Joint impact of acute stress and alcohol consumption on neurocognition and addiction vulnerability in adolescence and emerging adulthood: A preregistered systematic review.

Adolescence and early adulthood are developmental stages during which ongoing neurobiological maturation can shape long-term neurocognitive and behavioral trajectories. During this period, the refinement of stress-response systems coincides with the onset of alcohol use, a recognized challenge for brain development. Prominent neurobiological models of addiction have proposed a critical link between stress and alcohol-related processes; however, how these parallel processes may interact to influence neurobehavioral functioning during this sensitive developmental window remains fragmented and insufficiently understood. Following PRISMA guidelines, this systematic review synthesizes experimental research examining how acute stress influences alcohol-related outcomes and, conversely, how patterns of alcohol use may alter stress reactivity in adolescents and young adults. A systematic search of three databases (PsycINFO, PubMed, and Scopus) identified 24 studies based on experimentally induced stress paradigms and assessing alcohol use, physiological, or neurocognitive outcomes. The methodological quality of each study was evaluated, and potential differences associated with the type of experimental stress paradigm were examined. Overall, acute stress was most consistently associated with increased alcohol craving, particularly among individuals with heavier drinking patterns. Evidence linking acute stress to actual alcohol consumption was more heterogeneous and appeared to depend on methodological features such as the stress paradigm employed, individual drinking history, and contextual factors. Conversely, heavier alcohol use was associated with altered stress reactivity and reduced distress tolerance, suggesting a bidirectional relationship between stress systems and alcohol-related processes. These findings support dynamic stress-alcohol interactions and highlight the need for further research to clarify the neurobehavioral mechanisms underlying this relationship.