Friday, November 7, 2008

Alcoholics Have Problems Recognizing Danger

Alcoholics have trouble recognizing and avoiding dangerous situations because the area of their brain that is used to appreciate those kinds of concerns is functioning at a reduce level, stunting their ability to perceive danger. This may help explain why they do not react to the concerns of their friends and family members about their drinking.

Previous studies have shown that alcoholics have problems recognizing facial expressions and many other studies have shown cognitive deficits in alcoholics. A new study indicates that alcoholics may also have emotional processing deficits also.

Researchers studied 11 alcoholics and 11 healthy males and used fMRI brain imaging to track their brain-blood oxygenation level dependent (BOLD) responses while they were given facial-emotion decoding tasks.

Sensation Seekers

The subjects were ask to determine the intensity of happy, sad, anger, disgust and fear displayed via facial expressions. The results showed that alcoholics were most deficient at recognizing negative emotional expressions.

These deficits showed up on the fMRI images in the affective division of the anterior cingulate cortex -- part of the prefrontal brain area.

"The cingulate is involved in many higher order executive functions such as focused attention, conflict resolution and decision making," said Jasmin B. Salloum, research scientist at the National Institute on Alcohol Abuse and Alcoholism, in a news release. "Alcoholic patients are known to be sensation seekers and are less likely to shy away from signals that suggest danger."

Findings Have a Silver Lining

"Both sensation seeking and avoidance of danger are characteristic of subjects with axes II personality disorders, which many of our subjects had," Salloum said. "The findings in this study may shed some light on some of the problematic and psychopathological behaviors that are manifest in this patient group. It remains to be determined if the dysfunction of the anterior cingulate precedes alcoholism or is a result of long term drinking."

The study did have a silver lining, according to Andreas Heinz, director and chair of the department of psychiatry at Charite – University Medical Center Berlin.

"Now we can begin to understand why patients have problems avoiding dangerous situations and, particularly, why they may not react to the concerns of their friends and relatives: the brain area that should help them appreciate these concerns is functioning at a reduced level," said Heinz.

But Happy Faces Work

"Furthermore, we observed a normal or even increased brain response to happy faces. Our group recently made a similar observation, in that patients with strong brain responses to pleasant pictures have a reduced relapse risk," Heinz said. "So, relatives and friends may want to support alcoholic patients with positive messages that strengthen their self-esteem while being particularly careful, and even repetitive, in pointing out the dangers of alcohol and alcohol-associated environments. Otherwise, the patients may miss the message."

The study was published in the September 2007 issue of Alcoholism: Clinical & Experimental Research.

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