Stress and Addiction Research Lab

Helen Fox, PhD, leads the Stress and Addiction Research (STAR) Lab. Our work focuses on developing a greater understanding of some of the stress and immune system changes that occur in alcohol and substance users, as well as how these changes can represent innovative targets for addiction medications. We are also interested in understanding whether potential medications perform more effectively in specific populations of alcohol and substances users, such as women, older adults or individuals with certain co-occurring issues, such as depression or anxiety.

We use a range of experimental methodologies and designs, including randomized clinical trials, human laboratory paradigms, imaging, and intense, repeated measurement techniques to establish how mood, anxiety, sex, menstrual cycle and gonadal hormones impacts the stress system to increase motivation for alcohol and substance use. Findings from these studies have led to clinical trials examining the effects of anti-inflammatory and adrenergic medications on clinical improvement in alcohol and substance users, with the help of our collaborators at Yale and Stony Brook. 

Current Research

We are currently running two NIH-funded studies with our collaborators at Rutgers and Penn State.

The first is a multisite clinical trial, examining the efficacy of guanfacine extended release in reducing drinking and alcohol craving during stress in men and women with alcohol use disorder (PI: Helen Fox).

In the second study we investigate whether a combination of the drug guanfacine and Mindfulness Oriented Recovery Enhancement (MORE) can provide an optimal adjunct to buprenorphine maintenance in individuals with opioid use disorder, by changing brain connectivity (Co-PI, Helen Fox).

[No text in field]

STAR Lab Team

Helen Fox — 317-274-0830 
Bella Buehler — 317-274-0837 
Katie Mottweiler — 317-274-0851
Mitchell Smith — 317-278-5475



Research Funding

NIH — NIAAA (National Institute of Alcohol Abuse and Alcoholism)

NIH — NIDA (National Institute of Drug Abuse)

Peter F McManus Charitable Trust



Publications

Fox, H.C., Anderson, G.M., Tuit, K., Hansen, J., Kimmerling, A., Siedlarz, K.M., Morgan, P.T., Sinha, R. (2012). Prazosin effects on stress- & cue-induced craving and stress response in alcohol-dependent individuals: preliminary findings. Alcohol Clin Exp Res. 36(2):351-60. PMCID: PMC3243763

Fox, H.C., Seo, D., Tuit, K., Hansen, J., Kimmerling, A., Morgan, P.T., Sinha, R. (2012). Guanfacine effects on stress, drug craving and prefrontal activation in cocaine dependent individuals: preliminary findings. J Psychopharmacol. 26(7):958-72. PMCID: PMC3694403

Fox, H.C., Sofuoglu, M., Morgan, P.T., Tuit, K.L., Sinha, R. (2013). The Effects of Exogenous Progesterone on drug craving and stress arousal in cocaine dependence: Impact of gender and cue type. PNEC. 38(9):1532-44. PMCID: PMC3772967

Fox, H.C., Morgan, P.T., Sinha, R., (2014). Sex Differences in Guanfacine Effects on Drug Craving and Stress Arousal in Cocaine-Dependent Individuals. Neuropsychopharmacology, 39(6):1527-37. PMCID: PMC3988558

Fox, H.C., Sinha, R. (2014). The role of guanfacine as a therapeutic agent to address stress- related pathophysiology in cocaine dependent individuals. Advances in Pharmacology, 69:217-65. PMCID: PMC4017947

Milivojevic, V., Sinha, R., Sofuoglu, M., Fox, H.C. (2014). Effects of endogenous and exogenous progesterone on emotional intelligence in cocaine dependent men and women who also abuse alcohol. Human Psychopharmacology: Clinical and Experimental. 29(6):589-98. PMCID: PMC4498591

Fox, H.C., Sofuoglu, M., Sinha, R., (2015) Guanfacine enhances inhibitory control and attentional shifting in early abstinent cocaine dependent individuals. Journal of Psychopharmacology 29(3):312-23. PMCID: PMC4432477

Milivojevic, V., Fox, H.C., Sofuoglu, M., Covault, J., Sinha, R., (2016) Effects of progesterone stimulated allopregnanolone on craving and stress response in cocaine dependent men and women. PNEC. 65: 44-53. PMCID: PMC4752896

Milivojevic, V., Fox, H.C., Jayaram-Lindstrom N., Hermes G., Sinha, R. (2017) Sex Differences in Guanfacine Effects on Stress-induced Stroop Performance in Cocaine Dependence. Drug and Alcohol Dependence. 179:275-279.PMCID: PMC5599361

Milivojevic, V., Gustavo, A.A., Hermes, G., Sinha, R., Fox, H.C. (2020). Effects of Prazosin on provoked alcohol craving and autonomic and neuroendocrine response to stress in alcohol use disorder. ACER 44(7): 1488-1496. PMCID: PMC7572699

Sinha, R., Wemm, S., Fogelman, N., Seo, D., Milivojevic, V., Morgan, P.M., Angarita, G.A., Hermes, G., Fox, H.C., (2021) Moderation of prazosin's efficacy by alcohol withdrawal symptoms. The American Journal of Psychiatry, 178(5): 447-458. PMCID: PMC8119326

Fox, H.C., Talih, M., Malison, R., Anderson, G. M., Kreek, M.J., Sinha, R. (2005). Frequency of recent cocaine and alcohol use affects drug craving and associated responses to stress and to drug-related cues. Psychoneuroendocrinology, 30:880-891.

Fox, H.C., Bergquist, K.L., Hong, K.I., Sinha, R. (2007). Stress-induced and Alcohol Cue-induced Craving in Recently Abstinent Alcohol Dependent Individuals. Alcoholism: Clinical and Experimental Research 31 (3): 395-403

Hyman, S., Fox, H.C., Sinha, R. (2007). Stress and drug-cue induced craving in opioid dependent individuals on Naltrexone Exp and Clin. Psychopharmacology. 15(2)134-43.

Fox, H.C., Hong, K-I., Siedlarz, K.M., Sinha, R. (2008). Enhanced Sensitivity to Stress and Drug/ Alcohol Craving in Abstinent Cocaine Dependent Individuals Compared to Social Drinkers. Neuropsychopharmacology. 33(4):796-805. PMCID: PMC2746372

Sinha, R., Fox, H.C., Hong, K.A., Bergquist, K.L., Bhagwagar, Z., Siedlarz, K. (2009). Enhanced negative emotion and alcohol craving, and altered physiological responses following stress and cue exposure in alcohol dependent individuals. Neuropsychopharmacology. 34(5):1198-208 PMCID: PMC2734452

Fox, H.C., Bergquist, K.L., Gu, P., Sinha, R. (2010) Interactive effects of cumulative stress and impulsivity on alcohol consumption. Alcohol: clinical and Experimental Research. 34(8):1376- 138. PMCID: PMC3676668

Bergquist, K.L., Fox, H.C., Sinha, R. (2010) Self-reports of interoceptive responses during stress and drug cue related experiences in cocaine and alcohol dependent individuals. Experimental and Clinical Psychopharmacology. 18(3):229-37. PMCID: PMC3690464

Chaplin, T.M., Hong, K., Fox, H.C., Siedlarz, K.M., Bergquist, K., Sinha, R. (2010). Behavioral arousal in response to stress and drug cue in alcohol and cocaine addicted individuals versus healthy controls. Human Psychopharmacology: Clinical and Experimental. 25(5):368-76. PMCID: PMC2917911

D'Sa, C., Fox, H.C., Hong, K.A., Dileone, R.J., Sinha, R. (2011) Increased serum brain-derived neurotrophic factor (BDNF) is predictive of cocaine relapse outcomes: A prospective study.  Biological Psychiatry 70(8):706-11. PMCID: PCM3186871

Fox, H.C., Bergquist, K.L., Casey, J., Hong, K.A., Sinha, R. (2011) Selective cocaine-related difficulties in emotional intelligence: relationship to stress and impulse control. American Journal on Addictions. 20(2):151-60. PMCID: PMC3166613

Sinha, R., Fox, H.C., Hong, K.A., Siedlarz, K.A., Bergquist, K.T., Kreek, M.J. (2011). Stress and Cue- induced Alcohol Craving, Anxiety and Adrenal Sensitivity are Predictive of Alcohol Relapse Outcomes. JAMA Psychiatry. 68(9):942-52. PMCID: PMC3668981

Blaine, S.K., Milivojevic, V., Fox, H.C., Sinha, R., (2016) Alcohol effects on stress pathways: Impact on craving and relapse risk. The Canadian Journal of Psychiatry, 61 (3): 145-153. PMCID: PMC4813419

Syed, S., Sinha, R., Milivojevic, V., MacDougall, A., Lavalle, H., Angarita, G.A., Fox, H.C. (2023). HPA and autonomic response to psychological stress in abstinent alcohol use disorder individuals with and without depressive symptomatology. Human Psychopharm

Fox, H.C., D'Sa, C., Kimmerling, A., Siedlarz, K.M., Tuit, K.L., Stowe, R., Sinha, R. (2012) Immune system inflammation in cocaine dependent individuals: Implications for medications development. Human Psychopharmacology 27(2):156-66. PMCID: PMC3674778

Fox, H.C., Milivojevic, V., Angarita, A.G., Stowe, R., Sinha, R., (2017) Peripheral immune system suppression in early abstinent alcoholics: links to stress and cue-related craving. Journal of Psychopharmacology. 31 (7): 883-892. PMCID: PMC5660633

Milivojevic, V., Ansell, E.B., Simpson, C., Siedlarz, K., Sinha, R., Fox, H.C. (2017) Peripheral immune system adaptations and motivation for alcohol in non-dependent problem drinkers. Alcoholism: Clinical and Experimental Research. 41(3):585-595. PMCID: PMC5503305

Fox, H.C., Milivojevic, V., MacDougall, A., LaVallee, H., Simpson, C., Angarita, G.A., Sinha, R. (2019) Stress-related suppression of peripheral cytokines predicts future relapse in alcohol dependent individuals with and without sub-clinical depression. Addiction Biology, 25(6): 1-13. PMCID: PMC7371343

Milani, R.M., Fox, H.C., Parrott, A.C., Turner, J.J.D. (2004) Gender differences in psychological/ psychiatric symptomatology among Ecstasy/MDMA polydrug users, Alcohol/Tobacco users and non- drug users. Addict Behav. 29(5): 965-71.

Fox, H.C., Garcia, M., Kemp, K., Milivojevic, V., Kreek, M.J., Sinha, R. (2006) Gender differences in cardiovascular and corticoadrenal response to stress and drug-cue in cocaine dependent individuals. Psychopharmacology 185 (3) 348-357

Sinha, R., Fox, H.C., Hong, K.H., Morgan, P.T., Bergquist, K.L. (2007) Sex Steroid Hormones, Stress Response and Drug Craving in Cocaine Dependent Women: Implications for Relapse Susceptibility, Experimental and Clinical Psychopharmacology, 15(5):445-52. PMID:17924478

Fox, H.C., Hong, K.A., Paliwal, P., Morgan, P.T., Sinha, R. (2008). Altered levels of sex and stress hormones assessed daily over a 28-day cycle in early abstinent cocaine dependent females. Psychopharmacology, 195(4):527-36. PMCID: PMC2746368

Fox, H. C., Sinha, R. (2009). Sex differences in drug-related stress system changes: implications for treatment in substance-abusing women. Harvard Review of Psychiatry. 17(2):103-19. PMCID: PMC2746371

Fox, H.C., Hong, KI., Siedlarz, K.M., Bergquist, K.L., Anderson, G.M., Kreek, M.J., Sinha, R. (2009). Sex specific dissociations in autonomic and HPA responses to stress and cues in alcohol dependent patients with cocaine abuse. Alcohol Alcohol. 44(6):575-85.PMCID: PMC2781765

Moore DG, Turner JD, Parrott AC, Goodwin JE, Fulton SE, Min MO, Fox HC, Braddick FM, Axelsson EL, Lynch S, Ribeiro H, Frostick CJ, Singer LT (2009). During pregnancy, recreational drug-using women stop taking ecstasy and reduce alcohol consumption, but continue to smoke tobacco and cannabis: initial findings from the Development and Infancy Study. J Psychopharmacol. 24(9):1403-10. PMCID: PMC3564500

Milivojevic, V., Fox, H.C., Sinha R. (2017) Sex differences and the role of sex hormones in stress reactivity, emotion regulation and craving in drug and alcohol dependence. Alcohol, 60: 217-218

Ho, S., Rosenthal, R., Fox, H., Garry, D., Gopang, M., Rollins, M., Swain, J. (2022). Compassion within conflict: Toward a computational theory of social groups informed by maternal brain physiology. Behavioral and Brain Sciences, 45, E110. doi:10.1017/S0140525X21001436

Fox, H.C., Milivojevic, V., Sinha, R. (2023) Therapeutics for substance-using women: the need to elucidate sex-specific targets for better-tailored treatments. In Sex and Gender Effects in Pharmacology. Tsirka, S-A, E. and Acosta-Martinez, M. (Eds). Springer Nature

Fogelman N, Tate M, Wemm S, Sullivan L, Hart R, Vacey E, Fox HC, Sinha R (2024) Substance Use Patterns, Quantities, and Associated Risk Factors in Women with Polysubstance Misuse. Addiction Biology.

Fox, H.C., Toplis, A.S., Turner, J.J.D., Parrott, A.C. (2001). Auditory verbal learning in drug-free recreational ecstasy polydrug users. Human Psychopharmacology 16 (8): 613-618.

Fox, H.C., Parrott, A.C., Turner, J.J.D. (2001). Ecstasy/MDMA: Cognitive deficits related to dosage rather than awareness of problems. Journal of Psychopharmacology 15 (4): 273-281. (BAP/Organon Prize for best paper 2001)

Fox, H.C., McLean, A., Turner, J.J.D., Parrott, A.C., Rogers, R., Sahakian, B.J. (2002). Neuropsychological evidence of a relatively selective profile of temporal dysfunction in drug-free MDMA (“ecstasy”) polydrug users. Psychopharmacology 162: 203-214.

Fox, H.C., Parrott, A.C., Turner, J.J.D., (2003) Prepulse inhibition in drug-free recreational ecstasy polydrug users. Adiktologie 3 (1), 13-24.

Soar, K., Parrott, A.C., Fox, H.C. (2004). Persistent neuropsychological problems after 7 years of abstinence from recreational Ecstasy (MDMA): A case study. Psychological Reports. 95, 192-196.

Fox, H.C., Axelrod, S.R., Paliwal, P., Sleeper, J., Sinha, R. (2007). Difficulties in emotion regulation and impulse control during cocaine abstinence. Drug and Alc Dep. 89:298-301.

Fox, H.C., Hong, K.A., Sinha, R. (2008). Difficulties in emotion regulation and impulse control in recently abstinent alcoholics compared with social drinkers. Addictive Behaviors 33(2):388-94. PMID:18023295.

Fox, H.C., Jackson, E.D., Sinha, R. (2009). Cognitive deficits, cortisol and cocaine use in early abstinent cocaine abusers. Psychoneuroendocrinology. 34(8):1198-207. PMCID: PMC2746363.

Fox, H.C., Milivojevic, V., Blaine S.K., Sinha, R (2018) Stress system sensitivity and emotion regulation in early abstinence from substance use disorders - targets for medications development, In Foti, D. & Sangha, S (Eds) “Emotion and Motivated Behaviors: Integrating Animal and Human Neurobiology Research” Elsevier, Inc.

Fox, H.C., Karim, A. & Syed, S.A. (2020) Bio-Behavioral Indices of Emotion Regulation: Potential Targets for Treatment in Addiction. Curr Addict Rep 7, 333–343.

Ray, S., Kennelly, N., Fox, H. C., Greendyk, S., Hipol-Ligot, C., Johnson, L., Richardson, K., Sabra, A., & Wells, G. (2022). Efficacy of a 6-week mindfulness intervention in underserved residents receiving treatment for opioid use disorder during the COVID-19 Pandemic in New Jersey: A multisite pilot feasibility study. Journal of Addiction and Addictive Disorders 9:104. DOI:10.24966/AAD-7276/100104

Ray S, Bhanji J, Kennelly N, Fox HC, Dooley Budsock P, Delgado M, Cooperman N.A, Garland EL (2023) Mindfulness-Oriented Recovery Enhancement (MORE) in opioid use disorder: Immediate effects of guided meditation and extended affective neural effects in a pilot sample

Fox Lab Alumni

Verica Milivojevic, postdoctoral associate supported by R01 award AA-2009501 (PI: Fox) and R01 award AA-020504 (Co-PI: Fox). Subsequent affiliation: assistant professor in psychiatry, Yale Stress Center, Yale University

Alicia MacDougall, research assistant supported by R01 award AA-2009501 (PI: Fox). Subsequent affiliation: PhD student in behavioral health, Antioch University, New England

Heather LaVallee, research assistant supported by R01 award AA-2009501 (PI: Fox). Subsequent affiliation: Masters in marriage and family therapy, Southern Connecticut University

Casey Hine, research assistant supported by K01 award DA-0209040 (PI: Fox). Subsequent affiliation: Masters student in speech pathology, San Diego State University

Carlee Brigante, research assistant supported by R03 award AA-022500 (PI: Fox). Subsequent affiliation: Accelerated BS track in nursing, Quinnipiac University, CT

Goakhia Yang, research coordinator supported by R21AA-024880 (PI: Fox) Subsequent affiliation: University of Wisconsin-Milwaukee PhD neuroscience program

Suraj Bera, research coordinator supported by R21AA-024880 (PI: Fox) and 1R01DA047094 (Site PI: Fox). Subsequent affiliation: Hofstra University, PhD in clinical psychology.



Research Elective

Jason Wong (psychiatry resident, Stony Brook University) 

Sahib Singh (psychiatry resident, Stony Brook University) 

Alemante Tedla (psychiatry resident, Stony Brook University) 

Asif Karim (psychiatry resident, Stony Brook University) 

Sharif Syed (psychiatry resident, Stony Brook University) 

Jorge Alcina (clinical PhD student, Carlos Albizu University)