Brain dysfunction in social drinkers

Thirty-four social drinkers who had referred themselves to the Regional Brain Damage Unit for assessment of the effects of drinking alcohol were compared with 42 volunteer control subjects of equivalent age but with low alcohol intake, using two 'learning' tests — the Rey Auditory Verbal Learning Test (RAVLT) and the Austin Button Maze. The Maze Test gave no evidence of disorder, but the two groups were significantly different on the RAVLT. No abnormalities in standard cognitive tests were apparent. These results suggest that a deficit in learning ability may be an early feature of the brain dysfunction associated with excessive alcohol consumption.     

Alcoholic consumption patterns in South Australia: Some implications for prevention priorities

A survey aimed at assessing alcohol consumption patterns of persons aged over 18 years was conducted in South Australia during October 1983. Included in the survey were general questions relating to types and quantities of alcohol consumed, the effects of the wine cask and the impact of LA Beer on consumption patterns, as well as attitudinal data on random breath testing (RBT), and the characteristics of people tested at RBT sites.

Major findings of the survey were that whilst the average daily consumption of alcohol by persons was not significantly different from consumption reported in February 1977, there was an increase in the average daily consumption of alcohol by women during this period. The reported average consumption of beer fell, especially with men aged 40-64 years. In contrast, the average consumption of wine increased, particularly amongst women.

In regard to random breath testing, heavy consumers of alcohol were significantly less in favour of RBT than non or light drinkers. When respondents were questioned about the relationship between alcohol consumption and blood alcohol level, the results indicated that the public lacks knowledge and is very uncertain about this issue. Some implications for prevention priorities are discussed.     

Apolipoprotein distribution in plasma HDL subfractions in alcohol consumers

Alcohol intake is known to increase plasma HDL subfractions and apo A levels. Few data are available, however, with regard to precise apoprotein composition of plasma lipoproteins in alcohol consumers. The aim of the present study was to examine the lipid and apoprotein distribution in plasma lipoproteins of subjects with different levels of alcohol intake. Thirty-six male regular drinkers were classified as social (n = 10, average daily consumption greater than or equal to 5 and less than or equal to 20 g), moderate (n = 11, average daily consumption greater than 20 g and less than 70 g) and heavy drinkers (n = 15, average daily consumption greater than or equal to 70 g). Reference data were obtained from 11 subjects, all lifelong abstainers. Lipoproteins were fractioned by sequential ultracentrifugation and apolipoprotein distribution in VLDL, HDL-2 and HDL-3 was determined by isoelectrofocusing in polyacrylamide-urea gel. HDL-2 cholesterol was significantly higher in heavy drinkers (P less than 0.005). A parallel trend for HDL-3 cholesterol was observed. In alcohol consumers HDL-2 particles were enriched in apos C, in particular apo C-II (P 0.005), displacing apo A-I. These data suggest that apolipoprotein distribution in the HDL-2 subfraction is influenced by alcohol intake even at the lowest level.     

Modeling as a determinant of alcohol consumption: effect of subject sex and prior drinking history.

The purpose of this study was to assess the effects of modeling as a determinant of alcohol consumption by both male and female subjects who were classified as either light or heavy social drinkers. College student subjects (N = 64) were assigned to eight groups in a 2 x 2 x 2 factorial design. Male and female subjects, half of whom were classified as light drinkers and half heavy drinkers, were exposed either to a light drinking or heavy drinking model of the same sex during the course of a wine-tasting task. The taste-rating task served as an unobtrusive measure of alcohol consumption. The modeling factor was a significant determinant of drinking in this task: subjects exposed to the heavy drinking model drank more than subjects who observed the light drinking model. While all subjects drank a minimal amount in the light drinking model condition, an interaction effect was obtained in the heavy drinking model condition: heavy social drinkers, particularly the male subjects, drank significantly more wine in the presence of the heavy drinking model than did the light social drinkers. The results were discussed in terms of their implications for understanding the social determinants of drinking behavior in young adults.     

Motivations to control drinking behavior in abstainers, moderate, and heavy drinkers

Motives and motivational concepts to control quantity (Q) and frequency (F) of alcohol consumption were investigated in 192 participants using a questionnaire of motives to control drinking (MCD-Q/F) developed earlier. The daily quantity of consumption was assessed by the "30 day by beverage questionnaire." Participants were grouped into heavy or moderate drinkers (limits: females 40, males 60 gram alcohol/day) and abstainers. Analyses of motives showed the importance of car driving, controlling appetite/desire, and prevention of impaired mental performance. The relative impact of motivational concepts were analyzed by cluster analysis of motives revealing three clusters: 1) emotional concepts/fear of addiction, 2) physiological sensations/interaction with concrete actual plans, 3) cognitive concepts (plans, self-control, no impairment/no desire). MANOVA of MCD-Q/F indicate highest scores for moderate drinkers and significant lower scores in heavy drinkers in controlling frequency of drinking (MCD-F). Group effect for emotional concepts failed significance, higher scores of physiological concepts were found in imbibers compared to abstainers, and scores of cognitive concepts were lower in heavy drinkers. Results indicate that for imbibers a reduced motivation to control frequency of drinking as well as low scores in cognitive concepts and a trend to high scores in emotional concepts are associated with heavy drinking.     

A comparison of the effect of lorazepam on memory in heavy and low social drinkers

The cognitive deficits, particularly memory impairment, observed in association with organic brain damage caused by chronic alcohol ingestion, are consistent with the profile of benzodiazepine-induced amnesia. This study examined the cognitive capabilities of a group of heavy social drinkers (n=11) and a group of low social drinkers (n=11) under the influence of a pharmacological challenge (lorazepam 2 mg) and a placebo treatment. Lorazepam impaired visual memory and verbal learning in both groups, but the effect of lorazepam was exacerbated in the heavy social drinkers for delayed recall of verbal material. Heavy social drinkers had lower verbal fluency scores and were less able to copy complex figures than low social drinkers whether or not the pharmacological challenge was present. Lorazepam induced deficits, in both groups, which conformed to the classic profile of those observed in benzodiazepine-induced amnesia. The deficits, both in the absence and presence of lorazepam, shown by heavy social drinkers suggest that changes may have occurred in their brain functioning.     

Wernicke's encephalopathy and Korsakoff's psychosis: to fortify or not to fortify?

The conventional wisdom suggests that Korsakoff's psychosis, an amnesic disorder associated with prolonged alcohol consumption, is the chronic outcome of a thiamin deficiency first exhibited as Wernicke's encephalopathy. The present paper describes the debate in Australia over whether flour and alcoholic beverages should be fortified with thiamin, in an attempt to prevent Wernicke's encephalopathy and thus Korsakoff's psychosis. We conclude that the scientific evidence linking Wernicke's encephalopathy and Korsakoff's psychosis is tenuous. Certainly, it is not sufficient to support what would amount to mass medication.     

Comparison of a quantity-frequency method and a diary method of measuring alcohol consumption

This study compared the results obtained with two measures of alcohol consumption, a quantity-frequency (QF) method and a retrospective diary method, using a worksite sample. In order to control for the possibility of order effects, a subsample was chosen for readministration of the alcohol measures, when the order of presentation of the two measures was reversed for half of the subsample. Varying the order of presentation of the alcohol consumption items did not significantly affect the results obtained, except for an interaction effect between drinking group and order of presentation. Although subjects reported greater alcohol use on the diary than on the QF method at lower levels of consumption, the findings were reversed for higher levels of consumption. The relationship between the two measures is linear, with slope less than 1. Overall, subjects reported statistically significantly more alcohol consumption on the diary (mean [+/- SD] = 18.3 +/- 19.1 drinks) than on the QF method (mean = 16.9 +/- 19.5 drinks). The diary measure identified 20.9% of drinkers reporting consumption of more than 28 drinks per week, compared with 17.8% for the QF. However, the diary measure identified only 10.6% of drinkers reporting more than 42 drinks per week, compared with 10.2% for the QF. Consequently, the usefulness of the diary in detecting heavy drinkers appears to decrease with increasing consumption. These findings suggest the need for careful selection of alcohol consumption measures for research purposes and the need for caution in comparing the results of studies using different measures of alcohol consumption.     

Lifestyle modification with heavy alcohol drinkers: effects of aerobic exercise and meditation

To assess the effects of exercise and meditation on alcohol consumption in social drinkers, 60 male students, between the ages of 21 and 30, all classified as heavy social drinkers, were randomly assigned to one of three conditions: exercise (running), meditation, and a no-treatment control group. The study consisted of three distinct phases: pretreatment baseline (2 weeks), treatment intervention (8 weeks), and a follow-up period (6 weeks). Subjects in the running and meditation conditions met as a group during the treatment intervention phase, and all subjects self-monitored their daily consumption of alcohol throughout the study. The results showed that subjects in the exercise condition significantly reduced their alcohol consumption compared to the no-treatment control condition. The implications of these findings for treatment intervention, and the importance of subject compliance are discussed.     

The reliability and stability of a quantity-frequency method and a diary method of measuring alcohol consumption

The study aimed to assess the test-retest reliability of two commonly used measures of alcohol consumption, the quantity-frequency (QF) method and the diary method, as well as the stability of scores on the two measures over time. Two methods of assessing reliability and stability were employed. The first was a traditional method based on calculation of correlation coefficients for agreement between scores on repeated measures over a short retest interval to yield test-retest reliability coefficients, and over a long retest interval to yield stability coefficients. The second method was that devised by Wiley and Wiley (1970) to differentiate the effects of reliability and stability on repeated measures over time. The two methods were applied to a sample of heavy drinkers and to a sample of light drinkers. The results indicated that both the QF and diary measures are reliable in measuring alcohol consumption of light drinkers. Both measures are less reliable for heavy drinkers. The results indicate, in addition, that drinking consumption levels of light drinkers demonstrate a high degree of stability. However, the consumption levels of heavy drinkers demonstrate less stability, especially over a long time period. Heavy drinkers significantly reduced reported levels of alcohol consumption on both measures after the first test, suggesting a regression to the mean effect or the possibility of unintended intervention effects due to repeated measurement of drinking behaviour.     

Implementing a controlled drinking program

Controlled drinking as a treatment option for problem drinkers is now well established; there is a wealth of evidence demonstrating that problem drinkers can learn to maintain their consumption levels within safe limits.

There is a range of strategies that have been included in controlled drinking treatment programs. Unfortunately, most outcome studies have assessed the effect of a treatment package. There is a need for research investigating the effectiveness of the components of such treatment programs.

This paper will review issues involved with the implementation of a controlled drinking program as well as discussing the types of strategies which might be used.     

Dietary status in social drinkers

A prospective study of light-to-moderate drinkers was undertaken to establish the frequency of abnormal findings on CT, psychometric and dietary parameters over a range of alcohol consumption. In particular, it was desirable to exclude the possibility of poor nutrition contributing to the picture of CT atrophy, especially with the assessment of any demonstrable reversibility. Thirty-nine subjects were studied and 16 were found to be deficient in some part of their diet, although initial interviews established that they considered they took a balanced, adequate diet. Five subjects were re-examined after six months' abstinence from alcohol: in four cases the total kilocalorie intake was less than the initial total, a proportion having been contributed latter by the previous alcohol consumption. The dietary history was partially checked by estimation of the level of B vitamins. Seven subjects had a low red cell thiamin, four of these having a normal serum level. These findings in social drinkers (mean alcohol consumption ‡ 54 gms/day) lend support to the theory that thiamin deficiency in alcoholics is mediated by alcohol, rather than diet.     

Effects of brief counselling among male heavy drinkers identified on general hospital wards

Although the prevalence of heavy alcohol consumption among patients of general hospitals is well documented, no study has yet reported an effect of counselling on the ward in reducing the level of consumption among such patients after discharge. This study was designed to evaluate brief counselling to reduce alcohol consumption among male heavy drinkers identified on general hospital wards. Male patients were screened on wards of four teaching hospitals in Sydney, Australia. Identified heavy drinkers (n = 174) showing predominantly low levels of alcohol dependence were allocated to one of two forms of brief counselling (skills-based counselling or brief motivational interviewing) or to a non-intervention control group. Blind follow-up for 123 patients (71%) was carried out approximately 6 months after discharge from hospital and self-reports of alcohol consumption were compared with collateral sources of information. Patients who received counselling showed a significantly greater mean reduction in a quantity-frequency measure of weekly alcohol consumption than controls but there were no significant differences in reduced consumption between the two intervention groups. However, patients who were deemed “not ready to change” showed greater reductions if they had received brief motivational interviewing than if they had received skills-based counselling. The implications of these findings for counselling male in-patients to reduce alcohol consumption are discussed.     

脑卒中患者应用康复训练联合重复经颅磁刺激治疗的效果分析

目的评价康复训练联合重复经颅磁刺激治疗对脑卒中患者心理障碍及神经功能缺损的影响。方法选取河南科技大学第一附属医院2019年4月至2021年3月接收的脑卒中患者88例进行随机对照试验, 按随机数字表法分为参照组与联合组, 各44例。参照组中, 男24例, 女20例, 年龄49～83(64.3±5.2)岁, 应用康复训练治疗;联合组中, 男25例, 女19例, 年龄50～83(64.7±5.0)岁, 应用康复训练联合重复经颅磁刺激治疗。对比两组患者治疗前后心理障碍、神经功能和日常生活能力改善情况, 并采用SPSS 19.0处理数据, 组间比较采用t检验、χ2检验。结果治疗前, 两组患者抑郁、焦虑等心理障碍评分比较, 差异均无统计学意义(均P>0.05);治疗后, 联合组抑郁评分为(53.78±3.33)分、焦虑评分为(47.67±4.94)分, 参照组分别为(57.46±4.29)分、(53.05±4.83)分, 联合组抑郁、焦虑评分均低于参照组(t=4.495、5.165, 均P<0.001)。治疗前, 联合组神经功能、日常生活能力评分比较, 差异均无统计学意义(均P>...     

Psychosocial effects of longterm cannabis use in India. A study of fifty heavy users and controls.

Fifty cases of heavy cannabis users in India (25 smokers of charas and 25 drinkers of bhang) were studied for their physical and mental health and compared with 25 non-user controls. The average duration of cannabis use was more than 10 years with an estimated average consumption of about 150 mg of THC daily. Physical health and nutrition were relatively poor in users and there were more respiratory complaints. No case of definite psychosis related to the use of cannabis was found in the series, though minor neurotic complaints were present in all groups. In the social sphere cannabis users gave more often a history of poor work record, family maladjustment and episodes of violent behaviour.     

A brief intervention for prenatal alcohol use: an in-depth look

About 20% of pregnant women will drink alcohol, even though no universally safe level of prenatal alcohol consumption has been established. This study of 123 alcohol screen-positive pregnant women receiving a brief intervention in the 16th week of gestation examines the relationship of drinking goals, reasons for the goals, recognition of situations increasing risk of drinking, and subsequent antepartum consumption. While women who named abstinence as their antepartum drinking goal were more likely not to be consuming alcohol at the time of study enrollment (χ² = 16.80, df = 1, p = .001), current drinkers who named abstinence as their goal did reduce subsequent prenatal alcohol use (χ² = 10.04, df = 1, p = .002). All current drinkers who indicated fetal alcohol syndrome as a reason not to drink reduced their subsequent alcohol consumption (χ² = 11.04, df = 1, p = .001). Future efforts may include the partners and support systems of pregnant women in education or intervention programs to reduce prenatal alcohol consumption to enhance their effectiveness.     

Visuoperceptive deficits in long-term alcoholics and alcoholics with Korsakoff's psychosis

Compared with control subjects, alcoholics with Korsakoff's psychosis were significantly impaired in performance on the digit-symbol subtest of the Wechsler Adult Intelligence Scale and in four tasks assessing related processes. Other alcoholics showed similar, but not as severe, visuoperceptive deficits when compared with controls.     

The efficacy of two brief intervention strategies among injured, at-risk drinkers in the emergency department: impact of tailored messaging and brief advice

OBJECTIVE: This study used a randomized controlled trial design to compare the effectiveness of four interventions at reducing alcohol consumption, consequences, and heavy episodic drinking among injured, at-risk drinkers in the emergency department (ED). METHOD: Injured patients (n=4,476) completed a computerized survey; 575 at- risk drinkers were randomly assigned to one of four intervention conditions: tailored message booklet with brief advice, tailored message booklet only, generic message booklet with brief advice, and generic message booklet only. Regression models using the generalized estimating equation approach were constructed comparing the intervention conditions at baseline, 3-month follow-up, and 12-month follow-up. Gender and age were entered in models along with their interaction. RESULTS: Each of the intervention groups significantly decreased their alcohol consumption from baseline to 12-month follow-up; subjects in the tailored message booklet with brief advice group significantly decreased their average weekly alcohol consumption by 48.5% (p<.0001). Those in the brief advice conditions (tailored or generic) significantly decreased their average consumption during the 12 months of the study compared with the no brief advice conditions. Younger adult women (ages 19-22) who received some brief advice were the most likely to decrease their heavy episodic drinking. CONCLUSIONS: This was the first large-scale, brief intervention trial that included development and testing of computerized, highly tailored interventions with injured drinkers in the ED. ED-based interventions for alcohol problems would benefit from computerized screening, brief advice, and booklets to positively impact risky drinking practices.     

Dietary behavior of French men according to alcohol drinking pattern

Relationships of alcohol consumption with diet were studied in 216 French men aged 18-44. The sample was divided on the basis of alcohol intake in the preceding 7 days: controls (less than or equal to 43 g/day), moderate drinkers (44-87 g/day) and heavy drinkers (88-200 g/day). Moderate and heavy drinkers consumed more meat and meat products, bread and toast, dried vegetables and potatoes than controls but fewer nonalcoholic drinks and less milk, yogurt, cooked vegetables, raw and cooked fruits, pastries and confectioneries. Total energy intake was higher in drinkers than in controls but nonalcoholic energy intake was not significantly different; alcohol was simply added to food intake. Moderate and heavy drinkers consumed significantly less carbohydrates but more fat and protein than controls. Vitamins A and C intakes were lower in the moderate and heavy drinkers than in controls but folate and iron intakes were higher. The differences in dietary habits between controls and drinkers were not related to age nor to socioprofessional status since after adjustment for these two parameters the same relationships were still found.