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Chunk #49 — The Five Functional Domains — 3. Emotion and Psychosocial Skills — Impairments

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Profiles of impaired, spared, and recovered neuropsychologic processes in alcoholism.
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A number of fMRI studies have shown alcoholism-related abnormalities in the prefrontal cortex and the limbic system, which are important in emotion and cognition. For example, one fMRI study examined brain activation patterns in alcoholic and control participants as they were shown photographs of faces with positive, negative, and neutral expressions (Marinkovic et al., 2009). Nonalcoholic participants had strong amygdala and hippocampus activation when viewing emotional (compared with neutral) expressions, while alcoholics had similar responses to both neutral and emotional stimuli, which reflected blunted limbic activation to emotional faces. Another fMRI study showed that alcoholic participants were impaired in recognizing expressions of fearful faces and had lower activation in orbitofrontal and insular cortex than controls when viewing emotional faces (O’Daly et al., 2012). Gilman et al. (2010) found that alcoholics demonstrated greater activation in the inferior frontal gyrus, fusiform gyrus, and amygdala when they passively viewed negative facial expressions, and decreased activation in the precuneus and parahippocampal gyrus when they viewed positive facial expressions. Low activation in the anterior cingulate cortex during decoding of facial expressions of fear, disgust, and