Relevance of brain dysfunction to treatment objectives: Should alcohol-related cognitive deficits influence the way we think about treatment?

• Published in: Addictive behaviors 1981, Vol.6 (3), p.253-260
• Main Authors: Wilkinson, D.Adrian, Sanchez-Craig, Martha
• Format: Article
• Language: English
• Subjects: Adult; Alcohol Drinking; Alcoholism - complications; Alcoholism - psychology; Alcoholism - therapy; Feedback; Female; Humans; Learning - drug effects; Male; Middle Aged; Motor Skills - drug effects; Problem Solving - drug effects; Substance-Related Disorders - etiology; Vocabulary
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/0306-4603(81)90023-X

Chronic heavy consumption of alcohol is associated with cognitive deficits, such as impaired ability to abstract, to solve problems and to learn new information. Since much treatment for alcoholism involves the learning of coping strategies of various levels of complexity, an assessment of the cognitive abilities of the clients would appear to be required both for differential assignment to treatment and for the prediction of duration of treatment. This argument is based upon the assumption that learning-in-treatment is an important determinant of outcome, and that alcohol-related cognitive deficits account for a significant proportion of the variance in learning ability. There is very little literature, of even a descriptive nature, on the relationship of neuropsychological status to treatment outcome, although research interest has accelerated in the last two years. Formidable methodological problems are inherent in such research. Problems in designing a study of the possible relationship of cognitive deficit to treatment outcome are discussed. An alternative procedure would be to continue descriptive studies, and to assess the impact of objective feedback about physiological and functional consequences of chronic drinking on subsequent decisions to drink. This approach is proposed. In a treatment study of problem drinkers recovery of function resulted from abstinence or very low levels of consumption, but moderate levels of consumption prevented this process. These data should inform the setting of target levels for consumption in the initial stages in programs teaching non-problematic drinking.