As noted earlier, most assessments of cognitive performance in alcoholics have relied on samples that were not only drawn from treatment settings, but were also predominantly men. Two studies (Bergman, 1987; Jacobson, 1986) of structural brain changes in alcoholic men and women drawn from clinical samples concluded that women suffer more severe cerebral consequences of long-term alcohol dependence than do men. This reported difference is consistent with the hypothesis (Glenn et al., 1988) that cognitive processes in women are especially vulnerable to the toxic effects of alcohol. However, the reported difference in cerebral consequences may be the result of an inherent bias in studying clinical populations that is greater for women than for men. That is, given evidence that women are less likely than men to receive treatment for alcohol dependence (Dawson, 1996; Schober et al., 1996), they may have a higher threshold for alcohol related problems before receiving treatment. Indeed, Dawson (1996) found that, at the most common levels of alcohol dependence severity (5 to 10 symptoms), men were about 50% more likely than women to have received treatment,
