Multidimensionality and state dependency of alexithymia in recently sober alcoholics

Article Abstract:

Alexithymia refers to condition in which feelings and emotions seem remote and difficult to identify. Feelings are often defined in terms of bodily sensations (somatization). Patients with alexithymia often exhibit an external cognitive style in which they think that outside forces and authority figures (e.g., doctors) control their lives. They often lack imagination and are incapable of symbolic thinking. Recently, alexithymia has been shown to be common in the early stages of alcoholism recovery. To evaluate the relationship between alexithymia and depression in recently sober alcoholics, 130 consecutive male applicants (with an average age of 41 years) to an alcoholism inpatient treatment unit were studied. The men were of mixed ethnic backgrounds and were sober for an average of five days. They were administered a self-report measure for alexithymia and a self-report measure of depression. The alexithymia measure factored into three subscales: (1) feelings; (2) impoverished fantasy life; and (3) external thinking. High ratings of depression were found to be significantly related to high ratings of alexithymic feelings (remoteness and somatization), but not to the other two factors. Fifty-five of the men were re-administered the self-report measures at the end of the third week of treatment. At the second testing, patients were less depressed and had less difficulty with their feelings. However, they demonstrated a tendency to have more problems with imagination and external thinking. Findings indicate a continuous relationship between the feeling component of alexithymia and depression, but do not demonstrate a causal direction (whether alexithymia leads to depression or visa versa). Alexithymia appears to be a multidimensional construct in which only the feelings component is related to depression among newly sober alcoholics. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Affective disorders, Mood disorders, Alexithymia, Alcoholic myopathy

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Cognitive functioning and treatment outcome in alcoholics

Article Abstract:

A study of 87 male, alcohol-dependent patients was performed to determine the extent to which cognitive factors were correlated with the outcome of a 30-day hospital rehabilitation program. Patients were assessed at the start of the program by means of the Addiction Severity Index (ASI), a test instrument that provides information on psychological, medical, legal, alcohol, and related problems. Seven tests of cognitive ability were also given and patients were tested on their knowledge of the medical effects of alcoholism. Results showed that completion of the program was not correlated with any social, demographic, psychosocial, or cognitive variables explored. When patients were again evaluated with the ASI at the program's end, better follow-up results correlated most with greater alcohol and drug problem severity and poorer cognitive functioning. Six months later, greater severity of drug and alcohol problems, poorer complex cognitive performance, and a younger age were associated with greater improvement in problem levels as compared with baseline. More severe psychological or psychiatric problems at baseline were also highly associated with improvement in psychological or psychiatric problem levels. The findings are interpreted to mean that the alcoholic patients with additional drug problems improved their alcohol problem levels. They thus show that many factors besides cognitive functioning determine the outcome of treatment for alcoholism. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Alcoholism treatment, Cognition disorders, Cognitive disorders

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Adult children of alcoholics: a valid diagnostic group?

Article Abstract:

Adult children of alcoholics (COAs) are often assumed to have a common background that makes it more likely they will suffer psychological impairment, often leading to substance abuse or other manifestations of psychological problems. However, whether the diagnosis of adult COA is a valid and distinct clinical entity, with its own treatment needs, has not been demonstrated. To investigate this, 217 adult inpatients in three substance abuse treatment centers were studied to determine whether those who were COA had more personality and psychiatric disorders than those who were not. Subjects were evaluated according to several standardized tests. Results showed that 88 had at least one parent with alcoholism (the COA+ group). No differences were found in the diagnostic categories for the two groups (COA+ as compared with COA-), nor in the symptoms associated with 18 different diagnoses. Furthermore, personality tests did not show differences in personality disorder types for the COA+ and COA- groups. Substance abuse patterns did not differ between the groups, either, although the COA+ subjects had an increased number of drinking problems, alcohol-related health problems, and overall estimate of problem severity. Although statistically significant, these differences were considered clinically relatively unimportant. The study's limitations are pointed out. Limited support for adult COA as a valid clinical concept was found. (Consumer Summary produced by Reliance Medical Information, Inc.)

Children of alcoholics

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