Deficits in affective prosody comprehension: family history of alcoholism versus alcohol exposure

Selective visual and crossmodal impairment in the discrimination of anger and fear expressions in severe alcohol use disorder

BACKGROUND

Severe alcohol use disorder (SAUD) is associated with impaired discrimination of emotional expressions. This deficit appears increased in crossmodal settings, when simultaneous inputs from different sensory modalities are presented. However, so far, studies exploring emotional crossmodal processing in SAUD relied on static faces and unmatched face/voice pairs, thus offering limited ecological validity. Our aim was therefore to assess emotional processing using a validated and ecological paradigm relying on dynamic audio-visual stimuli, manipulating the amount of emotional information available.

METHOD

Thirty individuals with SAUD and 30 matched healthy controls performed an emotional discrimination task requiring to identify five emotions (anger, disgust, fear, happiness, sadness) expressed as visual, auditory, or auditory-visual segments of varying length. Sensitivity indices (d') were computed to get an unbiased measure of emotional discrimination and entered in a Generalized Linear Mixed Model. Incorrect emotional attributions were also scrutinized through confusion matrices.

RESULTS

Discrimination levels varied across sensory modalities and emotions, and increased with stimuli duration. Crucially, performances also improved from unimodal to crossmodal conditions in both groups, but discrimination for anger crossmodal stimuli and fear crossmodal/visual stimuli remained selectively impaired in SAUD. These deficits were not influenced by stimuli duration, suggesting that they were not modulated by the amount of emotional information available. Moreover, they were not associated with systematic emotional error patterns reflecting specific confusions between emotions.

CONCLUSIONS

These results clarify the nature and extent of crossmodal impairments in SAUD and converge with earlier findings to ascribe a specific role for anger and fear in this pathology.

Impaired affective prosody decoding in severe alcohol use disorder and Korsakoff syndrome

Recognizing others' emotions is a fundamental social skill, widely impaired in psychiatric populations. These emotional dysfunctions are involved in the development and maintenance of alcohol-related disorders, but their differential intensity across emotions and their modifications during disease evolution remain underexplored. Affective prosody decoding was assessed through a vocalization task using six emotions, among 17 patients with severe alcohol use disorder, 16 Korsakoff syndrome patients (diagnosed following DSM-V criteria) and 19 controls. Significant disturbances in emotional decoding, particularly for negative emotions, were found in alcohol-related disorders. These impairments, identical for both experimental groups, constitute a core deficit in excessive alcohol use.

Social cognition deficits and associations with drinking history in alcoholic men and women

BACKGROUND

Previous studies have demonstrated the presence of a social cognition factor as an element of general cognition in healthy control and clinical populations. Recently developed measures of social cognition include the social perception and faces subtests of the Wechsler Advanced Clinical Solutions (ACS) Social Cognition module. While these measures have been validated on various clinical samples, they have not been studied in alcoholics. Alcoholism has been associated with emotional abnormalities and diminished social cognitive functioning as well as neuropathology of brain areas underlying social processing abilities. We used the ACS Social Perception and Faces subtests to assess alcoholism-related impairments in social cognition.

METHODS

Social cognitive functioning was assessed in 77 abstinent alcoholic individuals (37 women) and 59 nonalcoholic control participants (29 women), using measures of the ACS Social Cognition module and subtests of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) that contain a social cognition component (Picture Completion and Comprehension). Group and gender differences in ACS and WAIS-IV performance were assessed, as well as relationships between measures of alcoholism severity and social cognitive functioning.

RESULTS

Alcoholics performed significantly worse than nonalcoholics on the ACS measures of Affect Naming and Faces Content. Alcoholic men were impaired relative to alcoholic women on Prosody Face Matching and Faces Content scores. Among alcoholics, longer durations of heavy drinking were associated with poorer performance on Affect Naming, and a greater number of daily drinks were associated with lower Prosody Face Matching performance. For alcoholic women, a longer duration of abstinence was associated with better performance on Affect Naming.

CONCLUSIONS

Alcoholic men and women showed different patterns of associations between alcoholism indices and clinically validated social cognition assessments. These findings extend into the social cognition domain, previous literature demonstrating the presence of cognitive deficits in alcoholism, their association with alcoholism severity, and variability by gender. Moreover, because impairments in social cognition can persist despite extended abstinence, they have important implications for relapse prevention.

Mental state decoding and mental state reasoning in recently detoxified alcohol-dependent individuals

Impaired social cognition has been associated with interpersonal problems and with the development of and relapse into alcohol abuse. In the present study, self-reported trait empathy, decoding of complex mental states and cognitive and affective mental state reasoning were assessed in alcohol-dependent participants, and the association with executive function and psychopathological characteristics was investigated. Twenty recently detoxified alcohol-dependent patients and 20 matched healthy controls were assessed with an abbreviated German version of the interpersonal reactivity index, the revised reading the mind in the eyes test, the faux pas story test, the trail making test and the letter-number-sequencing test. Patients were impaired relative to controls with regard to mental state decoding on the eyes test and showed reduced faux pas detection and impaired mental state reasoning reflected by lower faux pas understanding and faux pas empathy scores. There were no group differences regarding self-reported trait empathy. Performance on the sociocognitive measures was related to executive functioning and the severity of depressive symptoms. Although self-report measures might not always reliably detect impairments of social cognition, behavioural measures suggest pronounced impairments of mental state decoding and mental state reasoning in association with alcohol dependence. Findings ought to be incorporated into current treatment strategies.