Cognitive performance in treatment-naïve active alcoholics.

paper Cited Public

Authors: Smith, Stan; Fein, George
Year: 2010
Journal: Alcoholism, clinical and experimental research
PMID: 20860617
DOI: 10.1111/j.1530-0277.2010.01306.x
PMCID: PMC3246425

BACKGROUND: Most studies reporting cognitive deficits in chronic alcoholics have relied on treatment samples (predominantly men) from inpatient or outpatient treatment facilities. However, the majority of chronic alcoholics have never been in treatment and there is increasing evidence that treated and non-treatment-seeking alcoholic samples come from different populations with regard to alcohol use and other factors related to the severity of disease. Accordingly, in the present study, we assessed a broad range of cognitive functions in 55 treatment-naïve alcohol-dependent (TNAD) individuals and 55 nonalcoholic controls (NAC) matched for age and education. In addition, a goal of the present study was to assess potential differential effects of alcohol dependence on cognitive performance in TNAD men and women. METHODS: Comprehensive neuropsychological assessment was conducted on TNAD and NAC. The following 9 performance domains, each consisting of multiple measures, were examined: attention, auditory working memory, verbal processing, abstraction/cognitive flexibility, psychomotor function, immediate memory, delayed memory, reaction time, and spatial processing. RESULTS: Analysis revealed no cognitive deficits in TNAD, relative to NAC, in any of the 9 cognitive domains. TNAD performed better than NAC in the attention domain. In addition, while men performed better than women in the spatial domain, there were no TNAD versus NAC group by gender interactions for any domain. CONCLUSIONS: Our results extend findings that TNAD show minimal behavioral effects of chronic heavy alcohol use and are consistent with the contention that TNAD are relatively cognitively intact. Differences between our findings and those often reported for alcoholics recruited from treatment settings may be understood in terms of differences in alcohol use, along with genetic, psychiatric, and nutritional factors. In addition, the lack of differential effects of alcohol dependence on male and female cognitive performance in our study suggests that TNAD men and women do not differ in the severity of cerebral consequences of alcohol dependence.

#	Section	Preview
0	Introduction	Numerous studies have identified a pattern of cognitive deficits that can occur as a result of…
1	Introduction	Alcoholics in treatment constitute a small proportion of alcoholics in the general population.…
2	Introduction	Bias in treated samples can be associated with a number of factors that may contribute to the…
3	Introduction	In sum, the foregoing findings provide strong evidence that treated alcoholics and TNAD come from…
4	Introduction	Several recent studies by Fein and colleagues have focused on the effects of chronic alcohol…
5	Introduction	hypothesis that the neurological effects on non-treatment seeking alcohol dependent individuals are…
6	Introduction	The above results are consistent with the idea that treated alcoholics and TNAD individuals come…
7	Introduction	As noted earlier, most assessments of cognitive performance in alcoholics have relied on samples…
8	Introduction	a higher threshold for alcohol related problems before receiving treatment. Indeed, Dawson (1996)…
9	Introduction	episodic memory and spatial visualization tasks than did non/light drinking women, a pattern not…
10	Methods — Subjects	Participants consisted of TNAD (33 men and 25 women) matched for age and gender with non-alcoholic…
11	Methods — Procedures	Participant screening was initially conducted by a phone interview assessing alcohol use/dependence,…
12	Methods — Procedures	All participants completed the following general assessments: 1) psychiatric status was assessed…
13	Methods — Neuropsychological Assessment	All subjects were individually administered a comprehensive neuropsychological assessment, beginning…
14	Methods — Neuropsychological Assessment	the Nelson Adult Reading Test (AMNART), as an estimate of premorbid IQ (Grober et al., 1991). The…
15	Methods — Neuropsychological Assessment	For each of the neuropsychological domains, composite Z-scores were computed by averaging Z-scores…
16	Methods — Neuropsychological Assessment	For the NP measures, a multivariate analysis of variance (MANOVA) was carried out, with Group and…
17	Methods — Neuropsychological Assessment	The data were also analyzed by constructing age- and education-adjusted Z-scores based on our own…
18	Results	Table 1 presents demographic and family history variables for all participants, along with results…
19	Results	Analyses using the Z-scores computed based on standardized norms yielded the following: There were…

Citation	PMID	DOI	Status
Bechara, A et al., Neuropsychologia, 2002, Decision-making and addiction (part I): impaired activation of somatic states in substance dependent individuals when pondering decisions with negative future consequences	11992656	10.1016/s0028-3932(02)00015-5	Cited
Begleiter, H et al., Science, 1984, Event-related brain potentials in boys at risk for alcoholism	6474187	10.1126/science.6474187	Cited
Benegal, V et al., Addict Biol, 2007, Gray matter volume abnormalities and externalizing symptoms in subjects at high risk for alcohol dependence	17407506	10.1111/j.1369-1600.2006.00043.x	Cited
Benton, AL et al., Multilingual aphasia examination, 1983	—	—	—
Berglund, K et al., Alcohol Alcohol, 2006, Individuals with excessive alcohol intake recruited by advertisement: demographic and clinical characteristics	16314427	10.1093/alcalc/agh244	Cited
Bergman, H, Brain dysfunction related to alcoholism: Some results from the KARTAD project, in Neuropsychology of Alcoholism: Implications for Diagnosis and Treatment, 1987	—	—	—
Chao, LL et al., Clin Neurophysiol, 2003, Abnormal CNV in chronic heavy drinkers	14580606	10.1016/s1388-2457(03)00230-x	Cited
Cohen, E et al., Drug Alcohol Depend, 2007, Alcohol treatment utilization: findings from the National Epidemiologic Survey on Alcohol and Related Conditions	16919401	10.1016/j.drugalcdep.2006.06.008	Cited
Dawson, D, Addiction, 1996, Gender differences in the risk of alcohol dependence: United States, 1992	8997764	—	Cited
Dawson, DA et al., Addiction, 2005, Recovery from DSM-IV alcohol dependence: United States, 2001-2002	15733237	10.1111/j.1360-0443.2004.00964.x	Cited
Denman, SB, Denman Neuropsychology Memory Scale, 1987	—	—	—
Di Sclafani, V et al., Drug Alcohol Depend, 2008, Treatment-naive Active Alcoholics Have Greater Psychiatric Comorbidity Than Normal Controls but less than Treated Abstinent Alcoholics	18620818	10.1016/j.drugalcdep.2008.04.019	Cited
Drewe, EA, Cortex, 1974, The effect of type and area of brain lesion on Wisconsin card sorting test performance	4844468	10.1016/s0010-9452(74)80006-7	Cited
DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, 2000	—	—	—
Fein, G et al., Alcohol Clin Exp Res, 2002, Cortical gray matter loss in treatment-naive alcohol dependent individuals	11981133	—	Cited
Fein, G et al., Alcohol Clin Exp Res, 2010, Age-related gray matter shrinkage in a treatment naive actively drinking alcohol dependent sample	19860794	10.1111/j.1530-0277.2009.01079.x	Cited
Fein, G et al., Alcohol Clin Exp Res, Cognitive performance in long-term abstinent alcoholic individuals	16930216	10.1111/j.1530-0277.2006.00185.x	Cited
Fein, G et al., Alcohol Clin Exp Res, Impairment on a simulated gambling task in long-term abstinent alcoholics	15597080	10.1097/01.alc.0000141642.39065.9b	Cited
Fein, G et al., Alcohol Clin Exp Res, Normal performance on a simulated gambling task in treatment-naive alcohol-dependent individuals	16737453	10.1111/j.1530-0277.2006.00109.x	Cited
Fein, G et al., Alcohol, 2005, Treated and treatment-naive alcoholics come from different populations	15922134	10.1016/j.alcohol.2004.10.007	Cited
Fein, G et al., Alcohol, Cerebral reserve capacity: implications for alcohol and drug abuse	15066705	10.1016/j.alcohol.2003.10.003	Cited
Fein, G et al., Drug Alcohol Depend, 2008, Smaller feedback ERN amplitudes during the BART are associated with a greater family history density of alcohol problems in treatment-naive alcoholics	17869027	10.1016/j.drugalcdep.2007.07.017	Cited
Fein, G et al., West J Med, 1990, Cognitive impairments in abstinent alcoholics	2190421	—	Cited
Gazdzinski, S et al., Alcohol and Tobacco: From Basic Science to Clinical Practice, 2008, Are treated alcholics representative of the entire population with alcohol use disorders? A magnetic resonance study of brain injury	18358984	10.1016/j.alcohol.2008.01.002	Cited
Glenn, SW et al., Alcohol Alcohol, 1988, The effects of repeated withdrawals from alcohol on the memory of male and female alcoholics	3228455	10.1093/oxfordjournals.alcalc.a044826	Cited
Golden, CJ, Stroop Color and Word Test: A Manual for Clinical and Experimental Uses, 1978	—	—	—
Grafman, J et al., Brain, 1986, The effects of lateralized frontal lesions on mood regulation	3790971	10.1093/brain/109.6.1127	Cited
Grober, E et al., J Clin Exp Neuropsychol, 1991, Development and validation of a model for estimating premorbid verbal intelligence in the elderly	1779032	10.1080/01688639108405109	Cited
Gronwall, DM, Perceptual and Motor Skills, 1977, Paced auditory serial-addition task: a measure of recovery from concussion	866038	10.2466/pms.1977.44.2.367	Cited
Halpern, DF, Am Psychol, 1997, Sex differences in intelligence. Implications for education	9329293	10.1037//0003-066x.52.10.1091	Cited
Heaton, RK et al., Comprehensive Norms for an Expanded Halstead-Reitan Battery: Demographic Corrections, Research Findings, and Clinical Applications, 1991	—	—	—
Jacobson, R, Psychol Med, 1986, The contributions of sex and drinking history to the CT brain scan changes in alcoholics	3763773	10.1017/s003329170001031x	Cited
Janowsky, JS et al., Behav Neurosci, 1989, Cognitive impairment following frontal lobe damage and its relevance to human amnesia	2736069	10.1037//0735-7044.103.3.548	Cited
Kaskutas, LA et al., J Stud Alcohol, 1997, Predictors of help seeking among a longitudinal sample of the general population, 1984-1992	9065893	10.15288/jsa.1997.58.155	Cited
Krueger, RF et al., Psychol Med, 2009, Externalizing disorders: cluster 5 of the proposed meta-structure for DSM-V and ICD-11	19796431	10.1017/S0033291709990328	Cited
Lezak, M et al., Neuropsychological assessment, 2004	—	—	—
Lloyd, JJ et al., J Stud Alcohol, 2004, Clinical features associated with receipt of alcohol treatment	15700513	10.15288/jsa.2004.65.750	Cited
Lukassen, J et al., Soc Sci Med, 2005, Alcohol dependence and depression among heavy drinkers in Canada	15869834	10.1016/j.socscimed.2005.03.019	Cited
Mann, RE et al., Drug Alcohol Depend, 1985, Reliability of a family tree questionnaire for assessing family history of alcohol problems	4017879	10.1016/0376-8716(85)90030-4	Cited
Martin, PR et al., Alcohol Res Health, 2003, The role of thiamine deficiency in alcoholic brain disease	15303623	—	Cited
Mazas, CA et al., Alcohol Clin Exp Res, 2000, Decision-making biases, antisocial personality, and early-onset alcoholism	10924007	—	Cited
Moss, HB et al., Drug Alcohol Depend, 2007, Subtypes of alcohol dependence in a nationally representative sample	17597309	10.1016/j.drugalcdep.2007.05.016	Cited
Oscar-Berman, M, Neuropsychological vulnerabilities in chronic alcoholism, in Review of NIAAA’s Neuroscience and Behavioral Research Portfolio, vol NIAAA Research Monograph No 34, 2000	—	—	—
Osterrieth, PA, Archives de Psychologie, 1944, Le test de copie d’une figure complex	—	—	—
Parsons, OA et al., Neurol Clin, 1993, Neurobehavioral sequelae of alcoholism	8441371	—	Cited
Pfefferbaum, A et al., Am J Psychiatry, 2001, Sex differences in the effects of alcohol on brain structure	11156800	10.1176/appi.ajp.158.2.188	Cited
Porjesz, B et al., Alcohol Clin Exp Res, 1998, Amplitude of visual P3 event-related potential as a phenotypic marker for a predisposition to alcoholism: preliminary results from the COGA Project. Collaborative Study on the Genetics of Alcoholism	9756048	—	Primary
Powell, DH et al., MicroCog Assessment of Cognitive Functioning, 1993	—	—	—
Raimo, EB et al., Alcohol Clin Exp Res, 1999, Clinical characteristics of alcoholism in alcohol-dependent subjects with and without a history of alcohol treatment	10549991	—	Primary
Reitan, RM et al., The Halstead-Reitan Neuropsychological Test Battery, 1985	—	—	—
Robins, LN et al., The Diagnostic Interview Schedule for DSM-IV, 1998	—	—	—
Ruff, RM et al., Arch Clin Neuropsychol, 1996, Benton Controlled Oral Word Association Test: reliability and updated norms	14588937	—	Cited
Schober, R et al., Addict Behav, 1996, Barriers to help-seeking for change in drinking: a gender-focused review of the literature	8729710	10.1016/0306-4603(95)00041-0	Cited
Schwartz, M et al., The American-NART: Replication and extension of the British findings on the persistence of the word pronunciation skills in patients with dementia, 1987	—	—	—
Skinner, HA et al., Abnormal Psychology, Alcohol dependence syndrome: measurement and validation	7096790	10.1037//0021-843x.91.3.199	Cited
Skinner, HA et al., J Stud Alcohol, Reliability of alcohol use indices. The Lifetime Drinking History and the MAST	7182675	10.15288/jsa.1982.43.1157	Cited
Smith, A, Symbol Digit Modalities Test, 1982	—	—	—
Smith, A, The symbol digit modalities test: A neuropsychological test of learning and other cerebral disorders, Learning Disorders, 1968	—	—	—
Sobell, LC et al., Behav Assess, 1990, Self-reports issues in alcohol abuse: State of the art and future directions	—	—	—
Sobell, LC et al., Stud Alcohol, 1988, The reliability of alcohol abusers’ self-reports of drinking and life events that occurred in the distant past	3374136	10.15288/jsa.1988.49.225	Cited
Stoltenberg, SF et al., Addiction, 1998, Evaluating measures of family history of alcoholism: density versus dichotomy	9926555	10.1046/j.1360-0443.1998.931015117.x	Cited
Stuss, DT et al., Neuropsychologia, 1983, The involvement of orbitofrontal cerebrum in cognitive tasks	6877577	10.1016/0028-3932(83)90040-4	Cited
Stuss, DT et al., The Clinical Neuropsychologist, 1988, Three tests of attention and rapid information processing: an extension	—	—	—
Sullivan, EV et al., Alcohol Clin Exp Res, 2000, Pattern of motor and cognitive deficits in detoxified alcoholic men	10832902	—	Cited
Sullivan, EV et al., Neuropsychology, 2002, A profile of neuropsychological deficits in alcoholic women	11853359	10.1037//0894-4105.16.1.74	Cited
Sullivan, EV et al., Psychopharmacology (Berl), 2005, Neurocircuitry in alcoholism: a substrate of disruption and repair	15834536	10.1007/s00213-005-2267-6	Cited
Sullivan, EV, Alcohol Clin Exp Res, 2003, Compromised pontocerebellar and cerebellothalamocortical systems: speculations on their contributions to cognitive and motor impairment in nonamnesic alcoholism	14506401	10.1097/01.ALC.0000085586.91726.46	Cited
Tucker, JA et al., Addict Behav, 2004, Different variables are associated with help-seeking patterns and long-term outcomes among problem drinkers	14732433	10.1016/j.addbeh.2003.08.015	Cited
Wechsler, D, Administration and Scoring Manual, 1997, Wechsler Adult Intelligence Scale	—	—	—
Wechsler, D, Wechsler Adult Intelligence Scale-Revised, 1981	—	—	—
Wetzel, L et al., Short Category Test, Booklet Format, 1987	—	—	—
Yonker, JE et al., Alcohol Alcohol, 2005, Sex differences in spatial visualization and episodic memory as a function of alcohol consumption	15797882	10.1093/alcalc/agh141	Cited

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