Chunk #15 — 1 Definitions and Conceptual Framework for Reward Deficit in Alcoholism — 1.1 Theoretical Framework: Motivation, Withdrawal, and Opponent Process
Alcoholics show dramatic evidence of dysphoric states during acute withdrawal that persist into protracted abstinence. Alcohol withdrawal in humans produces well documented physical (somatic) symptoms, such as tremor, autonomic hyperactivity, nausea, vomiting, and seizures, but more importantly produces significant affective symptoms of anxiety, dysphoria, and depression-like symptoms. Acute withdrawal (i.e., the first week post-alcohol) is characterized by Beck Depression Inventory scores of approximately 20, which is categorized within the range of moderate depression (Potokar et al. 21997; 15–30), and Hamilton Depression Scores of 18, which is close to 20 (the cutoff for antidepressant medication in affective disorder; Brown and Schuckit 1988). Depression scores decline during subsequent weeks of treatment but remain at close to 10 for Hamilton Depression Scores for up to 4 weeks of an inpatient treatment program (Brown and Schuckit 1988). In another study of inpatient alcoholics during withdrawal, the Beck Depression Inventory score was at 15 at withdrawal and remained at 12.8 two days into withdrawal and at 9.4 two weeks post-withdrawal (de Timary et al. 2008). Similar results were obtained for anxiety measures (Potokar et al.
