Repeated challenges, such as with repeated alcohol binges, lead to attempts of the brain via molecular, cellular, and neurocircuitry changes to maintain stability but at a cost. For the alcoholism framework elaborated here, the residual deviation from a normal emotional state is termed the allostatic state. This state represents a combination of chronic elevation of the reward set point fueled by decreased function of reward circuits and recruitment of anti-reward systems, both of which lead to the compulsivity of alcohol-seeking and alcohol taking. How these systems are modulated by other known brain emotional systems localized to the basal forebrain, where the ventral striatum and extended amygdala project to convey emotional valence, how the dysregulation of brain emotional systems impacts on the cognitive domain linked to impairments in executive function, and how individuals differ at the molecular-genetic level of analysis to convey loading on these circuits remain challenges for future research (George and Koob 2010).
