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Stress can negatively affect recovery from alcohol use disorder. In this study, the authors examined factors that may predict levels of perceived and physiological stress during inpatient treatment. Predictors included pretreatment quantity/frequency of drinking, alcohol use expectancies, and family history of alcohol use disorder. Patients with higher cortisol levels endorsed fewer positive alcohol expectancies, whereas those with a greater family history of alcohol use disorder and higher pretreatment drinking perceived greater stress. Gender and length of abstinence were not significant influences. These findings provide a glimpse into subjective perceptions and physiological indicators of stress during inpatient treatment and could have implications for successful recovery strategies.