To support this hypothesis, a holistic view of alcoholism will be presented with the following arguments. A negative emotional state is a common presentation in most alcoholics during withdrawal and protracted abstinence. Compulsivity observed in alcoholism has an important negative reinforcement component that perpetuates alcoholism. Such negative emotional states become sensitized over time and set up an allostatic state that perpetuates dependence. Negative emotional states set up a powerful motivational state for relapse. Finally, the neurobiological substrates underlying the motivation to seek alcohol will be reviewed, and an argument will be presented that it is loss of reward function and gain of brain stress function that mediate the negative emotional state outlined as key to alcoholism.
