw findings of the study indicated that the connection between stress exposure and diagnosable alcohol problems could potentially run in either direction. This meant that the presence of alcohol use disorder might explain exposure to major stress, rather than exposure to major stress explaining the presence of alcohol use disorder. It was only after completing an additional analysis that the researchers concluded that their findings match up closest when stress is the cause of alcohol problems rather than the result.