Fear Extinction in Alcohol Dependence

Background: - Researchers want to learn if people with alcohol dependence have more difficulty learning to feel calm, or learn to fear things more easily. They also want to study how early life stress (ELS) affects the ability to learn to feel calm. Objective: - To see if people with alcohol dependence and/or ELS have a harder time learning to feel calm than people without these. Also, to see if DNA is changed by ELS and if this change affects fear conditioning and extinction. Eligibility: - Adults ages 21-65 with and without an alcohol use disorder (AUD) and with and without ELS. - Healthy volunteers. Design: - Participants will be screened with: - Medical history - Physical exam - Blood and urine tests - Psychological tests - Treatment for symptoms of alcohol withdrawal, if needed - Healthy volunteers will have 1 overnight visit (2 days, 1 night). AUD participants will stay at the clinic for about 4 weeks. - Participants will: - Rate alcohol use/craving, depression, anxiety, and childhood trauma. - Have psychophysiological measures: electrodes and mild electric shock. - Have a functional magnetic resonance imaging (MRI) scan. Participants will lie on a table in a metal cylinder with a coil over their head. In the first scanning session, they will see pictures, do a simple task, and may get shocks. Participants will also do a second scanning session in which they will perform the aforementioned fear conditioning and extinction task, as well as a facial expression matching task, an affective word processing task, and a task measuring valuation of monetary rewards. - Answer questions about their emotions (some participants). - Have blood drawn from an arm vein or intravenous (IV) line. - AUD participants will get a dexamethasone pill. The next day, they will get a hormone injected in and have blood drawn from an IV line. - AUD participants will have 3 follow-up visits with questions and blood and lab tests.