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In clinical practice, chronic alcohol use is often accompanied by poor emotional and self\u2010regulatory processes. Tonic and phasic changes in stress responsivity impact an individual's relapse risk to alcohol. A further complicating factor is the pervasive coexistence of depressive symptoms in those with Alcohol Use Disorder (AUD), where the contribution of depressive symptomatology to these processes is not well understood. Individuals with AUD (AD) (21 with and 12 without sub\u2010clinical depressive symptoms) and 37 social drinking controls (16 with and 21 without sub\u2010clinical depressive symptoms) as part of a more extensive study (Fox et\u00a0al., 2019). All participants were exposed to two 5\u2010min personalized guided imagery conditions (stress and neutral) in a randomized and counterbalanced order across consecutive days. Alcohol craving, negative mood, Stroop performance, and plasma measures (cortisol, adrenocorticotrophic hormone, and salivary alpha\u2010amylase) were collected before and after imagery exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Elevations in autonomic response (heart rate) to imagery (stress and neutral) were observed as a function of drinking (<jats:styled-content>in both depressed and non\u2010depressed individuals with alcohol use disorder compared with depressed and non\u2010depressed social drinkers<\/jats:styled-content>). Conversely, suppressed cortisol following stress was observed as a function of depressive symptomatology across both drinking groups. Individuals with comorbid AD and depressive symptoms demonstrated attenuated Adrenocorticotropic Hormone and poor Stroop performance compared with the other groups, indicating an interactive effect between drinking and depression on pituitary and inhibitory systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sub\u2010clinical depressive pathophysiology may be distinct from drinking severity and may alter relapse\u2010related stress adaptations during protracted abstinence from alcohol.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hup.2867","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T06:14:20Z","timestamp":1683785660000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hypothalamic\u2010pituitary\u2010adrenal and autonomic response to psychological stress in abstinent alcohol use disorder individuals with and without depressive 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