Distinct effects of protracted withdrawal on affect, craving, selective attention and executive functions among alcohol-dependent patients.
OBJECTIVE
The present study examined the effects of protracted alcohol withdrawal on affectivity, craving, selective attention and executive functions (EFs) in alcohol-dependent patients.


METHODS
Selective attention (The D2 Cancellation Test), flexibility (Trail Making Test), inhibition (Stroop Task), decision making (Iowa Gambling Task), craving (Obsessive-Compulsive Drinking Scale) and state affectivity (Positive and Negative Affectivity Schedule) were assessed in alcohol-dependent patients (DSM-IV, n = 35) matched to non-alcohol-dependent participants (n = 22) at the onset (T1: day 1 or 2) and at the end (T2: days 14-18) of protracted withdrawal during rehab.


RESULTS
Alcohol-dependent patients' abilities to focus their attention on relevant information, to switch from one pattern to another, to inhibit irrelevant information and to make advantageous choices were lower than those of control participants during both times of a withdrawal cure. No effect of time emerged from analyses for selective attention and EF deficits. Conversely, significant differences between T1 and T2 were observed for craving and affect scores indicating a weakening of alcohol craving and negative affect as well as an improvement of positive affect among patients from onset to the end of cure.


CONCLUSIONS
Control functions of the Supervisory Attentional System (Norman and Shallice, 1986) were impaired and did not improve during a 3-week withdrawal cure, whereas alcohol craving and negative state affectivity significantly improved in parallel during this period. Implications for understanding the clinical processes of withdrawal are discussed.
Cordovil De Sousa Uva
Mariana
M
Department of Psychology, Université Catholique de Louvain, Place du Cardinal Mercier 10, B-1348 Louvain-la-Neuve, Belgium. Mariana.Cordovil@uclouvain.be
Luminet
Olivier
O
Cortesi
Marie
M
Constant
Eric
E
Derely
Marc
M
De Timary
Philippe
P
D000328:Adult; D000339:Affect / Q000502:physiology*; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation; D001288:Attention / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D004493:Education; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D012959:Socioeconomic Factors; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D011795:Surveys and Questionnaires