The Modulation of the Startle Reflex as Predictor of Alcohol Use Disorders in a Sample of Heavy Drinkers: A 4‐Year Follow‐Up Study

• Published in: Alcoholism, clinical and experimental research clinical and experimental research, 2017-06, Vol.41 (6), p.1212-1219
• Main Authors: Jurado‐Barba, Rosa, Duque, Almudena, López‐Trabada, José Ramón, Martínez‐Gras, Isabel, García‐Gutiérrez, María Salud, Navarrete, Francisco, López‐Muñoz, Francisco, Jiménez‐Arriero, Miguel Ángel, Ávila, Cesar, Manzanares, Jorge, Rubio, Gabriel
• Format: Article
• Language: English
• Subjects: Adult; Alcohol Consumption; Alcohol Drinking - epidemiology; Alcohol Drinking - psychology; Alcohol Use Disorders; Alcoholic Intoxication - diagnosis; Alcoholic Intoxication - epidemiology; Alcoholic Intoxication - psychology; Alcoholism - diagnosis; Alcoholism - epidemiology; Alcoholism - psychology; Follow-Up Studies; Humans; Male; Middle Aged; Photic Stimulation - methods; Predictive Value of Tests; Reflex, Startle - physiology; Startle Reflex Response
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/acer.13399

Background Previous studies demonstrated that patients with alcohol use disorders (AUDs) show altered startle reflex responses to alcohol‐related stimuli. However, there is little information about the role of these altered responses in the development of AUDs. This study examined the startle reflex response to different visual stimuli and the role of these patterns in the development of AUDs in a 4‐year follow‐up. Methods Two hundred and thirty‐nine (nondependent) heavy‐drinking participants were selected. In the baseline period, the startle reflex responses to alcohol‐related, aversive, appetitive, and neutral pictures were assessed. Startle reflex responses to these pictures were used as predictive variables. Status drinking (alcohol dependence and nondependence) assessed at 4‐year follow‐up was used as outcome measure. Results At the 4‐year follow‐up assessment, 46% of participants fulfilled DSM‐IV alcohol abuse or dependence criteria. Alcohol dependence status was predicted by an attenuated startle reflex response to alcohol‐related and aversive pictures. Conclusions This study revealed that an attenuated modulation of startle reflex response to alcohol‐related and aversive stimuli could be used as a clinical marker to predict the development of AUDs in participants with previous alcohol consumption. The participants are 239 men with a heavy‐drinking profile who had not received previous formal treatment for Alcohol Use Disorder (AUD). Results show that in comparison with participants remaining as heavy drinkers and remitted at 4‐year follow‐up, alcohol‐dependent subjects show an attenuated startle reflex response to alcohol‐related, aversive, appetitive and neutral pictures. The predictive analysis shows that the startle reflex response to alcohol‐related and aversive pictures are significant predictors of alcohol‐dependence status at the follow‐up 4 years later.