{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:38:13Z","timestamp":1791326293572,"version":"4.3.1"},"reference-count":73,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R01-AA013892"],"award-info":[{"award-number":["R01-AA013892"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>High levels of stress and individual differences in acute stress responses are important predictors of chronic illness. This study examined the effects of stress and Alcohol Use Disorder (AUD) on heart rate variability (HRV) using the Yale Pain Stress Test (YPST), adapted from the well-established Cold Pressor Test (CPT). The YPST characterized three key (time periods) phases of the cardiovascular stress response to repeated trials of a pain-stress versus no pain-stress control condition: pre-stress baseline, acute reactivity, and recovery, using HRV as a physiological marker. Participants included 24 individuals who engaged in social drinking and 21 participants with AUD, all recruited from the Greater New Haven area. They were screened for psychiatric or medical conditions and other substance use disorders using DSM-5 criteria. Results showed significant main effects of stress condition and time across HRV metrics. While no significant three-way interaction among time period, condition, and drinking group was observed, there were significant condition \u00d7 time period effects and group \u00d7 condition effects. Participants with AUD exhibited lower high-frequency (HF) and low-frequency (LF) HRV during stress exposure compared to the recovery phase. They also showed a less dynamic LF\/HF ratio during stress relative to social drinking controls, suggesting greater sympathetic dominance. In contrast, participants who engaged in social drinking displayed autonomic flexibility across time periods. Findings suggest that individuals with AUD experience blunted autonomic reactivity and reduced HRV recovery following stress, highlighting diminished physiological flexibility potentially indicating risk for long-term stress-related chronic diseases. The results underscore the importance of evaluating autonomic function in clinical care and recovery planning for individuals with AUD.<\/jats:p>","DOI":"10.3390\/bs15121732","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T15:15:08Z","timestamp":1765811708000},"page":"1732","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing Autonomic Regulation Under Stress with the Yale Pain Stress Test in Social Drinking and Alcohol Use Disorder"],"prefix":"10.3390","volume":"15","author":[{"given":"Shaina","family":"Barreto","sequence":"first","affiliation":[{"name":"Every Cure, Boston, MA 02142, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"McGowan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55414, USA"},{"name":"Department of Psychology, Cognitive and Brain Science, University of Minnesota, Minneapolis, MN 55414, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0156-7220","authenticated-orcid":false,"given":"Nia","family":"Fogelman","sequence":"additional","affiliation":[{"name":"Yale Stress Center, Yale School of Medicine, New Haven, CT 06519, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3012-4349","authenticated-orcid":false,"given":"Rajita","family":"Sinha","sequence":"additional","affiliation":[{"name":"Yale Stress Center, Yale School of Medicine, New Haven, CT 06519, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie E.","family":"Wemm","sequence":"additional","affiliation":[{"name":"Yale Stress Center, Yale School of Medicine, New Haven, CT 06519, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"108519","DOI":"10.1016\/j.neuropharm.2021.108519","article-title":"Neurobiological mechanisms of early life adversity, blunted stress reactivity and risk for addiction","volume":"188","author":"Ginty","year":"2021","journal-title":"Neuropharmacology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/j.1469-8986.2011.01289.x","article-title":"Exposure to acute stress is associated with attenuated sweet taste","volume":"49","author":"Nakajima","year":"2012","journal-title":"Psychophysiology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1016\/S2468-2667(22)00317-6","article-title":"Health and cancer risks associated with low levels of alcohol consumption","volume":"8","author":"Anderson","year":"2023","journal-title":"The Lancet Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.biopsych.2011.11.022","article-title":"Cumulative adversity and smaller gray matter volume in medial prefrontal, anterior cingulate, and insula regions","volume":"72","author":"Ansell","year":"2012","journal-title":"Biological Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s00213-011-2473-3","article-title":"Blunted vagal reactivity predicts stress-precipitated tobacco smoking","volume":"220","author":"Ashare","year":"2012","journal-title":"Psychopharmacology"},{"key":"ref_6","unstructured":"Babor, T., Higgins-Biddle, J. 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