Brain, behavioral, and affective correlates of recovery from Alcohol Use Disorders
Thompson, Benjamin L.
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Alcohol Use Disorders (AUDs) generally are understood as disordered behaviors, and recovery from AUDs frequently is regarded in terms of positive and constructive changes in those behaviors. However, a large proportion of recovering individuals describe the experience of recovery from AUDs as consisting of both behavioral and affective changes. The affective changes that characterize recovery have been referred to as constituting “emotional sobriety,” which can be understood as a type of dynamic equilibrium with respect to the variability of the valence and intensity of affective experiences. Here, we describe neuroanatomical and behavioral correlates of emotional sobriety, as well as sex differences, through three independent but complimentary studies. In Study 1, we examined the association between the duration of abstinence (DOA) from alcohol and volumetric measures of the Brain Reward System (BRS) and its subregions, among groups of normal control (NC; n = 60) and AUD participants (n = 60). We found volumetric differences of BRS regions known to be involved in affective processing in association with different DOA. For example, long-term abstainers (greater than five years) exhibited less volume in the cingulate cortex, relative to NCs, and AUD women exhibited higher insular volume than AUD men in association with abstinence. In Study 2, we examined the association between abstinence and differences in affective states. Short-/mid-term abstainers (less than five years) exhibited affective dysregulation, relative to NCs, whereas long-term abstainers exhibited relatively normal affective states. AUD women exhibited higher positive affect than AUD men in association with abstinence. In Study 3, we examined the independent influence of mutual-help organization (MHO) activity upon affective states, over and above the effect observed in association with abstinence. Greater degrees of MHO activity were observed to be associated with increases in measures of positive affect, and sex differences also were detected in this association, with AUD women exhibiting higher positive affect than AUD men. Altogether, the findings of this dissertation indicate that the behavioral and affective changes that characterize recovery from AUDs emerge together in a dynamic, recursive interrelationship that is mediated through discrete corresponding neuroadaptations at the level of the BRS.