Effects on Mental Functioning
Five areas of mental ability are consistently
compromised by chronic alcohol abuse: memory formation,
abstract thinking, problem solving,attention and
concentration, and perception of emotion. As many as 70 percent of people who seek treatment for
alcohol-related problems suffer significant
impairment of these abilities.
Memory Formation
By memory formation we
mean the ability to form new memories, not the ability to recall information that was learned in the past. That is,
an individual with a chronic drinking
habit might vividly and accurately recall
what he learned early in life but not be able to tell what he ate for lunch four hours ago. And the richness and detail
of his memories during the past few
years of drinking might be significantly less than in those earlier memories. On some tests of mental
ability that assess different kinds
of brain functions, chronic drinkers often perform lust fine on most of the categories but perform poorly on the
memory sections. This selective and
profound memory deficit may be a result of damage to specific brain areas, such as the hippocampus, the
mammillary bodies, or the frontal
lobes.
Abstract
Thinking
By abstract thinking
we mean being able to think in ways that are not directly tied to concrete things. We think abstractly when we interpret the
meaning of stories, work on word puzzles, or solve geometry or algebra problems. Chronic drinkers often find these
abilities compromised. One way to
measure abstract thinking is to show someone a group of objects and ask her to group the objects according
to the characteristics they share.
Chronic drinkers will consistently group things based on their concrete characteristics (such as size, shape, and
color) rather than on the basis of
their abstract characteristics (such as what they are used for, or what kinds of things they are). It is as if
abstract thoughts do not come to mind
as easily for the chronic drinker.
Problem Solving
We all have to solve problems each day. Some are
simple ones, like determining whether
to do the laundry or the grocery shopping first. Some are more complicated, like setting up a new personal
computer or deciding on what
inventory to order for the next month's needs in a business. In either case, one of the required abilities is
mental flexibility. We need to be
able to switch
strategies and approaches to problems (particularly the complicated ones) to solve them efficiently. People
with a history of chronic drinking
often have a lot of difficulty with this. Under testing conditions, it often
appears that they get stuck in a particular mode of problem solving and take a lot longer to get to a
solution than someone who is better
able to switch strategies and try new approaches. This difficulty could relate to the effects of chronic
drinking on the "executive functions"
of the frontal lobes.
Attention and Concentration
Chronic drinkers also
develop difficulty in focusing their attention and maintaining concentration. This appears to be
particularly difficult when related to
tasks that require visual attention and concentration. Again, the deficits may not appear until the person is
challenged. In casual conversation,
the sober chronic drinker may be able to concentrate perfectly well, but placed
in a more challenging situation (like reading an instruction manual, driving a car, or operating a piece of
equipment), she may be quite impaired.
Perception of Emotion
One of the most
important elements of our social behavior is the ability to recognize and interpret the emotions of other
people. Alcoholics have a deficit in
the ability to perceive emotion in people's language. There is a specific brain function that normally gives us the
ability to detect attitude and emotion
in conversation. It turns out that chronic, heavy drinking markedly reduces this ability. It is important
to realize that this deficit is one
of perception and does not reflect the alcoholic's own emotional state. It's as if the subtle things like the tone and
cadences of the other person's language
that convey attitude and emotion are simply not perceived by the alcoholic. This is particularly interesting
because we know that chronic heavy
drinkers often have difficulty in social relationships. Perhaps this perceptual deficit causes some of these
problems.
Do These Deficits Go Away?
Chronic heavy drinkers who quit recover these functions partially during the first month or two after the last drink. However, once this
time passes, they have gotten back all that they will recover. It is
difficult to identify precisely how much recovery
occurs, but clear deficits do appear
to persist permanently in these individuals. In one study, people who had quit drinking completely after many years
of alcohol abuse were examined for
seven years. Even after this time they had significant memory deficits. This persistent pattern of memory
deficits in previous alcoholics is
common enough to have a specific diagnosis. It is generally
called either alcohol amnestic disorder or dementia
associated with alcoholism.
SCOTT SWARTZWELDER
