Neurocognitive Deficits in Alcoholics and Social Drinkers: A Continuum?

Our research program has investigated neurocognitive deficits in sober alcoholics for several decades. We have shown that both male and female adult alcoholics – compared with peer nonalcoholic controls – have deficits on tests of learning, memory, abstracting, problem-solving, perceptual analysis and synthesis, speed of information processing, and efficiency. The deficits are equivalent to those found in patients with known brain dysfunction of a mild to moderate nature. Attempts to identify factors other than alcoholism to account for these differences have been unsuccessful. The deficits appear to remit slowly over 4 to 5 years. Relapse of recovering alcoholics is predicted by behavioral (e.g., depressive symptoms and neurocognitive performance) and biological measures (e.g., event-related potentials) obtained at the end of treatment. Results of recent studies support the hypothesis of a continuum of neurocognitive deficits ranging from the severe deficits found in Korsakoff patients to moderate deficits found in alcoholics and moderate to mild deficits in heavy social drinkers (more than 21 drinks/week). Individual differences in the presence and magnitude of neurocognitive deficits in social drinkers and alcoholics are hypothesized to be due, in part, to individual differences in vulnerability of the brain to alcohol or its metabolites' toxic effects.     

No Electrocortical Evidence of Automatic Mismatch Dysfunction in Children of Alcoholics

The mismatch negativity (MMN) event-related potential (ERP) component is an automatic, attention-independent brain response to auditory stimulus change, which has been reported to be smaller in alcoholics relative to nonalcoholic controls. To determine whether MMN decrements might be a trait marker of alcoholism that is also present in nonalcoholic individuals at high risk for developing alcoholism, we investigated MMN in 9-to 18-year-old children of alcoholics ( n = 20) and control children ( n = 20) in three different stimulus conditions using a passive auditory oddball paradigm. There were no statistically significant between-group differences observed in amplitude, scalp topography, and peak latency of MMN. These findings, if replicated, suggest that reported MMN decrements in alcoholics most likely represent a state marker, and not a trait marker, of alcoholism. Also, inasmuch as another ERP component, the P300, is attention-dependent and reported to be smaller in children of alcoholics, the present results implicate that deviations in attentive, but not in automatic, information processing are associated with alcoholism vulnerability.     

Alcohol Schema Acquisition in Preschoolers: Differences Between Children of Alcoholics and Children of Nonalcoholics

Cognitive schemas provide the structure within which children organize their knowledge and beliefs about the use of alcohol. The development of schemas about alcohol should be affected both by age and parental patterns of alcohol use. We examined differences in alcohol schema development among 139 male children of alcoholics (COAs) and 82 controls [children of nonalcoholics (NCOAs)] utilizing the Appropriate Beverage Task as an indicator of these processes. Overall, the vast majority of the sample identified at least one alcoholic beverage from photographs, even at age 3. COAs were more likely to identify at least one alcoholic beverage. With age controlled, COAs were better able to identify specific alcoholic beverages and correctly identified a larger number of alcoholic beverages. There was a trend for these children of alcoholic men to attribute more alcoholic beverage use to male adults than NCOAs. Moreover, differences in these children's attributions of alcoholic consummatory behavior were predicted by their parents' current consumption levels. Results provide evidence that alcohol schemas are detectable in early childhood and are more common in children from alcoholic homes. Discussion focuses on the potential relevance of these risk attributes to the development of more fully formed alcohol expectancies and to the later emergence of alcohol-related difficulty.     

Mismatch Negativity in Young Children of Alcoholics from High-Density Families

The mismatch negativity (MMN) component of event-related potentials was recorded from a group of young children of alcoholics ( n = 19, 8 females) with a high-density family history of alcoholism and from a control group ( n = 23,12 females), between 8 and 15 years of age. A dichotic listening task was used, and subjects had to pay attention to an oddball paradigm in one ear and ignore the stimuli in the other ear. The event-related potentials elicited by the standard unattended tones were subtracted from those elicited by the infrequent deviant unattended tones, and the MMN was measured at 10 frontal and central electrodes. No group differences were observed in peak latency, peak amplitude, and mean amplitude of the MMN. These results indicated that preattentive mechanisms of mismatch detection were not impaired in young subjects at high risk for alcoholism. Results are discussed in relation to differences in electro-physiological indexes of automatic versus controlled information processing and in relation to the characteristics of the sample.     

Pathways into Risk: Temperament and Behavior Problems in Three- to Five-Year-Old Sons of Alcoholics

Evidence suggests that a child with a difficult temperament, reared in an alcoholic family, is at high risk for the development of behavior problems that antedate the emergence of antisocial behavior, alcoholism, and coactive psychopathology. However, the causal linkage between difficult temperament and problem behavior in childhood, and antisociality and alcohol abuse in adulthood is far from certain, in part because few studies assess emergent behavior patterns in young children of alcoholics. In this study, we investigated the temperament-behavior problem relationship in 191 3- to 5-year-old boys, 149 of whom were being reared in high-risk alcoholic, low socioeconomic environments. Boys were classified as high in problem behavior or not based on standardized clinical cut-off scores for Total Behavior Problems from the Child Behavior Checklist. Results indicated that boys rated in the clinical range for total behavior problems exhibited more characteristics of difficult temperament than boys who were not rated in the clinical range. Parents of the boys in the clinical group had significantly more alcohol-related problems, higher levels of antisociality, and significantly lower levels of socioeconomic status, income, and education. Results are consistent with the supposition that the difficult temperament-behavior problem relationship flourishes in the context of an antisocial, alcoholic family environment.     

Evidence of Alcohol-Related Efficiency Deficits in an Episodic Learning Task

Using a component processes model, the current study examined the cognitive processes of alcoholic and community control subjects engaged in the acquisition of new context-bound (e.g., episodic) information. Of particular interest was whether alcoholics were inferior to controls in the efficiency with which information was acquired and whether there was a gender × group interaction in cognitive efficiency. Alcoholic ( n = 16 females; n = 22 males) and community control ( n = 21 females; n = 21 males) subjects participated in a serial learning task that consisted of three 12-item word lists. Standard administration protocols for serial learning tasks were used. On efficiency measures, there were significant differences between groups [ F (1,75) = 8.51, p = 0.005] and sexes [ F (1,75) = 4.05, p = 0.048]. There was also a group × sex interaction [ F (1,75) = 7.73, p = 0.007]. Duncan multiple-range comparisons revealed alcoholic females to be significantly inferior to control females, but equivalent to male controls and alcoholics. These data are consistent with other studies revealing the sensitivity of cognitive efficiency to alcohol-related effects and extend previous findings to tasks involving episodic learning tasks.     

Visual and Auditory Event-Related Potentials in Young Children of Alcoholics from High- and Low-Density Families

Event-related potentials (ERPs), particularly the P3 wave, have been proposed as biological markers of genetic risk for alcoholism. The present study assesses the ERPs from 102 boys and girls (7 to 15 years old) divided into three groups: two groups of sons and daughters of alcoholic fathers, with and without other first- or second-degree relatives affected, and a control group of children of nonal-coholics. Both visual and auditory discrimination tasks with three stimuli (standard, target, and infrequent nontarget) were used. P3 amplitudes did not reach significant reduction for the high-risk males and were complex for females. There were significant differences among females in P3 visual latency elicited by targets; delays in this variable were associated with multigenerational familial alcoholism. Results are discussed in light of the tasks used for eliciting the ERPs and the characteristics of the selected sample.     

Gender Differences in Lifetime Psychiatric Disorders Between Sons and Daughters of Alcoholic Mothers: A Pilot Study

Lifetime prevalence of selected psychiatric disorders was assessed in 24 independent pairs of adult siblings (brother-sister) with an alcoholic mother, using the Diagnostic interview Schedule. Adult females were as likely as adult males to have had one or more lifetime diagnosis of psychiatric disorder. Lifetime prevalence of affective disorders was the same in male and female siblings. Although not statistically significant, compared with their sister, men were 3 times more likely to have had a diagnosis of alcohol abuse/dependence, and 3.5 times more likely to have had a diagnosis of general anxiety disorder. When compared with their brother, women were 1.66 times more likely to have had a diagnosis of drug abuse/dependence, 3 times more likely to have had a diagnosis of panic disorder, and 6 times more likely to have been diagnosed with phobia; however, these differences were not significant.     

Adult Offspring of Alcoholic Women as Family History Informants

Eighteen years after their mothers had been hospitalized for alcoholism, adult offspring were asked if any of their 1st-degree relatives had ever had a drinking problem. Proband and informant characteristics that affect the validity of reports of maternal drinking problems given by adult offspring of alcoholic women were identified. A history of alcohol-related medical problems in the mother was associated with reporting maternal alcoholism. Being African-American, having a history of suicide attempts in the mother, and having a good maternal posttreatment outcome were associated with false-negative reports. Adding multiple offspring informants increased sensitivity to 86%. Female alcoholic offspring tended to underreport maternal alcoholism.     

Videotape versus Computer Interactive Education in Alcoholic and Nonalcoholic Controls

Few studies have evaluated the ability of the alcoholic patient to learn treatment-related information and all have involved conventional educational modalities such as videotape or lecture. Since computer interactive (CI) programs allow for individualization, feedback, and active learning, we were interested in determining whether CI would prove to be a more effective educational/treatment modality for male alcoholic patients than the conventional videotape (V) modality. The current study compared the relative effectiveness of the CI and V educational interventions for VA alcoholic patients and a cognitively and sociodemographically matched sample of nonalcoholic VA patients. The 91 male alcoholic subjects (46 V, 45 CI) were lower socioeconomic outpatients in a VA Alcoholism Treatment program. Control subjects were 35 nonalcoholic men (18 V, 17 CI) attending an outpatient medical clinic at the same facility. All subjects were individually exposed in a single session to a 1 hr intervention on the Medical Effects of Alcohol. Baseline knowledge was measured prior to the intervention using a 21-item multiple choice test, while learning and retention were assessed with the same instrument 24 hr after the intervention. All four subgroups (two types of subjects x two types of intervention) identified approximately three more items correctly at the post-test than at baseline. Thus, neither alcoholics for nonalcoholics acquired more information when exposed to the CI intervention. Further, no differences were found overall in the learning of the alcoholic and nonalcoholic subjects. The implications of these findings and their limitations are discussed.     

兰州市城区学龄前儿童碘营养状况的调查

目的了解兰州市城区学龄前儿童的碘营养状况。方法按照东、西、南、北、中抽取兰州市城区5所幼儿园,每所幼儿园随机抽取150名儿童,对其进行神经心理发育商(DQ)、甲状腺体积、体格发育状况、尿碘及儿童食堂食用盐碘、饮用水碘的测查,并进行相关分析。结果兰州市城区学龄前儿童的平均DQ为110.01±10.00,较理论值高5个发育商值,且分布呈右偏态,不同性别学龄前儿童DQ的差异有统计学意义(P<0.05);尿碘中位数161.59μg/L,尿碘小于20μg/L的样品比例为2.1%;体格发育正常者为94.67%;甲状腺触诊肿大率9.3%;5所幼儿园儿童食堂精制碘盐食用率达100%。结论兰州市城区学龄前儿童智力及体格发育正常,碘营养状态适宜。     

Sons of Alcoholics Report Greater Hangover Symptoms than Sons of Nonalcoholics: A Pilot Study

We investigated alcohol-induced hangovers among college men at high and low risk for alcoholism. Thirteen sons of alcoholics reported significantly (p less than 0.001) greater hangover symptoms in the past year than 25 sons of nonalcoholics. The two groups reported comparable quantity-frequency of recent drinking. To the extent that hangover represents an acute withdrawal syndrome to alcohol, this raises the question of whether sons of alcoholics are "dependence-prone."     

Gender‐Related Influences of Parental Alcoholism on the Prevalence of Psychiatric Illnesses: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions

Background: Offspring of individuals with alcoholism are at increased risk for psychiatric illness, but the effects of gender on this risk are not well known. In this study, we tested the hypothesis that the gender of the parent with alcoholism and the gender of offspring affect the association between parental alcoholism and offspring psychiatric illness. Method: We analyzed the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) data to examine the gender‐specific prevalence of axis I and axis II disorders in 23,006 male and 17,368 female respondents with and without a history of paternal or maternal alcoholism. Adjusted odds ratios were calculated for the disorders based on gender and presence of maternal or paternal alcoholism. Results: Maternal or paternal alcoholism was associated with a higher prevalence of every disorder examined, regardless of the gender of offspring. Gender‐related differences in prevalences were present in nearly all examined disorders, and the association between parental alcoholism and offspring psychiatric disorders was significantly different in men and women. These differences included stronger associations in female offspring of men with alcoholism (alcohol abuse without dependence); in female offspring of women with alcoholism (mania, nicotine dependence, alcohol abuse, and schizoid personality disorder); in male offspring of men with alcoholism (mania); and in male offspring of women with alcoholism (panic disorder). Conclusions: Interactions between gender and parental alcoholism were specific to certain disorders but varied in their effects, and in general female children of women with alcoholism appear at greatest risk for adult psychopathology.     

Event-Related Potentials During Visual Selective Attention in Children of Alcoholics*

Event-related potentials were recorded from 7- to 18-year-old children of alcoholics (COAs, n= 50) and age- and sex-matched control children (n= 50) while they performed a visual selective attention task. The task was to attend selectively to stimuli with a specified color (red or blue) in an attempt to detect the occurrence of target stimuli. COAs manifested a smaller P3b amplitude to attended-target stimuli over the parietal and occipital scalp than did the controls. A more specific analysis indicated that both the attentional relevance and the target properties of the eliciting stimulus determined the observed P3b amplitude differences between COAs and controls. In contrast, no significant group differences were observed in attention-related earlier occurring event-related potential components, referred to as frontal selection positivfty, selection negativity, and N2b. These results represent neurophysiological evidence that COAs suffer from deficits at a late (semantic) level of visual selective information processing that are unlikely a consequence of deficits at earlier (sensory) levels of selective processing. The findings support the notion that a reduced visual P3b amplitude in COAs represents a high-level processing dysfunction indicating their increased vulnerability to alcoholism.     

Salty and sour taste characteristics and risk of alcoholism

BACKGROUND: This study examined gustatory measures (intensity and hedonic values of salt and citric acid solutions) that have been reported to differentiate nonalcoholics who are at risk of alcoholism by virtue of having an alcoholic father (PHP) from those with no such paternal history (PHN). The study tested the hypothesis that PHPs perceive salty and sour solutions to be more intense and less pleasurable than do PHNs. METHODS: A total of 112 nonalcoholic subjects (44.7% male and 40.2% PHP) provided intensity and pleasantness ratings for a series of salty and sour solutions in varying concentrations. RESULTS: PHP subjects rated salty solutions as more unpleasant than PHN subjects. PHP subjects also showed higher mean sour intensity ratings and less preference for sour solutions than PHN subjects. CONCLUSIONS: This study replicates and extends prior findings of salty and sour taste differences as a function of paternal history of alcoholism. Further research is needed to replicate these findings in other populations and to examine their implications for the transmission of alcoholism risk.     

Neurophysiological Correlates of Response Production and Inhibition in Alcoholics

Scalp recordings of the P300 component of the event-related potential were made from a group of medication-free, chronic male alcoholics and a control group, participating in a visual Go/No Go reaction time paradigm. Subjects were presented with large and small forms of the letters T and V. The large forms (Go stimuli) required a button press with either the left or right hand, whereas the small forms (No Go stimuli) required response inhibition. Recordings were made from 31 electrodes that, for statistical analyses, were grouped into five regions: frontal, central, parietal, occipital, and temporal. The results indicated that, in each of the five regions, both Go and No Go response amplitudes were larger in the controls than in the alcoholics. No group differences in latency were observed in any region. Surface energy (Wang et al., Brain Topogr. 6:193-202, 1994) magnitudes paralleled P300 amplitudes and in the controls, compared with the alcoholics, were larger during both Go and No Go trials. Our findings suggest that abstinent, chronic alcoholics differ electro-physiologically from control individuals. These differences are manifested as widespread reductions in P300 amplitudes during the performance of a simple information processing paradigm. The reduced amplitudes may reflect a deficiency in an inhibitory mechanism proposed to underlie P300 generation.     

Intellectual, cognitive, and academic performance among sons of alcoholics, during the early school years: differences related to subtypes of familial alcoholism

BACKGROUND: Research on intellectual and cognitive functioning of children of alcoholics has been marked by inconsistency, with some studies unable to document deficits. This discrepancy may reflect the substantial heterogeneity found in the alcoholic population and among families of alcoholics. The current study sought to examine the effects of familial alcoholism subtypes on intellectual, cognitive, and academic performance in early school-aged sons of alcoholics. METHODS: Subjects for the present study were 198 elementary-age boys who were participants in the larger MSU-UM Longitudinal Study. Familial alcoholism subtypes were determined based on fathers' alcoholism and antisocial personality disorder diagnoses. Intellectual functioning was measured with the Wechsler Intelligence Scale for Children-Revised (WISC-R); academic achievement was measured with the Wide Range Achievement Test-Revised. In addition, Mazes and Freedom from Distractability factor scores of the WISC-R were used to assess abstract planning and attention abilities. RESULTS: Children of antisocial alcoholics (AALs) displayed the worst IQ and academic achievement compared with children of nonantisocial alcoholics (NAALs) and controls. In addition, children of AALs displayed relatively poorer abstract planning and attention abilities compared with children from control families. Regression analyses revealed that familial alcoholism subtype continued to account for variance in child intellectual ability even when other factors were excluded. CONCLUSIONS: Findings indicate that children from AAL families are most susceptible to relative intellectual, cognitive, and academic deficits. The study further supports the proposition that familial risk characteristics (i.e., paternal alcoholism and antisociality) may serve as effective indicators of family risk for poor intellectual outcome among offspring as early as the elementary school years.     

Alcohol-Related God/Higher Power Control Beliefs,Locus of Control,and Recovery Within the Alcoholics Anonymous Paradigm

Abstract

This study explored the relationships among spirituality, control beliefs, and treatment outcomes by examining internal and God/Higher Power control beliefs in members of Alcoholics Anonymous (AA). Participants included 89 male and 55 female (N= 144) adult alcoholics who were currently attending AA meetings. Questionnaires assessing alcohol-related God/Higher Power control beliefs, drinking-related control beliefs, satisfaction with life, and length of sobriety were completed by AA members. Guided by Pargament et al.'s (1988) model of collaborative religious coping, it was hypothesized that greater length of sobriety and satisfaction with life would be found in individuals who simultaneously endorsed internal and God/Higher Power drinking-related control beliefs. Contrary to expectation, the results from this study showed that individuals who endorsed internal and God/Higher Power control beliefs did not have significantly better satisfaction with life or longer sobriety than the other groups. Instead, results showed that among individuals who have low God/Higher Power control beliefs, those who endorse internal drinking-related control beliefs have significantly longer sobriety than do those who are more external in their control beliefs. Control beliefs did not relate, either directly or indirectly, to life satisfaction.