COGNITIVE & PSYCHOSOCIAL RECOVERY IN ALCOHOLIC SUBTYPES

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APPLICANT'S ABSTRACT: In our first funding period (8/92-7/97), we have examined three cognitive processes (access, availability and efficiency) as candidate targets for alcohol-related neurocognitive impairment in subgroups of chronic alcoholics classified on the basis of other substance use/abuse. Data collected during this first funding period, as well as that obtained in related work, suggest that, of the three processes, cognitive efficiency may be the most vulnerable to alcohol effects. However, cognitive efficiency is itself a multifactorial term that subsumes a number of more special processes including memorial and attentional process. The primary focus of the current application is to localize further the specific alcohol-related cognitive deficits within the domain of efficiency, as being principally attentional and/or memorial. To answer this question, we propose to administer a battery of tests which will assess neurophysiological and behavioral concomitants of attentional and memorial processes. Recognizing that alcoholism is a heterogenous disorder, we will extend the study to examine the roles of possible cofactors, including affective state, childhood behavioral disorders, and the use of other substances. Data collected in the first funding period also speak to this issue and suggest that polysubstance use may be differentially related to both performance and psychosocial variables. The present application, using a revised experimental design, extends our laboratory's history of neurocognitive studies of male and female alcoholics by determining the role of attentional vs. memorial processes in alcoholic deficits and in further clarifying the role of polysubstance abuse and psychosocial variables in these deficits. This revised design will compare four groups of male and female alcoholics, defined on the basis of no other drug abuse (n=50), abuse of marijuana (n=50), abuse of stimulants (n=50), and abuse of other multiple stimulants (n=30) with male and female community controls (n=50). An additional focus of the project is to complete the longitudinal assessments for those subjects who will not have completed their retest during the currently funded project. By clarifying the nature of alcohol-related deficits in cognitive efficiency, the research proposed in this revised application for 4 years of continued funding will enhance our understanding of the neurocognitive impairment and provide data potentially important to developing more effective treatment approaches.