Estrogen Cycling, Stress, and Reversal Learning: Implications for Addiction

Abstract

Although sex differences are observed in the prevalence and development of various substance use disorders, additional research is necessary to elucidate the driving factors causing these differences, particularly from a neuropsychological perspective. While men are historically more likely to misuse alcohol, the rate of women with Alcohol Use Disorder (AUD) are approaching that of men. The two main behavioral components of AUD are impulsivity and compulsivity. The current study investigated the effects of sex and menstrual phase on impulsivity and compulsivity, as measured by a computerized probabilistic reversal learning task. Sixteen healthy people (7 women, 9 men) completed a scale of recent alcohol use, a scale of perceived stress, and a probabilistic reversal learning task to determine the main and interaction effects of menstrual phase and perceived stress on impulsive and compulsive behavior. Overall, women exhibited significantly higher impulsivity than men. Despite previous literature linking estrogen levels to impulsive performance on similar computerized tasks, the current study did not produce evidence of a relationship between menstrual phase and impulsive behavior, either alone or moderated by perceived stress. An increase in compulsivity was observed in the luteal phase, yet fell short of statistical significance. However, the study sample size lacked sufficient power to observe small effects in a group of healthy individuals. Future investigation is recommended with a larger sample size of a clinical population, and biological verification of ovarian hormone levels to determine if such a relationship between estrogen and impulsive and compulsive behaviors exists in individuals with AUD.