Face processing in chronic alcoholism: a specific deficit for emotional features

Non-abstinent recovery in alcohol use disorder is associated with greater regional cortical volumes than heavy drinking

BACKGROUND

Harm-reduction (i.e., non-abstinent recovery) approaches to substance use treatment have garnered increasing attention. Reduced levels of alcohol consumption post-treatment have been associated with better psychosocial functioning and physical health, yet less is known regarding differences in brain structures associated with varying levels of alcohol consumption. This study investigated regional cortical volumes after alcohol use disorder (AUD) treatment among individuals who achieved complete abstinence and those who returned to lower and higher levels of consumption.

METHODS

Data were collected from individuals with AUD (n = 68) approximately 8 months after the initiation of treatment. Using risk drinking levels defined by the World Health Organization, participants were classified as abstaining (AB) or relapsing with low (RL) or higher (RH) levels. Data were also obtained from 34 age-matched light/non-drinking controls (LN). All participants completed a 1.5 T magnetic resonance imaging session and volumes for 34 bilateral cortical regions of interest were quantitated with FreeSurfer. Generalized linear models were used to examine group differences in cortical volume. All group findings are significant at an FDR-corrected value of 0.018.

RESULTS

Adjusting for age and intracranial volume, significant group differences were found in 13/34 cortical regions. AB showed greater volumes than RL in 2/13 regions and RH in 6/13 regions. RH demonstrated significantly smaller volumes than LN in 12/13 ROIs, whereas RL differed from LN in 9/13 regions. RH and RL differed in only two cortical regions.

CONCLUSIONS

Individuals who consumed low-risk levels of alcohol post-treatment exhibited regional cortical volumes more similar to abstainers than individuals who returned to higher-risk levels. This suggests that low-risk levels of alcohol consumption are associated with brain integrity that is comparable to that seen with complete abstinence. Given the previously demonstrated improvement in psychosocial and physical health with reduced levels of alcohol consumption post-treatment, harm reduction may be a beneficial and more attainable goal for some individuals with AUD who are seeking treatment.

WOMEN'S USE OF ALCOHOL: NEUROBIOBEHAVIORAL CONCOMITANTS AND CONSEQUENCES

In this narrative review, we draw from historical and contemporary literature to explore the impact of alcohol consumption on brain and behavior among women. We examine three domains: 1) the impact of alcohol use disorder (AUD) on neurobiobehavioral outcomes, 2) its impact on social cognition/emotion processing, and 3) alcohol's acute effects in older women. There is compelling evidence of alcohol-related compromise in neuropsychological function, neural activation, and brain structure. Investigations of social cognition and alcohol effects in older women represent emerging areas of study. Initial analyses suggest that women with AUD show significant deficits in emotion processing, a finding also observed in older women who have consumed a moderate dose of alcohol. Critically, despite the long-recognized need for programmatic interrogation of alcohol's effect in women, studies with sufficient numbers of women for meaningful analysis represent a small proportion of the literature, constraining interpretation and generalization.

Facial expression and emotion

Human facial expressions are unique in their ability to express our emotions and communicate them to others. The mimic expression of basic emotions is very similar across different cultures and has also many features in common with other mammals. This suggests a common genetic origin of the association between facial expressions and emotion. However, recent studies also show cultural influences and differences. The recognition of emotions from facial expressions, as well as the process of expressing one's emotions facially, occurs within an extremely complex cerebral network. Due to the complexity of the cerebral processing system, there are a variety of neurological and psychiatric disorders that can significantly disrupt the coupling of facial expressions and emotions. Wearing masks also limits our ability to convey and recognize emotions through facial expressions. Through facial expressions, however, not only "real" emotions can be expressed, but also acted ones. Thus, facial expressions open up the possibility of faking socially desired expressions and also of consciously faking emotions. However, these pretenses are mostly imperfect and can be accompanied by short-term facial movements that indicate the emotions that are actually present (microexpressions). These microexpressions are of very short duration and often barely perceptible by humans, but they are the ideal application area for computer-aided analysis. This automatic identification of microexpressions has not only received scientific attention in recent years, but its use is also being tested in security-related areas. This article summarizes the current state of knowledge of facial expressions and emotions.

Age as a potential modulator of alcohol-related deficits

Although their individual significance is well-documented, the interaction effects of age, sex, and alcohol use disorder (AUD) have undergone little systematic investigation. Here, we extend prior work interrogating sex and group (AUD vs. community comparison [CC]) by probing the main and interaction effects of age on emotion processes as well as two conventional neuropsychological tests. Main effects for age and group were anticipated; however, interaction effects comprise our primary focus. While sex differences in AUD prevalence are commonly reported, sex differences within AUD samples are inconsistently found. Therefore, we pose our inquiry regarding sex as exploratory. In this study, 54 CC (n = 30 women) and 55 AUD (n = 14 women) subjects completed a battery that included an emotional face discrimination task, the Trail-Making Test-B (TMT-B), and the Digit Symbol Substitution Test (DSST). The initial/full models included the main and interaction effects of age (as a continuous variable; 25-59 years of age), sex, and group (AUD, CC). In analysis of the emotional face discrimination task, performance on a non-affective face discrimination task was entered as a covariate. Analysis of emotion identification revealed group and age main (p = .02; d = .53 & .003; d = .50, respectively) and interaction effects (p = .05; d = .41). The latter suggested that age and emotion processing performance were positively correlated in the AUD group, but unrelated in the CC group. Notably, neither sex, main, nor interaction effects achieved significance. Using the full model, analysis of the TMT-B and DSST failed to show sex effects or reveal expected performance decrement in the AUD group. To clarify the latter, simple models including only group as well as correlations between age and performance by group for each task were conducted. These analyses demonstrated the expected AUD-related deficits and suggested differential relationships between age and neurocognitive performance as a function of both group and task. Outcomes across tasks emphasize the need to reframe aging effects, particularly in the context of AUD.

Decoding Emotion in Drug Abusers: Evidence for Face and Body Emotion Recognition and for Disgust Emotion

Background: Different drugs damage the frontal cortices, particularly the prefrontal areas involved in both emotional and cognitive functions, with a consequence of decoding emotion deficits for people with substance abuse. The present study aimed to explore the cognitive impairments in drug abusers through facial, body and disgust emotion recognition, expanding the investigation of emotions processing, measuring accuracy and response velocity. Methods: We enrolled 13 addicted to cocaine and 12 alcohol patients attending treatment services in Italy, comparing them with 33 matched controls. Facial emotion and body posture recognition tasks, a disgust rating task and the Barrat Impulsivity Scale were included in the experimental assessment. Results: We found that emotional processes are differently influenced by cocaine and alcohol, suggesting that these substances impact diverse cerebral systems. Conclusions: Drug abusers seem to be less accurate on elaboration of facial, body and disgust emotions. Considering that the participants were not cognitively impaired, our data support the hypothesis that emotional impairments emerge independently from the damage of cognitive functions.

Cognitive training in recently-abstinent individuals with alcohol use disorder improves emotional stroop performance: Evidence from a randomized pilot trial

BACKGROUND

Cognitive training interventions appear capable of improving alcohol-associated neurobehavioral deficits in recently detoxified individuals. However, efficacy remains incompletely characterized in alcohol use disorder (AUD) and available data address only non-affective cognitive outcomes; enhancement of social cognition remains uninvestigated. We utilized a training paradigm in which successfully ignoring emotionally-valent stimuli benefitted task performance. We hypothesized trained individuals would display improvements in an affective inhibitory control task, and that individuals trained with high valence (relative to neutral) stimuli would evince greater improvement.

METHODS

42 recently detoxified inpatients with AUD were assigned to one of three groups (Emotional Training, Neutral Training, or Treatment as Usual [TAU]). Training consisted of two computerized working memory tasks (dual-modality n-back task; attend/ignore task) which included task-irrelevant stimuli (emotional vs. neutral). Post-training performance efficiency (indexing speed-accuracy tradeoffs) in an emotional Stroop task was the outcome of interest.

RESULTS

Significant group by time interactions were detected for emotional Stroop performance, supporting our hypothesis that trained groups would exhibit greater improvement than TAU controls (F[2,39]=8.61, p < .01). Additionally, the emotional training condition appeared to result in greater improvement relative to neutral training (F[1,26]=4.98, p < .01).

CONCLUSION

Results are consistent with current literature suggesting the potential of training to enhance cognitive recovery in early abstinence. Findings inform the development of training protocols, suggesting integration of task-irrelevant distractor stimuli in training may enhance cognitive control outcomes. Further, they expand the relevant domains for application of training approaches, providing novel evidence that among individuals with AUD, training-associated benefits may extend to social cognitive domains.

A biological framework for emotional dysregulation in alcohol misuse: from gut to brain

Alcohol use disorder (AUD) has been associated with impairments in social and emotional cognition that play a crucial role in the development and maintenance of addiction. Repeated alcohol intoxications trigger inflammatory processes and sensitise the immune system. In addition, emerging data point to perturbations in the gut microbiome as a key regulator of the inflammatory cascade in AUD. Inflammation and social cognition are potent modulators of one another. At the same time, accumulating evidence implicates the gut microbiome in shaping emotional and social cognition, suggesting the possibility of a common underlying loop of crucial importance for addiction. Here we propose an integrative microbiome neuro-immuno-affective framework of how emotional dysregulation and alcohol-related microbiome dysbiosis could accelerate the cycle of addiction. We outline the overlapping effects of chronic alcohol use, inflammation and microbiome alterations on the fronto-limbic circuitry as a convergence hub for emotional dysregulation. We discuss the interdependent relationship of social cognition, immunity and the microbiome in relation to alcohol misuse- from binge drinking to addiction. In addition, we emphasise adolescence as a sensitive period for the confluence of alcohol harmful effects and emotional dysregulation in the developing gut-brain axis.

The impact of emotional face stimuli on working memory performance among men and women with alcohol use disorder

BACKGROUND

Individuals with alcohol use disorder (AUD) often display compromise in emotional processing and non-affective neurocognitive functions. However, relatively little empirical work explores their intersection. In this study, we examined working memory performance when attending to and ignoring facial stimuli among adults with and without AUD. We anticipated poorer performance in the AUD group, particularly when task demands involved ignoring facial stimuli. Whether this relationship was moderated by facial emotion or participant sex were explored as empirical questions.

METHODS

Fifty-six controls (30 women) and 56 treatment-seekers with AUD (14 women) completed task conditions in which performance was advantaged by either attending to or ignoring facial stimuli, including happy, neutral, or fearful faces. Group, sex, and their interaction were independent factors in all models. Efficiency (accuracy/response time) was the primary outcome of interest.

RESULTS

An interaction between group and condition (F_1,107 = 6.03, p < .02) was detected. Individual comparisons suggested this interaction was driven by AUD-associated performance deficits when ignoring faces, whereas performance was equivalent between groups when faces were attended. Secondary analyses suggested little influence of specific facial emotions on these effects.

CONCLUSIONS

These data provide partial support for initial hypotheses, with the AUD group demonstrating poorer working memory performance conditioned on the inability to ignore irrelevant emotional face stimuli. The absence of group differences when scenes were to be ignored (faces remembered) suggests the AUD-associated inability to ignore irrelevance is influenced by specific stimulus qualities.

Delta Event-Related Oscillations Are Related to a History of Extreme Binge Drinking in Adolescence and Lifetime Suicide Risk

Alcohol exposure typically begins in adolescence, and heavy binge drinking is associated with health risk behaviors. Event-related oscillations (EROs) may represent sensitive biomarkers or endophenotypes for early alcohol exposure as well as other risk behaviors such as suicidal thoughts and actions. In this study, young adults (age 18–30 years) of American Indian (AI) (n = 479) and Mexican American (MA) (n = 705) ancestry were clinically assessed, and EROs were generated to happy, sad and neutral faces. Extreme adolescent binge drinking (10+ drinks) was common (20%) in this population of AI/MA and associated with a significantly increased risk of a lifetime history of suicidal acts (SA, suicide attempts, deaths) but not suicidal thoughts (ST, ideation, plans). ST were reported among MA participants, whereas SA were more common among AI young adults. Extreme adolescent binge drinking was also associated with errors in detection of sad and neutral faces, increases in delta ERO energy, and decreases in phase locking (PL), particularly in parietal areas. A lifetime history of ST was associated with increases in delta ERO energy and PL, whereas SA were associated with decreases in both. These studies suggest that ERO measures may represent important potential biomarkers of adolescent extreme binge drinking and risk for suicidal behaviors.

Impact of polysubstance use on social and non-affective cognitive performance among treatment-seeking individuals with alcohol use disorders

BACKGROUND

Individuals with alcohol use disorder (AUD) display deficits across a range of cognitive processes. Decrements in social cognition may be particularly important for interpersonal functioning and post-treatment adaptation. Although social cognitive deficits are associated with chronic use of numerous substances, the role of polysubstance use in AUD-associated deficits remains largely unaddressed.

METHODS

Community volunteers (n = 49; 22 men) and inpatient treatment-seekers with AUD were administered neurocognitive tasks indexing emotion processing and non-affective cognitive functioning. Tasks included an emotion discrimination task, a working memory task with affective stimuli, a general face processing (control) task, two measures of executive function, and two measures of visual spatial function. AUD subgroups included individuals with no recent (6-month) polysubstance use (AUD-Only; n = 22; 15 men), and those with at least weekly use (Poly-SU; n = 22; 18 men).

RESULTS

Poly-SU individuals evinced disadvantaged performance relative to other groups on the emotion discrimination task [ps ≤ 0.001], affective working memory task [ps ≤ 0.050], and two executive function measures [ps ≤ 0.051]. No differences were observed for visual spatial functioning [ps ≥ 0.498] or general face processing [ps ≥ 0.190]. No performance differences between AUD-Only and community volunteers were noted.

CONCLUSIONS

Results extend the emerging literature exploring emotion processing in AUD and add to the established literature regarding cognitive deficits in this population. The data suggest that among individuals with AUD, those with polysubstance use may be particularly vulnerable to deficits in decoding emotional face content. The current work highlights the need to incorporate more nuanced and careful considerations of polysubstance use in the design and analysis for future investigations of alcohol-associated deficits in emotion processing.

Alcohol use disorder and cannabis use disorder symptomatology in adolescents are differentially related to dysfunction in brain regions supporting face processing

Despite extensive behavioral evidence of impairments in face processing and expression recognition in adults with alcohol or cannabis use disorders (AUD/CUD), neuroimaging findings have been inconsistent. Moreover, relatively little work has examined the relationship of AUD or CUD symptoms with face or expression processing within adolescents. Given the high prevalence of alcohol and cannabis use during adolescence, understanding how these usage behaviors interact with neural mechanisms supporting face and expression processing could have important implications for youth social and emotional functioning. In this study, adolescents (N = 104) responded to morphed fearful and happy expressions during fMRI and their level of AUD and/or CUD symptoms were related to the BOLD response data. We found that AUD and CUD symptom severity were both negatively related to responses to faces generally. However, whereas this relationship was shown for AUD within ventromedial prefrontal cortex and lingual gyrus, it was shown for CUD within rostromedial prefrontal cortex including anterior cingulate cortex. Additionally, AUD symptom levels were associated with differential responses within medial temporal pole and inferior parietal lobule as a function of expression. These results have potential implications for understanding the social and emotional functioning of adolescents with AUD and CUD symptoms.

Towards a Dynamic Exploration of Vision, Cognition and Emotion in Alcohol-Use Disorders

Abstract: Visuoperceptive impairments are among the most frequently reported deficits in alcohol-use disorders, but only very few studies have investigated their origin and interactions with other categories of dysfunctions. Besides, these deficits have generally been interpreted in a linear bottom-up perspective, which appears very restrictive with respect to the new models of vision developed in healthy populations. Indeed, new theories highlight the predictive nature of the visual system and demonstrate that it interacts with higher-level cognitive functions to generate top-down predictions. These models nota-bly posit that a fast but coarse visual analysis involving magnocellular pathways helps to compute heuristic guesses regard-ing the identity and affective value of inputs, which are used to facilitate conscious visual recognition. Building on these new proposals, the present review stresses the need to reconsider visual deficits in alcohol-use disorders as they might have cru-cial significance for core features of the pathology, such as attentional bias, loss of inhibitory control and emotion decoding impairments. Centrally, we suggest that individuals with severe alcohol-use disorders could present with magnocellular dam-age and we defend a dynamic explanation of the deficits. Rather than being restricted to high-level processes, deficits could start at early visual stages and then extend and potentially intensify during following steps due to reduced cerebral connec-tivity and dysfunctional cognitive/emotional regions. A new research agenda is specifically provided to test these hypotheses.

Emotional processing and social cognition in alcohol use disorder

OBJECTIVE

To review deficits in emotional processing and social cognition potentially contributing to the dysfunctional emotion regulation and difficulties with interpersonal relationships observed in individuals with alcohol use disorder (AUD) and to provide directions for future research.

METHOD

First is presented a review of emotional and social-cognitive impairments in recently detoxified AUD individuals that include alexithymia, difficulties in decoding others' emotions, and reduced theory of mind and empathy skills. Social cognition disorders in AUD pose different issues discussed, such as whether (1) these deficits are consequences of excessive alcohol consumption or premorbid risk factors for addiction, (2) emotional and social impairments impede positive treatment outcome, (3) recovery of social abilities is possible with sustained abstinence, and (4) AUD patients are unaware of their emotional and social dysfunctions. Finally, current knowledge on structural and functional brain correlates of these deficits in AUD are reviewed.

RESULTS

Emotional and social-cognitive functions affected in AUD can potentially compromise efforts to initiate and maintain abstinence by hampering efficacy of clinical treatment. Such dysfunction can obstruct efforts to enable or reinstate higher-order abilities such as emotional self-regulation, motivation to change, success in interpersonal/social interactions, and emotional insight and awareness of social dysfunctions (i.e., accurate metacognition).

CONCLUSIONS

The present review highlights the need to account for emotional processing and social cognition in the evaluation and rehabilitation of alcohol-related neurocognitive disorders and to consider psychotherapeutic treatment involving remediation of emotional and social skills as implemented in psychiatric and neurological disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Heavy episodic drinking in late adolescents: The role of theory of mind and conformity drinking motives

BACKGROUND

Heavy episodic drinking (HED) implies severe consequences for health, both in the short and long term. Peer conformity has shown contradictory relationships with HED, suggesting the presence of a complex interaction between social and individual factors.

OBJECTIVE

This study investigated the moderation role of conformity in the relationship between theory of mind (ToM) and HED.

METHOD

Participants were 170 Italian adolescents (M_age = 18.71, SD_age = 0.77) recruited in public high schools. Self-report measures were administered for evaluating drunkenness and HED. The Drinking Motives Questionnaire was used to assess three drinking motives, namely coping with negative emotions, enhancement of positive feelings, and the need for peer conformity, whereas the Reading the Mind in the Eyes Test was adopted to test advanced theory of mind skills. ANOVAs, MANOVAs and regression moderation analyses were performed.

RESULTS

Drunkenness, HED and drinking motives did not vary with gender. Only social motives were higher in boys (vs. girls). HED was positively related to drunkenness and to social, coping and enhancement motives. However, only enhancement significantly predicted HED. Finally, conformity moderated the relationship between ToM and HED. In the presence of high conformity, adolescents with impaired ToM reported significantly more HED than adolescents with high ToM.

CONCLUSIONS

In the presence of conformity needs, social cognition impairment appeared to be a risk factor for HED, whereas good socio-cognitive skills were protective. Implications for research, clinical assessment and prevention are discussed.

Neurophysiological and Interpersonal Correlates of Emotional Face Processing in Alcohol Use Disorder

BACKGROUND

A growing literature suggests deficient emotional facial expression (EFE) processing among recently abstinent individuals with alcohol use disorders (AUDs). Further investigation is needed to clarify valence-related discrepancies and elucidate neural and psychosocial correlates. We examined neurobehavioral indices of EFE processing and interpersonal problems in treatment seekers with AUDs and healthy community controls (CCs).

METHODS

Thirty-four individuals with AUDs and 39 CCs completed an emotion judgment task (EJT), requiring discrimination between happy, angry, and sad EFEs. A second task requiring discrimination of male and female faces with neutral expressions served as the control task (i.e., sex judgment task, SJT). Neurophysiological (i.e., N170 and P3) and behavioral measures were analyzed using generalized linear mixed models (GLMM). Interpersonal problems were assessed with the Inventory of Interpersonal Problems-64 (IIP-64). The relationship of IIP-64 and EJT performance was investigated via within-group correlations.

RESULTS

Analysis of the SJT revealed no group differences in behavioral measures, N170 amplitude, or P3 latency. P3 amplitudes, however, were significantly lower in the AUD group. For the EJT, initial observations of group differences in P3 amplitude were accounted for by differences in the control task. Behavioral analyses indicated that the AUD group was significantly less accurate than the CC group. Hypothesis-driven analyses using GLMM-estimated group differences indicated that anger processing was affected to a greater degree than were other emotions. Significant EJT/IIP-64 correlations were observed for anger processing within the AUD group and were confined to IIP-64 subscales with relatively high ratings on the affiliation dimension.

CONCLUSIONS

Findings provide partial support for an emotion-specific processing deficit in persons with AUDs. Anger processing was more robustly affected than other emotions and was associated with interpersonal problems characterized by being overly needy, nonassertive, and overly accommodating. Results extend prior reports and reinforce the need for comprehensive study of emotion processing and its real-world implications.

Altered oscillatory brain dynamics of emotional processing in young binge drinkers

Heavy episodic drinking, also termed binge drinking, is commonly practiced by young adults. It is accompanied by a range of cognitive, affective, and social problems, but the neural dynamics underlying changes in emotional functions is poorly understood. To investigate the behavioral and brain indices of affective processing as a function of binge drinking, young, healthy participants (23.3 ± 3.3 years) were assigned to two groups (n = 32 each) based on their drinking habits. Binge drinking (BD) participants reported drinking heavily with at least five binge episodes in the last 6 months, whereas light drinkers (LD) reported no more than one binge episode in the last 6 months. Participants provided subjective ratings of emotionally evocative images with negative, positive, erotic, and neutral themes mostly selected from the International Affective Picture System (IAPS). Electroencephalography (EEG) signal was recorded with a 64-channel system and analyzed in theta frequency band (4-7 Hz) with Morlet wavelets. Subjective ratings of the IAPS pictures were equivalent across both groups. However, affective modulation of event-related theta power both during early appraisal and later integrative processing stages was attenuated in BD, particularly those engaging in high-intensity drinking. These findings suggest that binge drinking is associated with altered neurophysiological indices of affective functions that are reflected in lower theta responsivity to emotions. The blunted long-range cortico-cortical and corticolimbic integration is consistent with compromised affective functions in alcohol use disorder. These findings may have implications for diagnostic and intervention strategies in heavy alcohol users.

Aspects of alcohol use disorder affecting social cognition as assessed using the Mini Social and Emotional Assessment (mini-SEA)

BACKGROUND

Alcohol Use Disorder (AUD) is associated with problems with processing complex social scenarios. Little is known about the relationship between distinct AUD-related factors (e.g., years of problematic drinking), aspects of cognitive function and dysfunction in individuals diagnosed with AUD, and the relative impact these may have on social cognition.

AIMS

To explore differences in social cognition between a group of participants diagnosed with AUD and controls, using a clinical measure, the Mini Social and Emotional Assessment (mini-SEA). The mini-SEA was used to evaluate social and emotional understanding through a facial emotional recognition task and by utilising a series of social scenes some of which contain a faux pas (social error).

METHODS

Eighty-five participants (individuals with AUD and controls) completed demographic questions and a general cognitive and social cognitive test battery over three consecutive days.

RESULTS

Between group analyses revealed that the participants with AUD performed less well on the faux pas test, and differences were also revealed in the emotional facial recognition task. Years of problematic alcohol consumption was the strongest predictor of poor ToM reasoning.

CONCLUSION

These results suggest a strong link between AUD chronicity and social cognition, though the direction of this relationship needs further elucidation. This may be of clinical relevance to abstinence and relapse management, as basic social cognition skills and ability to maintain interpersonal relationships are likely to be crucial to recovery.

Affective impairments in binge drinking: Investigation through emotional facial expression decoding

OBJECTIVE

Binge drinking, an excessive alcohol consumption pattern frequently observed in young people, is known to be associated with psychological and cerebral deficits. While cognitive dysfunctions have been widely investigated, emotional abilities have scarcely been explored. Such an exploration would however offer a more exhaustive understanding of the deficits associated with binge drinking, as well as of the possible transition towards alcohol-dependence.

METHODS

46 young adults (23 binge drinkers, 12 women; 23 control participants, 12 women) were recruited among university students. They performed an emotional recognition task consisting of the visual decoding of six basic emotions (i.e. anger, contempt, disgust, fear, happiness, and sadness). Accuracy scores and detection thresholds were collected for each emotion.

RESULTS

Binge drinkers showed lower performance than control participants for the decoding of all emotions and increased detection threshold, this later reflecting less ability to capture an emotion. Binge drinking is thus associated with a need for higher emotional intensity to perform correct detection. Moreover, these emotional difficulties appear specifically related to alcohol consumption.

CONCLUSION

These findings reinforce previous experimental evidence of altered emotional processing among binge drinkers, and extend these results for various emotional contents. They support the hypothesis of a continuum between binge drinking and alcohol-dependence, in which massive emotional impairments have been documented. Indeed, these impairments could be involved in the onset and maintenance of excessive alcohol consumption, notably through the established relationship between emotional deficits and social distress.

Dysfunctional Early Processing of Facial Expressions in Hazardous Drinkers: Evidence from an ERP Study

Chronic alcohol intoxication impairs multiple cognitive functions. According to the dual system model (DSM), the development of alcohol dependence (AD) involves the imbalance between the automatic-affective system and the reflective system. However, the cognitive functions of non-AD hazardous drinkers (HDs) remain unclear. The present study aimed to explore how the HDs process facial expressions differently from the healthy subjects. Sixteen HDs and seventeen control subjects (CSs) completed an emotional working memory (WM) task while the electroencephalogram (EEG) was recorded. We found that there was no significant group difference in behavioral performance between the two groups. In the ERP data, relative to the CSs, the HDs showed delayed latencies of P1 and N170. Moreover, the CSs showed significant differences between the amplitudes of neural/fear and disgust expressions while these differences were insignificant in the HDs. The current results suggest that the main deficits in the processing of facial expression in HDs existed in the early automatic-affective system instead of in the reflective system.

Crossmodal processing of emotions in alcohol-dependence and Korsakoff syndrome

INTRODUCTION

Decoding emotional information from faces and voices is crucial for efficient interpersonal communication. Emotional decoding deficits have been found in alcohol-dependence (ALC), particularly in crossmodal situations (with simultaneous stimulations from different modalities), but are still underexplored in Korsakoff syndrome (KS). The aim of this study is to determine whether the continuity hypothesis, postulating a gradual worsening of cognitive and brain impairments from ALC to KS, is valid for emotional crossmodal processing.

METHODS

Sixteen KS, 17 ALC and 19 matched healthy controls (CP) had to detect the emotion (anger or happiness) displayed by auditory, visual or crossmodal auditory-visual stimuli. Crossmodal stimuli were either emotionally congruent (leading to a facilitation effect, i.e. enhanced performance for crossmodal condition compared to unimodal ones) or incongruent (leading to an interference effect, i.e. decreased performance for crossmodal condition due to discordant information across modalities). Reaction times and accuracy were recorded.

RESULTS

Crossmodal integration for congruent information was dampened only in ALC, while both ALC and KS demonstrated, compared to CP, decreased performance for decoding emotional facial expressions in the incongruent condition.

CONCLUSIONS

The crossmodal integration appears impaired in ALC but preserved in KS. Both alcohol-related disorders present an increased interference effect. These results show the interest of more ecological designs, using crossmodal stimuli, to explore emotional decoding in alcohol-related disorders. They also suggest that the continuum hypothesis cannot be generalised to emotional decoding abilities.

Executive Functions, Memory, and Social Cognitive Deficits and Recovery in Chronic Alcoholism: A Critical Review to Inform Future Research

Alcoholism is a complex and dynamic disease, punctuated by periods of abstinence and relapse, and influenced by a multitude of vulnerability factors. Chronic excessive alcohol consumption is associated with cognitive deficits, ranging from mild to severe, in executive functions, memory, and metacognitive abilities, with associated impairment in emotional processes and social cognition. These deficits can compromise efforts in initiating and sustaining abstinence by hampering efficacy of clinical treatment and can obstruct efforts in enabling good decision making success in interpersonal/social interactions, and awareness of cognitive and behavioral dysfunctions. Despite evidence for differences in recovery levels of selective cognitive processes, certain deficits can persist even with prolonged sobriety. Herein is presented a review of alcohol-related cognitive impairments affecting component processes of executive functioning, memory, and the recently investigated cognitive domains of metamemory, social cognition, and emotional processing; also considered are trajectories of cognitive recovery with abstinence. Finally, in the spirit of critical review, limitations of current knowledge are noted and avenues for new research efforts are proposed that focus on (i) the interaction among emotion-cognition processes and identification of vulnerability factors contributing to the development of emotional and social processing deficits and (ii) the time line of cognitive recovery by tracking alcoholism's dynamic course of sobriety and relapse. Knowledge about the heterochronicity of cognitive recovery in alcoholism has the potential of indicating at which points during recovery intervention may be most beneficial.

Effects of depression and past-year binge drinking on cognitive control processes during a flanker task in college-aged adults

BACKGROUND

Recent but largely separate literatures have examined neurocognitive alterations related to both depression and binge drinking, suggesting similar patterns of impairments in attention control and decisional processes. However, depression and problematic alcohol use tend to co-occur, and few studies have examined whether cognitive processing effects of depression and binge drinking are independent or interacting.

OBJECTIVE

The current study examined joint effects of depressive symptoms and past-year binge drinking on cognitive processing (measured via EEG assessment).

METHODS

University students aged 18 and over (N = 46; 63.4% female) were recruited based on self-reported depressive symptoms and also provided reports of alcohol use (51% reported significant depression; 46% reported at-least one past-year binge-drinking episode). Participants completed a computerized flanker task, assessing cognitive control processes. Forty-one participants providing useable data were included in analyses.

RESULTS

Past-year binge drinking was associated with slower and more accurate behavioral responding. The interaction of binge-drinking and depressive symptoms was related to the magnitude of early attentional components (N1 and N2), with individuals reporting high depressive symptoms and a history of binge-drinking exhibiting attenuated early attentional engagement (e.g., less negative N1) coupled with enhanced attention control processing (e.g., more negative N2). Depressive symptoms also predicted a lack of discriminated P3 amplitudes on congruent versus incongruent trials.

CONCLUSION

The data suggest that depression and binge drinking in the past-year jointly interact to predict early attentional processing, with the pattern of responding consistent with a compensatory response process. Results highlight the importance of future work on binge-drinking accounting for co-occurring depression.

Preserved Crossmodal Integration of Emotional Signals in Binge Drinking

Binge drinking is an alcohol consumption pattern with various psychological and cognitive consequences. As binge drinking showed qualitatively comparable cognitive impairments to those reported in alcohol-dependence, a continuum hypothesis suggests that this habit would be a first step toward alcohol-related disorders. Besides these cognitive impairments, alcohol-dependence is also characterized by large-scale deficits in emotional processing, particularly in crossmodal contexts, and these abilities have scarcely been explored in binge drinking. Emotional decoding, most often based on multiple modalities (e.g., facial expression, prosody or gesture), yet represents a crucial ability for efficient interpersonal communication and social integration. The present study is the first exploration of crossmodal emotional processing in binge drinking, in order to test whether binge drinkers already present the emotional impairments described among alcohol-dependent patients, in line with the continuum hypothesis. Twenty binge drinkers and 20 matched controls performed an experimental task requiring the identification of two emotions (happiness or anger) presented in two modalities (visual or auditory) within three conditions (unimodal, crossmodal congruent or crossmodal incongruent). In accordance with previous research in binge drinking and alcohol-dependence, this study was based on two main hypotheses. First, binge drinkers would present a reduced facilitation effect (i.e., classically indexed in healthy populations by faster reaction times when two congruent modalities are presented simultaneously). Second, binge drinkers would have higher difficulties to inhibit interference in incongruent modalities. Results showed no significant difference between groups in emotional decoding ability, whatever the modality or condition. Control participants, however, appeared slower than binge drinkers in recognizing facial expressions, also leading to a stronger facilitation effect when the two modalities were presented simultaneously. However, findings did not show a disrupted facilitation effect in binge drinkers, whom also presented preserved performance to inhibit incongruence during emotional decoding. The current results thus suggest that binge drinkers do not demonstrate a deficit for emotional processing, both in unimodal and crossmodal contexts. These results imply that binge drinking might not be characterized by impairments for the identification of primary emotions, which could also indicate that these emotional processing abilities are well-preserved at early stages of excessive alcohol consumption.

Preserved Affective Sharing But Impaired Decoding of Contextual Complex Emotions in Alcohol Dependence

BACKGROUND

Prior research has repeatedly shown that alcohol dependence is associated with a large range of impairments in psychological processes, which could lead to interpersonal deficits. Specifically, it has been suggested that these interpersonal difficulties are underpinned by reduced recognition and sharing of others' emotional states. However, this pattern of deficits remains to be clarified. This study thus aimed to investigate whether alcohol dependence is associated with impaired abilities in decoding contextual complex emotions and with altered sharing of others' emotions.

METHODS

Forty-one alcohol-dependent individuals (ADI) and 37 matched healthy individuals completed the Multifaceted Empathy Test, in which they were instructed to identify complex emotional states expressed by individuals in contextual scenes and to state to what extent they shared them.

RESULTS

Compared to healthy individuals, ADI were impaired in identifying negative (Cohen's d = 0.75) and positive (Cohen's d = 0.46) emotional states but, conversely, presented preserved abilities in sharing others' emotional states.

CONCLUSIONS

This study shows that alcohol dependence is characterized by an impaired ability to decode complex emotional states (both positive and negative), despite the presence of complementary contextual cues, but by preserved emotion-sharing. Therefore, these results extend earlier data describing an impaired ability to decode noncontextualized emotions toward contextualized and ecologically valid emotional states. They also indicate that some essential emotional competences such as emotion-sharing are preserved in alcohol dependence, thereby offering potential therapeutic levers.

Brain responses to emotional salience and reward in alcohol use disorder

Heightened neural responsiveness of alcoholics to alcohol cues and social emotion may impede sobriety. To test mesocorticolimbic network responsivity, 10 (8 men) alcohol use disorder (AUD) patients sober for 3 weeks to 10 months and 11 (8 men) controls underwent fMRI whilst viewing pictures of alcohol and non-alcohol beverages and of emotional faces (happy, sad, angry). AUD and controls showed similarities in mesocorticolimbic activity: both groups activated fusiform for emotional faces and hippocampal and pallidum regions during alcohol picture processing. In AUD, less fusiform activity to emotional faces and more pallidum activity to alcohol pictures were associated with longer sobriety. Using graph theory-based network efficiency measures to specify the role of the mesocorticolimbic network nodes for emotion and reward in sober AUD revealed that the left hippocampus was less efficiently connected with the other task-activated network regions in AUD than controls when viewing emotional faces, while the pallidum was more efficiently connected when viewing alcohol beverages. Together our findings identified lower occipito-temporal sensitivity to emotional faces and enhanced striatal sensitivity to alcohol stimuli in AUD than controls. Considering the role of the striatum in encoding reward, its activation enhancement with longer sobriety may reflect adaptive neural changes in the first year of drinking cessation and mesocorticolimbic system vulnerability for encoding emotional salience and reward potentially affecting executive control ability and relapse propensity during abstinence.

The effect of alcohol dependence on automatic visuo-spatial perspective taking

BACKGROUND

Alcoholism is associated with cognitive deficits that affect social functioning. Previous research has shown that alcoholism is associated with deficits in conscious, deliberate social processing. However, little is known about whether alcoholism also affects rapid, spontaneous processing. We therefore investigated the extent to which alcoholism affects the ability to spontaneously adopt the viewpoint of another in a visuo-spatial perspective taking (VSPT) task.

METHODS

VSPT was measured in participants responding to a dot probe presented for 35ms alongside neutral faces, fearful faces and baseline stimuli (rectangles).

RESULTS

Non alcohol dependent participants showed the standard reaction time cost to fearful faces, but not neutral faces relative to baseline. However, Alcohol dependent (AD) participants showed a reaction time cost to both fearful and neutral faces.

CONCLUSIONS

AD participants are not impaired in their ability to automatically adopt the perspective of another. However, unlike non-AD participants, they show automatic perspective taking to both neutral and fearful faces.

Cognitive, emotion control, and motor performance of adolescents in the NCANDA study: Contributions from alcohol consumption, age, sex, ethnicity, and family history of addiction

OBJECTIVE

To investigate development of cognitive and motor functions in healthy adolescents and to explore whether hazardous drinking affects the normal developmental course of those functions.

METHOD

Participants were 831 adolescents recruited across 5 United States sites of the National Consortium on Alcohol and NeuroDevelopment in Adolescence 692 met criteria for no/low alcohol exposure, and 139 exceeded drinking thresholds. Cross-sectional, baseline data were collected with computerized and traditional neuropsychological tests assessing 8 functional domains expressed as composite scores. General additive modeling evaluated factors potentially modulating performance (age, sex, ethnicity, socioeconomic status, and pubertal developmental stage).

RESULTS

Older no/low-drinking participants achieved better scores than younger ones on 5 accuracy composites (general ability, abstraction, attention, emotion, and balance). Speeded responses for attention, motor speed, and general ability were sensitive to age and pubertal development. The exceeds-threshold group (accounting for age, sex, and other demographic factors) performed significantly below the no/low-drinking group on balance accuracy and on general ability, attention, episodic memory, emotion, and motor speed scores and showed evidence for faster speed at the expense of accuracy. Delay Discounting performance was consistent with poor impulse control in the younger no/low drinkers and in exceeds-threshold drinkers regardless of age.

CONCLUSIONS

Higher achievement with older age and pubertal stage in general ability, abstraction, attention, emotion, and balance suggests continued functional development through adolescence, possibly supported by concurrently maturing frontal, limbic, and cerebellar brain systems. Determination of whether low scores by the exceeds-threshold group resulted from drinking or from other preexisting factors requires longitudinal study. (PsycINFO Database Record

Étude du sentiment de familiarité dans l’alcoolo-dépendance : une hyperfamiliarité aux visages

L’alcoolo-dépendance est une maladie chronique hautement récidivante dont l’enjeu principal est la prévention des rechutes. Les rechutes sont favorisées par le ressenti du sujet vis-à-vis de son environnement social [1]. L’alcoolo-dépendance entraîne des troubles cognitivo-comportementaux dont des déficits de reconnaissance émotionnelle et une altération des interactions sociales [2] majorant le risque de rechutes [3]. Ces troubles pourraient être liés à une altération du sentiment de familiarité. La familiarité se définit comme un sentiment de connaissance préalable d’un stimulus générant une émotion inconsciente, sans souvenir conscient de son identité [4]. Nous nous proposons d’étudier la familiarité aux visages dans l’alcoolo-dépendance. Douze patients alcoolo-dépendants (AD) étaient appariés en sexe et en âge à 12 témoins (T). Les participants ne présentaient ni trouble psychiatrique, ni neurologique, ni addiction en dehors d’un trouble d’usage sévère d’alcool pour le groupe AD (classification DSM-5). Des morphes entre visages familiers et inconnus (contenant 5 à 95 % du visage familier) étaient présentés. Les sujets devaient indiquer les visages leur semblant familiers. Un pourcentage de réponse « familier » était alors calculé par niveau de familiarité, permettant de construire une fonction psychométrique par sujet, et d’en déduire le seuil de familiarité (pourcentage de familiarité contenue dans le morphe pour lequel 50 % des stimuli étaient considérés comme familiers). Les interactions sociales étaient évaluées par une échelle de cognition sociale (MASC). Le seuil de familiarité était significativement plus faible dans le groupe AD que dans le groupe T (48,79 % versus 54,94 % – p = 0,025). Parallèlement les 2 groupes différaient sur les scores au MASC (AD : 26/45 ; T : 31/45 – p = 0,015). Ces résultats démontrent une hyperfamiliarité dans l’alcoolo-dépendance, associée à une altération de la cognition sociale. L’implication de l’altération de ces deux processus sur les risques de rechute est abordée.

Relations Between Cognitive Abilities, Drinking Characteristics, and Emotional Recognition in Alcohol Dependence: A Preliminary Exploration

BACKGROUND

Alcohol dependence is characterized by wide-ranging cognitive impairments, but also by emotional facial expressions (EFEs) recognition deficits. Although they play a crucial role both in the development and in the maintenance of the disease, cognitive and emotional disorders have up to now been mostly explored separately. As a result, not much is known regarding their interactions. This study thus aims at exploring the relations between cognition and emotion in alcohol dependence, and more specifically between cognitive performance, drinking characteristics, and EFE recognition.

METHODS

About 26 recently detoxified alcohol-dependent individuals and 26 matched controls were tested for cognitive abilities (by means of a standardized neuropsychological battery) and for EFE recognition.

RESULTS

Alcohol-dependent individuals simultaneously presented altered performances for executive abilities and EFE recognition (particularly for disgust recognition). Moreover, a regression analysis showed that EFE performance was centrally related to episodic memory and cognitive flexibility.

CONCLUSIONS

These results clarify the relations between EFE recognition, cognitive abilities, and drinking characteristics in alcohol dependence and clearly suggest that cognitive factors should be taken into account in future studies exploring emotional processes in alcohol dependence. Specific cognitive programs should be developed to rehabilitate cognitive and emotional abilities simultaneously.

Cognitive and affective theory of mind abilities in alcohol-dependent patients: the role of autobiographical memory

BACKGROUND

Many studies of patients with alcohol dependence (AD) have highlighted their difficulty in identifying both their own emotional state and those of a social partner. We examined (1) the cognitive and affective theory of mind (ToM) abilities of AD patients and (2) how the efficiency of their autobiographical memory (AM) can affect the effectiveness of ToM ability.

METHOD

In a cross-sectional design, AD patients (N=50) and healthy controls (N=30) completed a ToM movie paradigm (Versailles-Situational Intention Reading, V-SIR) in which they inferred the intentions of characters in movies depicting social interactions, and the "Reading the Mind in the Eyes" Test (RMET), which assessed the emotional dimension of the ToM. AM was investigated using the "Autobiographical Memory Interview" (AMI) to assess both episodic and semantic components of AM.

RESULTS

Concerning ToM, patients with AD showed lower performance in the RMET than control participants, whereas no difference was observed on the V-SIR test. AD patients had lower scores than controls on the AMI, for both episodic and semantic components and for different periods of life. A multiple linear regression analysis also showed that AM deficits might predict lower ToM performance, especially for the RMET task.

CONCLUSIONS

Patients with AD have a specific affective ToM deficit. They used episodic memories to perceive the emotions of others, whereas controls used preferentially semantic memories to perform the task. Both these deficits could constitute a risk of relapse and should be a target for psychotherapeutic interventions.

Atypical parietal lobe activity to subliminal faces in youth with a family history of alcoholism

BACKGROUND

Adults with alcohol use disorders (AUDs) show different behavioral and neurological functioning during emotional processing tasks from healthy controls. Adults with a family history (FHP) of AUD also show different activation in limbic brain areas, such as the amygdala. However, it is unclear if this pattern exists during adolescence before any episodes of heavy alcohol use.

OBJECTIVES

We hypothesized that the amygdalar response to subliminally-presented fearful faces would be reduced in FHP adolescents compared to peers who were family history negative (FHN) for AUD.

METHOD

An adapted Masked Faces paradigm was used to examine blood oxygen level-dependent response to subliminal fearful vs. neutral faces in 14 FHP (6 females, 8 males) and 15 FHN (6 females, 9 males) youth, ages 11-15 years. Both FHP and FHN youth had no history of heavy alcohol consumption.

RESULTS

A significant difference was seen between groups in the left superior parietal lobule FHN youth showed deactivation to fearful and neutral masked faces compared to baseline, whereas FHP youth showed deactivation only to fearful masked faces. No significant differences in amygdalar activation were seen between groups.

CONCLUSION

The left superior parietal lobule is part of the fronto-parietal network, which has been implicated in attentional control. Lack of reduced neural activity to neutral faces among FHP youth may represent differences in suppressing attention networks to less salient emotional stimuli, or perhaps, a higher threshold of saliency for emotional stimuli among at-risk youth.

Beyond inhibition: a dual-process perspective to renew the exploration of binge drinking

Binge drinking is a widespread alcohol-consumption pattern in youth and is linked to cognitive consequences, mostly for executive functions. However, other crucial factors remain less explored in binge drinking and notably the emotional-automatic processes. Dual-process model postulates that addictive disorders are not only due to impaired reflective system (involved in deliberate behaviors), but rather to an imbalance between under-activated reflective system and over-activated affective-automatic one (involved in impulsive behaviors). This proposal has been confirmed in alcohol-dependence, but has not been tested in binge drinking. The observation of comparable impairments in binge drinking and alcohol-dependence led to the “continuum hypothesis,” suggesting similar deficits across different alcohol-related disorders. In this perspective, applying the dual-process model to binge drinking might renew the understanding of this continuum hypothesis. A three-axes research agenda will be proposed, exploring: (1) the affective-automatic system in binge drinking; (2) the systems’ interactions and imbalance in binge drinking; (3) the evolution of this imbalance in the transition between binge drinking and alcohol-dependence.

Emotional facial expression processing in depression: data from behavioral and event-related potential studies

Behavioral literature investigating emotional processes in depressive populations (i.e., unipolar and bipolar depression) states that, compared to healthy controls, depressive subjects exhibit disrupted emotional processing, indexed by lower performance and/or delayed response latencies. The development of brain imaging techniques, such as functional magnetic resonance imaging (fMRI), provided the possibility to visualize the brain regions engaged in emotional processes and how they fail to interact in psychiatric diseases. However, fMRI suffers from poor temporal resolution and cognitive function involves various steps and cognitive stages (serially or in parallel) to give rise to a normal performance. Thus, the origin of a behavioral deficit may result from the alteration of a cognitive stage differently situated along the information-processing stream, outlining the importance of access to this dynamic "temporal" information. In this paper, we will illustrate, through depression, the role that should be attributed to cognitive event-related potentials (ERPs). Indeed, owing to their optimal temporal resolution, ERPs can monitor the neural processes engaged in disrupted cognitive function and provide crucial information for its treatment, training of the impaired cognitive functions and guidelines for clinicians in the choice and monitoring of appropriate medication for the patient.

Are visual impairments responsible for emotion decoding deficits in alcohol-dependence?

Emotional visual perception deficits constitute a major problem in alcohol-dependence. Indeed, the ability to assess the affective content of external cues is a key adaptive function, as it allows on the one hand the processing of potentially threatening or advantageous stimuli, and on the other hand the establishment of appropriate social interactions (by enabling rapid decoding of the affective state of others from their facial expressions). While such deficits have been classically considered as reflecting a genuine emotion decoding impairment in alcohol-dependence, converging evidence suggests that underlying visual deficits might play a role in emotional alterations. This hypothesis appears to be relevant especially as data from healthy populations indicate that a coarse but fast analysis of visual inputs would allow emotional processing to arise from early stages of perception. After reviewing those findings and the associated models, the present paper underlines data showing that rapid interactions between emotion and vision could be impaired in alcohol-dependence and provides new research avenues that may ultimately offer a better understanding of the roots of emotional deficits in this pathological state.

Profiles of impaired, spared, and recovered neuropsychologic processes in alcoholism

Long-term chronic alcoholism is associated with disparate and widespread residual consequences for brain functioning and behavior, and alcoholics suffer a variety of cognitive deficiencies and emotional abnormalities. Alcoholism has heterogeneous origins and outcomes, depending upon factors such as family history, age, gender, and mental or physical health. Consequently, the neuropsychologic profiles associated with alcoholism are not uniform among individuals. Moreover, within and across research studies, variability among subjects is substantial and contributes to characteristics associated with differential treatment outcomes after detoxification. In order to refine our understanding of alcoholism-related impaired, spared, and recovered abilities, we focus on five specific functional domains: (1) memory; (2) executive functions; (3) emotion and psychosocial skills; (4) visuospatial cognition; and (5) psychomotor abilities. Although the entire brain might be vulnerable in uncomplicated alcoholism, the brain systems that are considered to be most at risk are the frontocerebellar and mesocorticolimbic circuitries. Over time, with abstinence from alcohol, the brain appears to become reorganized to provide compensation for structural and behavioral deficits. By relying on a combination of clinical and scientific approaches, future research will help to refine the compensatory roles of healthy brain systems, the degree to which abstinence and treatment facilitate the reversal of brain atrophy and dysfunction, and the importance of individual differences to outcome.

Recognition of facial expressions by alcoholic patients: a systematic literature review

BACKGROUND

Alcohol abuse and dependence can cause a wide variety of cognitive, psychomotor, and visual-spatial deficits. It is questionable whether this condition is associated with impairments in the recognition of affective and/or emotional information. Such impairments may promote deficits in social cognition and, consequently, in the adaptation and interaction of alcohol abusers with their social environment. The aim of this systematic review was to systematize the literature on alcoholics' recognition of basic facial expressions in terms of the following outcome variables: accuracy, emotional intensity, and latency time.

METHODS

A systematic literature search in the PsycINFO, PubMed, and SciELO electronic databases, with no restrictions regarding publication year, was employed as the study methodology.

RESULTS

The findings of some studies indicate that alcoholics have greater impairment in facial expression recognition tasks, while others could not differentiate the clinical group from controls. However, there was a trend toward greater deficits in alcoholics. Alcoholics displayed less accuracy in recognition of sadness and disgust and required greater emotional intensity to judge facial expressions corresponding to fear and anger.

CONCLUSION

The current study was only able to identify trends in the chosen outcome variables. Future studies that aim to provide more precise evidence for the potential influence of alcohol on social cognition are needed.

Below and beyond the recognition of emotional facial expressions in alcohol dependence: from basic perception to social cognition

Studies that have carried out experimental evaluation of emotional skills in alcohol-dependence have, up to now, been mainly focused on the exploration of emotional facial expressions (EFE) decoding. In the present paper, we provide some complements to the recent systematic literature review published by Donadon and de Lima Osório on this crucial topic. We also suggest research avenues that must be, in our opinion, considered in the coming years. More precisely, we propose, first, that a battery integrating a set of emotional tasks relating to different processes should be developed to better systemize EFE decoding measures in alcohol-dependence. Second, we propose to go below EFE recognition deficits and to seek for the roots of those alterations, particularly by investigating the putative role played by early visual processing and vision-emotion interactions in the emotional impairment observed in alcohol-dependence. Third, we insist on the need to go beyond EFE recognition deficits by suggesting that they only constitute a part of wider emotional deficits in alcohol-dependence. Importantly, since the efficient decoding of emotions is a crucial ability for the development and maintenance of satisfactory interpersonal relationships, we suggest that disruption of this ability in alcohol-dependent individuals may have adverse consequences for their social integration. One way to achieve this research agenda would be to develop the field of affective and social neuroscience of alcohol-dependence, which could ultimately lead to major advances at both theoretical and therapeutic levels.

Heart rate correlates of utilitarian moral decision-making in alcoholism

BACKGROUND

Recent studies of moral reasoning in patients with alcohol use disorders have indicated a 'utilitarian' bias, whereby patients are more likely to endorse emotionally aversive actions in favor of aggregate welfare (e.g., to kill a person in order to save a group of people). The aim of the present study was to examine psychophysiological correlates of this tendency indexed by heart rate.

METHODS

The sample was composed by 31 alcohol-dependent individuals and 34 healthy controls without alcohol use disorders. Electrocardiogram was recorded at rest and during execution of a validated moral judgment task, including non-moral scenarios, and moral dilemmas that were either high in emotional salience ("personal scenarios") or low in emotional salience ("impersonal scenarios").

RESULTS

Alcohol-dependent individuals showed a blunted response to moral dilemmas. Furthermore, healthy controls displayed decreased heart rate to the personal vs. impersonal or non-moral scenarios, while alcohol-dependent individuals failed to differentiate dilemmas in terms of heart rate both prior decision-making and its post appraisal. These deficits were not related to baseline differences in Heart Rate.

CONCLUSION

Our findings indicate that alcohol-dependent individuals failed to engage emotional aversive reactions to personal moral violations in terms of heart rate response.

Binge drinking influences the cerebral processing of vocal affective bursts in young adults

Binge drinking is now considered a central public health issue and is associated with emotional and interpersonal problems, but the neural implications of these deficits remain unexplored. The present study aimed at offering the first insights into the effects of binge drinking on the neural processing of vocal affect. On the basis of an alcohol-consumption screening phase (204 students), 24 young adults (12 binge drinkers and 12 matched controls, mean age: 23.8 years) were selected and performed an emotional categorisation task on morphed vocal stimuli (drawn from a morphed fear-anger continuum) during fMRI scanning. In comparison to controls, binge drinkers presented (1) worse behavioural performance in emotional affect categorisation; (2) reduced activation of bilateral superior temporal gyrus; and (3) increased activation of right middle frontal gyrus. These results constitute the first evidence of altered cerebral processing of emotional stimuli in binge drinking and confirm that binge drinking leads to marked cerebral changes, which has important implications for research and clinical practice.

Experimental and clinical usefulness of crossmodal paradigms in psychiatry: an illustration from emotional processing in alcohol-dependence

Crossmodal processing (i.e., the construction of a unified representation stemming from distinct sensorial modalities inputs) constitutes a crucial ability in humans' everyday life. It has been extensively explored at cognitive and cerebral levels during the last decade among healthy controls. Paradoxically however, and while difficulties to perform this integrative process have been suggested in a large range of psychopathological states (e.g., schizophrenia and autism), these crossmodal paradigms have been very rarely used in the exploration of psychiatric populations. The main aim of the present paper is thus to underline the experimental and clinical usefulness of exploring crossmodal processes in psychiatry. We will illustrate this proposal by means of the recent data obtained in the crossmodal exploration of emotional alterations in alcohol-dependence. Indeed, emotional decoding impairments might have a role in the development and maintenance of alcohol-dependence, and have been extensively investigated by means of experiments using separated visual or auditory stimulations. Besides these unimodal explorations, we have recently conducted several studies using audio-visual crossmodal paradigms, which has allowed us to improve the ecological validity of the unimodal experimental designs and to offer new insights on the emotional alterations among alcohol-dependent individuals. We will show how these preliminary results can be extended to develop a coherent and ambitious research program using crossmodal designs in various psychiatric populations and sensory modalities. We will finally end the paper by underlining the various potential clinical applications and the fundamental implications that can be raised by this emerging project.

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.

Emotion-word processing difficulties in abstinent alcoholics with and without lifetime externalizing disorders

BACKGROUND

Evidence suggests that abstinent alcoholics have difficulties processing a variety of emotion-laden stimuli, and some of these difficulties may not fully resolve with long-term abstinence. The current study examined whether emotion-word processing difficulties were present in long-term abstinent alcoholics (LTAA; 18+ months of sobriety) with and without a previously diagnosed externalizing (EXT; antisocial personality disorder and/or attention-deficit/hyperactivity disorder diagnosis) disorder.

METHODS

Subjects (N = 121) completed an affective go/no-go (AGNG) task with positive, negative, and neutral emotion-word stimuli, and a lexical decision-making (LDM) task with nonemotion word and nonword stimuli. Nonsubstance abusing controls (NSAC; n = 38, 50.0% women, mean age = 48 ± 7.8), LTAA with EXT (n = 32, 41% women, mean age = 47.1 ± 6.6), and LTAA without EXT (n = 51, 47% women, mean age = 49.7 ± 6.5) were compared between signal discriminability (d') and mean response times (RT) for correct responses (mcRT).

RESULTS

In the LDM task, LTAA had lower (d') values and slower mcRT than NSAC. In the AGNG task, LTAA and NSAC did not differ in AGNG task mcRT. LTAA had lower (d') values than NSAC, and this effect was partially associated with group differences in LDM task (d') values. In LTAA, lower AGNG (d') values also were associated with an earlier age of first drink, greater lifetime alcohol use, and a history of EXT disorder.

CONCLUSIONS

Our findings suggest that detecting the emotional content of words is impaired in LTAA, and this impairment is over and above LTAA's more general lexical processing difficulties. Results also suggest that specific emotion processing impairments in LTAA may be exacerbated by greater lifetime alcohol use burden and other comorbid EXT diagnoses.

Impaired processing of emotion in music, faces and voices supports a generalized emotional decoding deficit in alcoholism

AIM

To test the generalized emotional decoding impairment hypothesis in alcoholism.

DESIGN

Cross-sectional behavioural study comparing emotion recognition conveyed by faces, voices and musical excerpts.

SETTING

Alcohol detoxification unit of Brugmann University Hospital.

PARTICIPANTS

Twenty-five recently detoxified alcohol-dependent patients were compared to 25 normal controls matched for sex, age and educational level.

MEASUREMENTS

From faces, voices and musical excerpts, participants were instructed to rate the intensity of several emotions on a scale from 0 for 'absent' to 9 for 'highly present'. Depression, anxiety and sustained/selective attention capacities were controlled for.

FINDINGS

Alcohol-dependent patients were less accurate than controls in identifying the target emotion in faces (P < 0.001), voices (P < 0.001) and musical excerpts (P < 0.001).

CONCLUSIONS

Alcohol-dependent patients who are completing detoxification are impaired in recognizing emotions conveyed by faces, voices and music; these results suggest a generalized emotional decoding impairment. Hypothetically, deficits in the fronto-parietal mirror neurone system could link all these disturbances together.

Neural evidence for emotional involvement in pathological alcohol craving

AIMS

Reducing craving is a key to success in the treatment of alcohol dependence. The emotion circuit may be involved in pathological craving for alcohol. In this study, we investigated neural correlates of emotional involvement in craving in alcohol dependence.

METHODS

The study included 17 detoxified alcoholic patients and 25 social drinkers. We used functional magnetic resonance imaging to examine brain activation (blood oxygen level-dependent signals) while participants reported craving and emotion in response to visually presented, alcohol-related stimuli and emotional stimuli.

RESULTS

In the craving-rating paradigm, negative emotional stimuli as well as alcohol cues activated craving-related brain regions in alcoholic patients. Activations of the inferior parietal lobule and dorsolateral prefrontal cortex by negative emotional stimuli were negatively correlated with craving; meanwhile limbic activation was positively correlated with craving. For the emotion paradigm, greater limbic activation was evident by alcohol-related stimuli in the alcohol-dependent group.

CONCLUSIONS

Our findings constitute neural evidence for emotional involvement in pathological craving for alcohol, underscoring the importance of emotion management in abstinent alcoholic patients for relapse prevention.

Decoding of emotional components in complex communicative situations (irony) and its relation to empathic abilities in male chronic alcoholics: an issue for treatment

BACKGROUND

Previous research has shown that deficits in the domain of emotions strongly characterize alcoholism. Patients diagnosed with alcoholism show impairments in emotional mimic recognition, as well as in the domain of emotional prosody. These data suggest that male alcoholics might suffer from a generalized emotional impairment associated with dysfunctions in empathy. Taken altogether, those deficits might influence alcoholics' relational domain and their performance in complex communicative situations such as ironic interactions. The present study investigates the ability of chronic male alcoholics to recognize the emotional component of ironic contexts and its relation to the comprehension of ironic meaning as a function of their empathic abilities.

METHODS

Forty-four male subjects participated in a story comprehension task. They were asked to read stories with either an ironic or a nonironic ending. Participants were asked to fill in a questionnaire about communicative intentions and the emotional states of the stories' characters. Moreover, the correct comprehension of the ironic meaning was assessed through a self-reported questionnaire and related to the empathy quotient (EQ) which was measured in a preexperimental phase.

RESULTS

Alcoholic subjects showed a lower EQ in comparison to healthy subjects and recognized significant fewer ironic endings. Social skills results were particularly impaired. The correlation between EQ and ironic endings recognition was significant. Moreover, alcoholics showed a tendency to attribute positive emotions to both ironic and nonironic contexts, showing an opposite pattern in comparison with control subjects who tended to associate negative emotions to ironic contexts.

CONCLUSIONS

The present study indicates that emotional recognition deficits that have been previously observed in chronic alcoholics extend to complex interactive contexts. This deficit is associated with a more general impairment of empathy, especially in its social skill component. Clinical implications of the present results are discussed.

The "Reading the Mind in the Eyes" test as a new way to explore complex emotions decoding in alcohol dependence

It has been repeatedly shown that alcohol dependence is associated with emotional impairments, particularly for emotional facial expression decoding. Nevertheless, most earlier studies focused on basic emotions and did not explore more subtle affective states. In order to obtain a more accurate evaluation, and in view of earlier results showing impaired performance for this task among high-risk children of alcohol-dependent participants, the "Reading the Mind in the Eyes" test was used here to explore emotional recognition in alcohol dependence. We showed that the deficit described earlier for basic negative emotions is (1) generalizable to complex and positive emotions; and (2) specific for emotional features. This strengthens the proposition of a general face recognition impairment in alcohol dependence.

ERP and RT delays in long-term abstinent alcoholics in processing of emotional facial expressions during gender and emotion categorization tasks

BACKGROUND

There is considerable evidence that alcoholics differ from nonalcoholics in the processing of stimuli that have emotional content. The current study examines those differences that are present in multi-year abstinent individuals.

METHODS

We compared reaction time (RT), accuracy, and Event Related Potentials (ERP) measures in long-term abstinent alcoholics (LTAA, n = 52) with that in age- and gender-comparable nonalcoholic controls (NAC, n = 47). Subjects were presented with male and female faces exhibiting happy, neutral, or sad facial expressions and were instructed to identify the picture gender in 1 task and the emotion being expressed in a subsequent task.

RESULTS

LTAA had slower RTs than NAC when instructed to identify emotion, while RT was comparable when identifying gender. There were no differences between groups on task accuracy. P160 latency was increased in LTAA for both tasks compared to NAC, though P160 amplitude did not differ between groups. The P160 effect was about 5 x as large as the RT effect and was statistically independent of the RT effect, while the RT effect was no longer present after removing variance because of the P160 effect.

CONCLUSIONS

Our data demonstrate slower early processing of emotional facial stimuli in alcoholics that is unresolved by long-term abstinence and is most sensitively indexed by delayed P160 latency in LTAA.