Problematic Internet use and excessive alcohol consumption have been associated with a host of maladaptive outcomes. Further, low (blunted) cardiovascular and stress hormone (e.g. cortisol) reactions to acute psychological stress are a feature of individuals with a range of adverse health and behavioural characteristics, including dependencies such as tobacco and alcohol addiction. The present study extended this research by examining whether behavioural dependencies, namely problematic Internet use, excessive alcohol consumption, and their comorbidity would also be associated with blunted stress reactivity
A large sample of university students (N = 2313) were screened using Internet and alcohol dependency questionnaires to select four groups for laboratory testing: comorbid Internet and alcohol dependence (N = 17), Internet dependence (N = 17), alcohol dependence (N = 28), and non-dependent controls (N = 26). Cardiovascular activity and salivary cortisol were measured at rest and in response to a psychological stress protocol comprising of mental arithmetic and public speaking tasks.
Neither problematic Internet behaviour nor excessive alcohol consumption, either individually or in combination, were associated with blunted cardiovascular or cortisol stress reactions.
It is possible that problematic Internet behaviour and excessive alcohol consumption in a student population were not related to physiological reactivity as they may not reflect ingrained addictions but rather an impulse control disorder and binging tendency.
The present results serve to indicate some of the limits of the developing hypothesis that blunted stress reactivity is a peripheral marker of the central motivational dysregulation in the brain underpinning a wide range of health and behavioural problems.
Zulkefly, S. N. & Baharudin, R. (2009). Mobile phone use amongst students in a university in Malaysia: Its correlates and relationship to psychological health. European Journal of Scientific Research, 27(2), 206–218
al’Absi, M., Wittmers, L. E., Erickson, J., Hatsukami, D. & Crouse, B. (2003). Attenuated adrenocortical and blood pressure responses to psychological stress in ad libitum and abstinent smokers. Pharmacology, Biochemistry and Behavior, 74, 401–410
Allen, K. L., Byrne, S. M., Oddy, W. H. & Crosby, R. D. (2013). Early onset binge eating and purging eating disorders: Course and outcome in a population-based study of adolescents. Journalof Abnormal Child Psychology, 41, 1083–1096
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV). Washington, DC:American Psychiatric Association
Bamber, D., Cockerill, I. M. & Carroll, D. (2000). The pathological status of exercise dependence. British Journal of Sports Medicine, 34, 125–132
Beard, K. W. & Wolf, E. M. (2001). Modification in the proposed diagnostic criteria for Internet addiction. Cyberpsychology & Behavior, 4, 377–383
Berczik, K., Szabo, A., Griffiths, M. D., Kurimay, T., Kun, B., Urban, R. & Demetrovics, Z. (2012). Exercise addiction: Symptoms, diagnosis, epidemiology, and etiology. Substance Use & Misuse, 47, 403–417
Bernardy, N. C., King, A. C., Parsons, O. A. & Lovallo, W. R. (1996). Altered cortisol response in sober alcoholics: An examination of contributing factors. Alcohol, 13, 493–498
Bewick, B. M., Trusler, K., Mulhern, B., Barkham, M. & Hill, A. J. (2008). The feasibility and effectiveness of a web-based personalised feedback and social norms alcohol intervention in UK university students: A randomised control trial. Addictive Behaviors, 33, 1192–1198
Bosch, J. A., Berntson, G. G., Cacioppo, J. T., Dhabhar, F. S. & Marucha, P. T. (2003). Acute stress evokes selective mobilization of T cells that differ in chemokine receptor expression: A potential pathway linking immunologic reactivity to cardiovascular disease. Brain, Behavior and Immunity, 17, 251–259
Bosch, J. A., De Geus, E. J., Carroll, D., Goedhart, A. D., Anane, L. A., Van Zanten, J. J., Helmerhorst, E. J. & Edwards, K. M. (2009). A general enhancement of autonomic and cortisol responses during social evaluative threat. Psychosomotic Medicine, 71, 877–885
Breslau, N. (1995). Psychiatric comorbidity of smoking and nicotine dependence. Behavior Genetics, 25, 95–101
Brindle, R. C., Ginty, A. T. & Conklin, S. M. (2013). Is the association between depression and blunted cardiovascular stress reactions mediated by perceptions of stress? International Journal of Psychophysiology, 90, 66–72
Brown, S. A., McGue, M., Maggs, J., Schulenberg, J., Hingson, R., Swartzwelder, S., Hingson, R., Swartzwelder, S., Martin, C., Chung, T., Tapert, S. F., Sher, K., Winters, K. C., Lowman, C. & Murphy, S. (2008). A developmental perspective on alcohol and youths 16 to 20 years of age. Pediatrics, 121, 290–310
Bush, G., Luu, P. & Posner, M. I. (2000). Cognitive and emotional influences in anterior cingulate cortex. Trends in Cognitive Sciences, 4, 215–222
Cao, F., Su, L., Liu, T. & Gao, X. (2007). The relationship between impulsivity and Internet addiction in a sample of Chinese adolescents. European Psychiatry, 22, 466–471
Carroll, D. (1992). Health psychology: Stress, behaviour and disease. London: The Falmer Press
Carroll, D., Ginty, A. T., Der, G., Hunt, K., Benzeval, M. & Phillips, A. C. (2012). Increased blood pressure reactions to acute mental stress are associated with 16-year cardiovascular disease mortality. Psychophysiology, 49, 1444–1448
Carroll, D., Lovallo, W. R. & Phillips, A. C. (2009). Are large physiological reactions to acute psychological stress always bad for health? Social and Personality Psychology Compass, 3, 725–743
Carroll, D., Phillips, A. C. & Der, G. (2008). Body mass index, abdominal adiposity, obesity, and cardiovascular reactions to psychological stress in a large community sample. Psychosomatic Medicine, 70, 653–660
Carroll, D., Phillips, A. C. & Lovallo, W. R. (2011). The behavioural and health corollaries of blunted physiological reactions to acute psychological stress: Revising the reactivity hypothesis. In R. A. Wright & G. H. E. Gendolla (Eds.), How motivationaffects cardiovascular response: Mechanisms and applications (pp. 243–263). Washington, D.C.: APA Press
Choi, J. S., Park, S. M., Lee, J., Hwang, J. Y., Jung, H. Y., Choi, S. W., Kim, D. J., Oh, S. & Lee, J. Y. (2013). Resting-state beta and gamma activity in Internet addiction. International Journalof Psychophysiology, 89, 328–333
Christo, G., Jones, S. L., Haylett, S., Stephenson, G. M., Lefever, R. M. H. & Lefever, R. (2003). The Shorter PROMIS Questionnaire: Further validation of a tool for simultaneous assessment of multiple addictive behaviours. Addictive Behaviors, 28, 225–248
Dai, X., Thavundayil, J., Santella, S. & Gianoulakis, C. (2007). Response of the HPA-axis to alcohol and stress as a function of alcohol dependence and family history of alcoholism. Psychoneuroendocrinology, 32, 293–305
Dawson, D. A., Grant, B. F., Stinson, F. S. & Chou, P. S. (2004). Another look at heavy episodic drinking and alcohol use disorders among college and noncollege youth. Journal of Studieson Alcohol, 65, 477–488
De Rooij, S. R., Schene, A. H., Phillips, D. I. & Roseboom, T. J. (2010). Depression and anxiety: Associations with biological and perceived stress reactivity to a psychological stress protocol in a middle-aged population. Psychoneuroendocrinology, 35, 866–877
Dong, G., Devito, E. E., Du, X. & Cui, Z. (2012). Impaired inhibitory control in ‘Internet addiction disorder’: A functional magnetic resonance imaging study. Psychiatry Research, 203, 153–158
Durkee, T., Kaess, M., Carli, V., Parzer, P., Wasserman, C., Floderus, B., Apter, A., Balazs, J., Barzilay, S., Bobes, J., Brunner, R., Corcoran, P., Cosman, D., Cotter, P., Despalins, R., Graber, N., Guillemin, F., Haring, C., Kahn, J. P., Mandelli, L., Marusic, D., Mészáros, G., Musa, G. J., Postuvan, V., Resch, F., Saiz, P. A., Sisask, M., Varnik, A., Sarchiapone, M., Hoven, C. W. & Wasserman, D. (2012). Prevalence of pathological Internet use among adolescents in Europe: Demographic and social factors. Addiction, 107, 2210–2222
Egorov, A. Y. & Szabo, A. (2013). The exercise paradox: An interactional model for a clearer conceptualization of exercise addiction. Journal of Behavioral Addictions, 2, 199–208
Ehlers, C. L. & Criado, J. R. (2010). Adolescent ethanol exposure: Does it produce long-lasting electrophysiological effects? Alcohol, 44, 27–37
Errico, A. L., Parsons, O. A., King, A. C. & Lovallo, W. R. (1993). Attenuated cortisol response to biobehavioral stressors in sober alcoholics. Journal of Studies on Alcohol and Drugs, 54, 393–398
Evans, B. E., Greaves-Lord, K., Euser, A. S., Tulen, J. H., Franken, I. H. & Huizink, A. C. (2012). Alcohol and tobacco use and heart rate reactivity to a psychosocial stressor in an adolescent population. Drug and Alcohol Dependence, 126, 296–303
Gianaros, P. J., May, J. C., Siegle, G. J. & Jennings, J. R. (2005). Is there a functional neural correlate of individual differences in cardiovascular reactivity? Psychosomatic Medicine, 67, 31–39
Ginty, A. T., Gianaros, P. J., Derbyshire, S. W., Phillips, A. C. & Carroll, D. (2013). Blunted cardiac stress reactivity relates to neural hypoactivation. Psychophysiology, 50, 219–229
Ginty, A. T., Phillips, A. C., Higgs, S., Heaney, J. L. J. & Carroll, D. (2012). Disordered eating behaviour is associated with blunted cortisol and cardiovascular reactions to acute psychological stress. Psychoneuroendocrinology, 37, 715–724
Girdler, S. S., Jamner, L. D., Jarvik, M., Soles, J. R. & Shapiro, D. (1997). Smoking status and nicotine administration differentially modify hemodynamic stress reactivity in men and women. Psychosomatic Medicine, 59, 294–306
Greydanus, D. E. & Greydanus, M. M. (2012). Internet use, misuse, and addiction in adolescents: current issues and challenges. International Journal of Adolescent Medicine and Health, 24, 283–289
Griffiths, M. D. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8, 19–25
Griffiths, M. D. (2000). Internet addiction — Time to be taken seriously? Addiction Research, 8, 413–418
Gronwall, D. M. (1977). Paced auditory serial-addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367–373
Hagemann, D., Waldstein, S. R. & Thayer, J. F. (2003). Central and autonomic nervous system integration in emotion. Brain and Cognition, 52, 79–87
Hamer, M., O’Donnell, K., Lahiri, A. & Steptoe, A. (2010). Salivary cortisol responses to mental stress are associated with coronary artery calcification in healthy men and women. European Heart Journal, 31, 424–429
Hanson, K. L., Medina, K. L., Padula, C. B., Tapert, S. F. & Brown, S. A. (2011). Impact of adolescent alcohol and drug use on neuropsychological functioning in young adulthood: 10-year outcomes. Journal of Child & Adolescent Substance Abuse, 20, 135–154
Hardie, E. & Tee, M. (2007). Excessive Internet use: The role of personality, loneliness, and social support networks in Internet addiction. Australian Journal of Emerging Technologies and Society, 5, 34–47
Heaney, J. L., Ginty, A. T., Carroll, D. & Phillips, A. C. (2011). Preliminary evidence that exercise dependence is associated with blunted cardiac and cortisol reactions to acute psychological stress. International Journal of Psychophysiology, 79, 323–329
Hu, M. C., Davies, M. & Kandel, D. B. (2006). Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States. American Journal of Public Health, 96, 299–308
Jurca, R., Jackson, A. S., LaMonte, M. J., Morrow, J. R., Blair, S. N., Wareham, N. J., Haskell, W. L., Van Mechelen, W., Church, T. S., Jakicic, J. M. & Laukkanen, R. (2005). Assessing cardiorespiratory fitness without performing exercise testing. American Journal of Preventive Medicine, 29, 185–193
Karim, R. & Chaudhri, P. (2012). Behavioral addictions: An overview. Journal of Psychoactive Drugs, 44, 5–17
Kirschbaum, C., Scherer, G. & Strasburger, C. J. (1994). Pituitary and adrenal hormone responses to pharmacological, physical, and psychological stimulation in habitual smokers and nonsmokers. Clinical Investigator, 72, 804–810
Kirschbaum, C., Strasburger, C. J. & Langkrar, J. (1993). Attenuated cortisol response to psychological stress but not to CRH or ergometry in young habitual smokers. Pharmacology, Biochemistryand Behavior, 44, 527–531
Klein, H. (1994). Changes in college students’ use and abuse of alcohol, and in their attitudes toward drinking over the course of their college years. Journal of Youth and Adolescence, 23, 251–269
Ko, C. H., Yen, J. Y., Yen, C. F., Chen, C. S., Weng, C. C. & Chen, C. C. (2008). The association between Internet addiction and problematic alcohol use in adolescents: The problem behavior model. Cyberpsychology & Behavior, 11, 571–576
Koo-Loeb, J. H., Pedersen, C. & Girdler, S. S. (1998). Blunted cardiovascular and catecholamine stress reactivity in women with bulimia nervosa. Psychiatry Research, 80, 13–27
Kypri, K., Cronin, M. & Wright, C. S. (2005). Do university students drink more hazardously than their non-student peers? Addiction, 100, 713–714
Lam, L. T. & Peng, Z. W. (2010). Effect of pathological use of the Internet on adolescent mental health. Archives of Pediatrics & Adolescent Medicine, 164, 901–906
Lanza, S. T. & Collins, L. M. (2006). A mixture model of discontinuous development in heavy drinking from ages 18 to 30: The role of college enrollment. Journal of Studies on Alcohol and Drugs, 67, 552–561
Lovallo, W. R. (2011). Do low levels of stress reactivity signal poor states of health? Biological Psychology, 86, 121–128
Lovallo, W. R., Dickensheets, S. L., Myers, D. A., Thomas, T. L. & Nixon, S. J. (2000). Blunted stress cortisol response in abstinent alcoholic and polysubstance-abusing men. Alcoholism-Clinical and Experimental Research, 24, 651–658
Marmorstein, N. R. (2009). Longitudinal associations between alcohol problems and depressive symptoms: Early adolescence through early adulthood. Alcoholism: Clinical and Experimental Research, 33, 49–59
Marmot, M. G., Smith, G. D., Stansfeld, S., Patel, C., North, F., Head, J., White, I., Brunner, E. & Feeney, A. (1991). Health inequalities among British civil servants: The Whitehall II study. Lancet, 337, 1387–1393
Monteleone, P., Scognamiglio, P., Canestrelli, B., Serino, I., Monteleone, A. M. & Maj, M. (2011). Asymmetry of salivary cortisol and alpha-amylase responses to psychosocial stress in anorexia nervosa but not in bulimia nervosa. Psychological Medicine, 41, 1963–1969
Morahan-Martin, J. & Schumacher, P. (2000). Incidence and correlates of pathological Internet use among college students. Computers in Human Behavior, 16, 13–29
Morrison, C. M. & Gore, H. (2010). The relationship between excessive Internet use and depression: A questionnaire-based study of 1, 319 young people and adults. Psychopathology, 43, 121–126
Odgers, C. L., Caspi, A., Nagin, D. S., Piquero, A. R., Slutske, W. S., Milne, B. J., Dickson, N., Poulton, R. & Moffitt, T. E. (2008). Is it important to prevent early exposure to drugs and alcohol among adolescents? Psychological Science, 19, 1037–1044
Panknin, T. L., Dickensheets, S. L., Nixon, S. J. & Lovallo, W. R. (2002). Attenuated heart rate responses to public speaking in individuals with alcohol dependence. Alcoholism: Clinical and Experimental Research, 26, 841–847
Paris, J. J., Franco, C., Sodano, R., Frye, C. A. & Wulfert, E. (2010). Gambling pathology is associated with dampened cortisol response among men and women. Physiology & Behavior, 99, 230–233
Phillips, A. C., Der, G., Hunt, K. & Carroll, D. (2009). Haemodynamic reactions to acute psychological stress and smoking status in a large community sample. International Journal of Psychophysiology, 73, 273–278
Phillips, A. C., Hunt, K., Der, G. & Carroll, D. (2011). Blunted cardiac reactions to acute psychological stress predict symptoms of depression five years later: Evidence from a large community study. Psychophysiology, 48, 142–148
Phillips, A. C., Roseboom, T. J., Carroll, D. & De Rooij, S. R. (2012). Cardiovascular and cortisol reactions to acute psychological stress and adiposity: Cross-sectional and prospective associations in the Dutch Famine Birth Cohort Study. Psychosomatic Medicine, 74, 699–710
Pirke, K. M., Platte, P., Laessle, R., Seidl, M. & Fichter, M. M. (1992). The effect of a mental challenge test of plasma norepinephrine and cortisol in bulimia nervosa and in controls. Biological Psychiatry, 32, 202–206
Ring, C., Burns, V. E. & Carroll, D. (2002). Shifting hemodynamics of blood pressure control during prolonged mental stress. Psychophysiology, 39, 585–590
Rohleder, N. & Kirschbaum, C. (2006). The hypothalamic-pituitary- adrenal (HPA) axis in habitual smokers. International Journal of Psychophysiology, 59, 236–243
Roy, M. P., Steptoe, A. & Kirschbaum, C. (1994). Association between smoking status and cardiovascular and cortisol stress responsivity in healthy young men. International Journal of Behavioral Medicine, 1, 264–283
Saunders, J. B., Aasland, O. G., Babor, T. F., Delafuente, J. R. & Grant, M. (1993). Development of the Alcohol Use Disorders Screening Test (AUDIT). WHO collaborative project on early detection of persons with harmful alcohol consumption. II. Addiction, 88, 791–804
Sheffield, D., Smith, G. D., Carroll, D., Shipley, M. J. & Marmot, M. G. (1997). The effects of recent food, alcohol, and tobacco intake and the temporal scheduling of testing on cardiovascular activity at rest and during psychological stress. Psychophysiology, 34, 204–212
Singh, K. & Shen, B. J. (2013). Abdominal obesity and chronic stress interact to predict blunted cardiovascular reactivity. International Journal of Psychophysiology, 90, 73–79
Sinha, R., Fox, H. C., Hong, K. I., Hansen, J., Tuit, K. & Kreek, M. J. (2011). Effects of adrenal sensitivity, stress- and cueinduced craving, and anxiety on subsequent alcohol relapse and treatment outcomes. Archives of General Psychiatry, 68, 942–952
Straneva, P., Hinderliter, A., Wells, E., Lenahan, H. & Girdler, S. (2000). Smoking, oral contraceptives, and cardiovascular reactivity to stress. Obstetrics & Gynecology, 95, 78–83
Swahn, M. H., Simon, T. R., Hammig, B. J. & Guerrero, J. L. (2004). Alcohol-consumption behaviors and risk for physical fighting and injuries among adolescent drinkers. Addictive Behaviors, 29, 959–963
Van Leeuwen, A. P., Creemers, H. E., Greaves-Lord, K., Verhulst, F. C., Ormel, J. & Huizink, A. C. (2011). Hypothalamic-pituitary-adrenal axis reactivity to social stress and adolescent cannabis use: The TRAILS study. Addiction, 106, 1484–1492
Vogeli, C., Shields, A. E., Lee, T. A., Gibson, T. B., Marder, W. D., Weiss, K. B. & Blumenthal, D. (2007). Multiple chronic conditions: Prevalence, health consequences, and implications for quality, care management, and costs. Journal of General Internal Medicine, 22, 391–395
Weinstein, A. & Lejoyeux, M. (2010). Internet addiction or excessive Internet use. American Journal of Drug and Alcohol Abuse, 36, 277–283
Wemm, S., Fanean, A., Baker, A., Blough, E. R., Mewaldt, S. & Bardi, M. (2013). Problematic drinking and physiological responses among female college students. Alcohol, 47, 149–157
Widyanto, L. & Griffiths, M. (2006). ‘Internet Addiction’: A critical review. International Journal of Mental Health and Addiction, 4, 31–51
Widyanto, L. & McMurran, M. (2004). The psychometric properties of the Internet addiction test. Cyberpsychology & Behavior, 7, 443–450
Young, K. S. (1996). Internet addiction: The emergence of a new clinical disorder. Cyberpsychology & Behavior, 1, 237–244
Young, K. S. (1998). Caught in the net. New York: John Wiley & Sons, Inc
Young, K. S. (1999). The research and controversy surrounding Internet addiction. Cyberpsychology & Behavior, 2, 381–383