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Maladaptive decision-making that typifies drug addiction could reflect alterations in cognitive and emotional processing when these individuals are faced with choices. Even if this is true, it is not clear whether these deficits are a cause or a consequence of chronic drug use. The following experiments were designed to determine the effect of acute alcohol intoxication on affective processing in healthy individuals, as measured through a variety of behaviours. In the first experiment, acute alcohol intoxication did not impair performance on a task that recruits the orbitofrontal cortex, a key area for decision-making. In the second experiment examining preference formation, there was a clear dissociation between alcohol’s effect on implicit and explicit memory: acute intoxication impaired explicit memory, while leaving implicit learning intact. In a subsequent experiment, both alcohol and placebo groups showed altered physiological and subjective responses to a psychosocial stressor. Although acute alcohol intoxication did not affect risk-taking, an individual variable (tension-reactivity) moderated performance on this laboratory task. This experiment also revealed a relationship between stress-reactivity and subsequent risk-taking, one explanation being that high levels of cortisol increased individual sensitivity to task outcomes. Finally, an analysis of the accumulated information on drinking rates, impulsivity, and drug use suggests that female drinking rates may be approaching the levels reported by males. There were also significant differences in sensitivity to alcohol’s effects when participants were intoxicated in the lab. Heavy drinkers showed a greater sensitivity to the pleasurable effects of alcohol despite feeling less intoxicated and desiring more alcohol than other individuals. These combined effects could put heavy drinkers at greater risk for alcohol-related problems. Taken as a whole, these studies suggest that individual factors play a stronger role in moderating affective processing than do the direct pharmacological effects of alcohol. / Thesis (Ph.D, Psychology) -- Queen's University, 2008-03-20 14:29:40.722

BACKGROUND: Evidence supports that an elevated level of total plasma homocysteine (tHcy) signifies a breakdown in the methionine-homocysteine cycle. This may result in folate deficiency, DNA methylation and oxidative stress, all of which are potential mechanisms that may lead to cancer. Few studies examined the effects of alcohol consumption on tHcy levels. No studies considered polymorphisms in alcohol dehydrogenase 1C (ADH1C), a gene that encodes for an enzyme that metabolizes alcohol to acetaldehyde, a folate antagonist; ADH1C*1 encodes for an enzyme with a higher capacity to generate acetaldehyde than ADH1C*2. PURPOSE: This study examined the association between alcohol intake and risk of elevated tHcy while exploring a potential gene-environment interaction with polymorphisms in ADH1C. METHOD: This was a case-control study nested in a larger cross-sectional study funded by Canadian Institutes of Health Research. The target population was recruited from Kingston and Halifax from 2006 to 2008 and included 100 cases and 187 controls selected from healthy male and female subjects aged 20-50 years. Cases were defined as subjects with tHcy ≥ 10 mol/L and controls < 10 mol/L. Alcohol consumption was categorized into three groups: ≤12.0 g/day, 12.1–24.0 g/day, and >24.0 g/day. ADH1C was dichotomized by collapsing ADH1C*1/*2 and ADH1C*2/*2 into one group and examined against ADH1C*1/*1. RESULTS: Compared to ≤12.0 g/day, odds ratio (OR) for 12.1-24.0 g/day was 0.53 [95% confidence interval (CI), 0.25-1.13] and for >24.0 g/day was 1.19 (95% CI, 0.60-2.24), suggesting a J-shaped trend with risk of elevated tHcy. A reduced OR was observed for ADH1C*1/*1 (OR= 0.52, 95% CI, 0.27-1.03). The alcohol-ADH1C interaction was not statistically significant (p-value = 0.21), though a stronger J-shape trend was suggested in ADH1C*1/*1. Among consumers of ≤12.0 g/day, a reduced measure of effect was observed for ADH1C*1/*1 (OR= 0.44, 95% CI, 0.19-1.00). CONCLUSION: A J-shaped trend was suspected between risk of elevated tHcy and alcohol consumption. Additionally, a nonsignificant reduced effect of ADH1C*1/*1 on risk of elevated tHcy, with a more pronounced effect in the lowest group of alcohol consumption. This suggests that ADH1C may be associated to homocysteine through factors unrelated to alcohol intake. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2008-09-26 21:06:15.185

Stress contributes to both the initiation and maintenance of drug use. Drug intake, specifically alcohol, may be reinforced under stressful conditions by reducing anxiety or tension. The pharmacological effects of alcohol, however, cannot account entirely for the tension-reducing experience of intoxication. This suggests that cognitive factors contribute to the stress-dampening effects of alcohol. This study examined this hypothesis by testing how tension-reduction alcohol expectancies moderate the relationship between stress and alcohol intoxication. Stress response was operationalized as an increase in subjective anxiety and impaired sustained attention. Verbal learning, which was hypothesized to not be impaired by the stressor, was used as a cognitive control. One hundred and nine undergraduate students were randomly assigned to one of five groups (low, medium or high dose alcohol; sober; or placebo). Following beverage consumption, participants completed cognitive tasks before and after the Trier Social Stress Test. Participants completed the State-Trait Anxiety Inventory – State upon arrival in the lab, as well as pre- and post-stressor. They also completed the State-Trait Anxiety Inventory – Trait and the College Drinking Influences Survey, which includes a Stress Reduction scale. Social stress did not hinder cognitive performance, whereas alcohol impaired sustained attention and verbal learning abilities. The stressor evoked a subjective stress response that was reduced by alcohol and the expectancy of alcohol (i.e., placebo). There was no evidence to suggest that tension reduction alcohol expectancies moderated this effect. These findings replicate alcohol’s ability to dampen a stress response and, furthermore, demonstrate that the expectancy of alcohol is as effective as the drug itself in reducing subjective response to stress. This study highlights the need for further research to elucidate which factors modulate the stress-dampening effect of alcohol in undergraduate students. This knowledge, in turn, could present an opportunity for screening and early interventions to circumvent problem drinking as alcohol consumption is used by this population to cope with stress. / Thesis (Master, Psychology) -- Queen's University, 2010-09-24 13:28:03.555

The possible significance of cognitive and situational factors in determining the response to alcohol suggests that behavioral changes following drinking may reflect a lack of self-control not solely attributable to the pharmacological effect. In an initial experiment subjects were requested to overcome the effects of alcohol (1.32 ml/kg 95% ethanol). In comparison with a no-motivation group (n = 11), motivated subjects (n = 14) demonstrated compensation on aspects of tasks involving memory, coordination and affect. It was speculated that attributions of causality (internal or external) for relative control might influence its occurrence and maintenance. In a second experiment false dose feedback was expected to interact with relative control to affect subjects' (n = 45) attributions. A greater level of sobriety was achieved by subjects who were led to attribute responsibility to themselves. Also, it appeared that further drinking was affected by cognitive influences. Implications of the self-control phenomenon, especially regarding the non-pharmacological role and the etiology of excessive drinking, are discussed.

Epidemiologic studies have found that approximately one third of individuals will experience either alcohol abuse or dependence during their lifetime. However, only a minority will seek help or perceive a need for help. The purpose of this thesis is to provide a longitudinal investigation of the predictors of new onset perceived need for care and help-seeking in individuals with a lifetime alcohol use disorder who have no prior history of perceived need or help-seeking. Methods: Data were drawn from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n=34,653), a 3-year longitudinal nationally representative survey of the United States population. Results: Respondents with an incidence of perceived need and help-seeking were more likely to be male, younger, less educated, and black. Those who sought help and perceived a need for help were more likely to have a concurrent Axis I or II disorder after controlling for sociodemographic differences and social, legal, economic problems. They also had very high odds of having a persistent alcohol use disorder (OR=4.68) and experiencing social or legal problems related to their alcohol use after controlling for sociodemographics and psychiatric comorbidity (AOR’s from 5.59-38.42). Conclusion: Individuals with a history of having no perceived need for care or help-seeking may represent a unique group among those with an alcohol use disorder. Psychiatric comorbidity and social or legal problems related to alcohol use were both independent predictors of perceived need and help-seeking.

This study uses a phenomenological methodology to understand Japanese women, living in Tohoku region, Japan, who have the experience of alcohol dependency and recovery. Moreover, the purpose of the study was to understand what would be the most effective ways if supporting women in rural communities. Six women were interviewed to obtain the meanings they attach to recovery. Nine themes emerged. It was found that the women had common turning points prior to beginning their recovery, and had adopted various changes in their process of recovery. For all women in the study, the essential meaning of recovery was to live and to live fully. Recommendations are presented regarding the advocacy required to create the conditions necessary for women to live fully. This involves greater education of the community at large about alcohol dependency and the creation of supportive environments for individuals in recovery and their families.

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