Cognitive deficits in chronic alcoholics

Assessment of cognitive functioning of methadone-maintenance patients: impact of adult ADHD and current cocaine dependence

The purpose of this study was to determine if methadone-maintained patients (MMP) with cocaine dependence (CD) and/or adult Attention Deficit Hyperactivity Disorder (ADHD) exhibited compounded cognitive dysfunction associated with their poly-substance use and/or co-morbid psychiatric diagnoses. The sample consisted of 79 MMP (59% male, 51% Caucasian), maintained on methadone doses ranging from 40-130 mg/day, who were placed into one of four diagnostic categories: (1) a control group (no ADHD, no CD) (n = 24), (2) CD alone (n = 18), (3)ADHDalone (n = 18), and (4)ADHD+ CD(n = 19). The California Computerized Assessment Package (CalCAP) was administered to assess cognitive functioning requiring focused and sustained attention in a standardized fashion. There were no group differences on Simple Reaction tasks. Compared to the control group, the ADHD+ CD group was slower and less accurate on 33% of the Choice Reaction (CR) tasks. Specifically, individuals in the ADHD + CD group and the ADHD alone group performed significantly worse on tasks measuring attention and psychomotor responding. These tasks are associated with broader cognitive skills in working memory, language discrimination and flexibility of cognitive sets that may have implications for treatment outcome. Diagnostic services capable of identifying cognitive deficits among MMP with ADHD and/or CD are needed to maximize the likelihood of treatment success and to serve as an indicator for the efficacy of therapeutic approaches.

Brain impairment in social drinkers? No cause for concern

Correlations between measures of alcohol consumption and cognitive test scores have been interpreted to reflect a chronic toxic effect of ethanol on brain function in light to moderate social drinkers. However, the data indicate that there is little support across research groups for any specific relationship and, at best, the effect of alcohol consumption accounts for only a small proportion of variance. Consideration of test validity suggests that the principal measure of ability used in this research is not capable of elucidating cerebral deficit. Further, the pattern of observed correlations is not consistent with the assumption that the putative effects of social drinking involve deficits less severe but similar in type to those seen in chronic alcoholics. Instead, an association between innate ability, demographic variables, and drinking behavior in the general population is the most parsimonious explanation of all the data.

A Revised Table for Computing Conceptual Quotient Equivalents for the Shipley Institute of Living Scale

Errors were noted in the table of conceptual quotients provided in the manual for the Shipley Institute of Living Scale. In this paper, corrected values for these conceptual quotients are provided.

Employment factors in outpatient recovery of alcoholics: a multivariate study

This study examined the effects of patient and treatment variables on alcoholic outpatient recovery over a one year period. One-hundred-seventy-four subjects, dichotomized by age (less than or equal to 42 or greater than 42) and employment status (employed or unemployed), were randomly assigned to one of three treatment groups (medical check-up, medication, or multi-therapy). Seventy-eight percent of these subjects were available for follow-up. Dependent measures included neuropsychological functioning and subject ratings of mood and alcohol consumption. Statistical analysis was by a 2 X 3 X 2 MANOVA. Employment status was a significant variable relative to positive outcome changes on mood and neuropsychological functioning. Moreover, older employed alcoholics showed a significant reduction of confusion. No group differences were noted at outcome with respect to age or treatment. The implications of the results for conventional alcoholism outpatient treatment are discussed.

Vitamin and mineral nutrition in chronic alcoholics including patients with Korsakoff's psychosis

1. A group of 129 patients with chronic alcoholism were assessed for their nutritional status with respect to certain minerals and vitamins, and compared with control subjects. 2. In all subjects the plasma values were normal for calcium, magnesium and zinc. 3. As in other studies a seasonal variation was found in the plasma levels of 25-hydroxyvitamin D in the control subjects and the alcoholic subjects; in all seasons lower levels were found in the alcoholics than in the controls, but none of the alcoholic patients had results in the range found in osteomalacia. 4. The alcoholic subjects had low levels of ascorbic acid both in the plasma and in the leucocytes. 5. Although vitamin A and beta-carotene levels were within the reference range, the results in alcoholics were found to be lower than in the control subjects. 6. We suggest that subclinical vitamin deficiencies other than thiamine deficiency contribute to the cerebral impairment frequently found in alcoholism.

Assessment of neuropsychological functions in chronic alcoholics using a standardized version of Luria's Neuropsychological Technique

The Standardized Version of Luria's Neuropsychological Technique was administered to separate groups of alcoholics 3 and 11 weeks abstinent from alcohol and to an equated control group. The alcoholics were impaired compared to controls on most of the battery scales; 3-week abstinent alcoholics performed poorer than 11-week abstinent alcoholics on most scales, however, only on the Rhythm scale was the difference significant. These results and other analyses suggest that chronic alcoholics suffer from a mild diffuse-generalized brain dysfunction which persists for up to at least 11 weeks of abstinence.

Neuropsychologic decrements as a function of alcohol intake in male students

Drinking history and sober neuropsychologic performance were examined in 45 male university students between the ages of 21 and 30 yr. Sober performance on the Shipley-Hartford Institute of Living Scale was significantly and inversely related to the amount of alcohol consumed per drinking event. Neither frequency of drinking nor lifetime alcohol consumption were significantly related to cognitive performance in controlled multiple regression equations. These findings emphasize the need for more information about the effects of social drinking on health.

Neuropsychological consequences of posttreatment drinking behavior in male alcoholics

A prospective study was designed to determine the neuropsychological consequences of continued alcohol consumption after treatment for alcoholism. Performance on 24 commonly used clinical neuropsychological tests was examined in 56 male alcoholics approximately 7 months after completion of an inpatient alcoholism treatment program. Abstainers (n = 17) performed better than those who resumed alcohol consumption. Although there was a significant decrease in alcohol consumption, posttreatment drinking behavior still predicted cognitive performance, with increased frequency and quantity per occasion having more deleterious consequences even at consumption levels that are deemed by some to be socially acceptable. It is concluded that alcohol consumption by former alcoholics might serve to maintain cognitive performance at reduced levels, and that this possibility should be considered in determining appropriate treatment goals for alcoholic patients.