Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 2016 PREDICTORS OF CAFFEINE-RELATED WITHDRAWAL SYMPTOMS IN COLLEGE FRESHMEN David J. Pomm Virginia Commonwealth University Follow this and additional works at: https://scholarscompass.vcu.edu/etd Part of the Human and Clinical Nutrition Commons, Other Psychiatry and Psychology Commons, and the Substance Abuse and Addiction Commons © The Author Downloaded from https://scholarscompass.vcu.edu/etd/4467 This Thesis is brought to you for free and open access by the Graduate School at VCU Scholars Compass. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of VCU Scholars Compass. For more information, please contact [email protected]. PREDICTORS OF CAFFEINE-RELATED WITHDRAWAL SYMPTOMS IN COLLEGE FRESHMEN A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University By: DAVID JONATHAN POMM Bachelor of Science, Eastern Mennonite University, 2008 Director: Dace S. Svikis, Ph.D. Professor, Department of Psychology Deputy Director, VCU Institute for Women’s Health Virginia Commonwealth University Richmond, VA July 21, 2016 ii Acknowledgements This project would not have been possible without the continual support, guidance, and enthusiasm of my mentor and advisor, Dr. Dace Svikis. Dr. Svikis’ influence in my professional development and research has been extraordinary, and I have been privileged to complete this project under her direction and expertise. I would also like to extend appreciation to my committee members, Dr. Rosalie Corona and Dr. Pamela Dillion, for their valuable contributions and support. Lastly, I thank my wife, Brianna, for her unconditional support, love, patience, and encouragement. iii Table of Contents Page Acknowledgements .................................................................................................................... ii List of Tables ......................................................................................................................... v-vi List of Figures .......................................................................................................................... vii Abstract ................................................................................................................................... viii Introduction ................................................................................................................................. 1 Physical and Chemical Properties of Caffeine ........................................................................... 2 Pharmacology of Caffeine .......................................................................................................... 4 Pharmacokinetics .................................................................................................................... 4 Mechanism of Action .............................................................................................................. 5 Physiological & Behavioral Effects of Caffeine ..................................................................... 7 Dietary Sources of Caffeine ........................................................................................................ 9 Epidemiology ............................................................................................................................ 13 Caffeine Consumption World Wide ..................................................................................... 13 Caffeine Consumption in the U.S. ........................................................................................ 14 Overview of Caffeine and Caffeine Dependence ..................................................................... 20 Reinforcing Properties of Caffeine ....................................................................................... 20 Caffeine Intoxication ............................................................................................................ 22 Physical Dependence ............................................................................................................ 23 Tolerance............................................................................................................................... 26 Withdrawal ............................................................................................................................ 28 Caffeine-Related Withdrawal Symptoms ............................................................................. 31 Headache .......................................................................................................................... 31 Marked fatigue or drowsiness .......................................................................................... 33 Dysphoric mood, depressed mood, or irritability ............................................................ 35 Difficulty concentrating ................................................................................................... 36 Flu-like symptoms (nausea, vomiting, or muscle pain/stiffness) .................................... 36 Characteristics of Caffeine Withdrawal Syndrome .............................................................. 39 Functional Impairment & Prevalence .............................................................................. 39 Dosing Parameters & Time Course of Withdrawal ......................................................... 40 Caffeine Withdrawal & Habitual Caffeine Consumption ................................................ 41 Biological Basis of Caffeine Withdrawal ........................................................................ 42 Individual Differences in Caffeine Use & Withdrawal ....................................................... 42 Gender .............................................................................................................................. 42 Comorbid Alcohol & Nicotine Use ................................................................................. 46 Personality........................................................................................................................ 48 Anxiety, Depression, & Family History .......................................................................... 49 Genetics............................................................................................................................ 52 Statement of Problem ................................................................................................................ 55 Aims & Hypothesis ............................................................................................................... 57 Methods..................................................................................................................................... 58 Page iv Data Set ................................................................................................................................. 58 Participants ............................................................................................................................ 58 Study Procedures .................................................................................................................. 59 Informed Consent.................................................................................................................. 59 Data and DNA Collection ..................................................................................................... 59 Measures ................................................................................................................................... 60 Study Variables ......................................................................................................................... 64 Data Analysis and Procedures .................................................................................................. 66 Results ....................................................................................................................................... 68 Demographic Correlates of Caffeine Use ............................................................................. 68 Aim 1. Prevalence of Recent Caffeine Use and Withdrawal by Beverage Type and Gender ................................................................................................................... 70 Aim 2. Univariable and Multivariable Analyses Identifying Variables Associated with Caffeine Withdrawal Headache ............................................................................................ 77 Multivariable Regression Analysis ....................................................................................... 87 Discussion ................................................................................................................................. 89 Implications......................................................................................................................... 107 Study Limitations, Strengths, and Future Directions .......................................................... 107 Conclusion .......................................................................................................................... 110 List of References ................................................................................................................... 112 v List of Tables Page Table 1. Physical & Chemical