Alcoholism is a complex, dynamic disease punctuated by periods of abstinence and relapse, and influenced by multiple vulnerability and resilience factors. This review highlights the cognitive deficits in executive functions, memory, and metacognitive abilities, with associated impairment in emotional processes and social cognition that occur in some alcoholics, and the variable recovery that occurs over time with abstinence. Despite extensive study of cognitive impairment and recovery, knowledge lacunae abound. For example, it is now critical to investigate the emotional and social components contributing to functional impairment in chronic alcoholism. One focus might be on the interaction among emotionally-based cognition processes and identification of vulnerability factors that play a role in the development of emotional and social processing deficits. Treatment focusing on improving level of awareness about impaired and spared cognitive and emotional processing deficits may reveal how an alcoholic compensates for functional compromise, similar to the approach taken by traumatic brain injury (TBI) rehabilitation programs.
