Emotional processing and social cognition in alcohol use disorder

Abstract

Objective: To review deficits in emotional processing and social cognition potentially contributing to the dysfunctional emotion regulation and difficulties with interpersonal relationships observed in individuals with alcohol use disorder (AUD) and to provide directions for future research.

Method: First is presented a review of emotional and social-cognitive impairments in recently detoxified AUD individuals that include alexithymia, difficulties in decoding others' emotions, and reduced theory of mind and empathy skills. Social cognition disorders in AUD pose different issues discussed, such as whether (1) these deficits are consequences of excessive alcohol consumption or premorbid risk factors for addiction, (2) emotional and social impairments impede positive treatment outcome, (3) recovery of social abilities is possible with sustained abstinence, and (4) AUD patients are unaware of their emotional and social dysfunctions. Finally, current knowledge on structural and functional brain correlates of these deficits in AUD are reviewed.

Results: Emotional and social-cognitive functions affected in AUD can potentially compromise efforts to initiate and maintain abstinence by hampering efficacy of clinical treatment. Such dysfunction can obstruct efforts to enable or reinstate higher-order abilities such as emotional self-regulation, motivation to change, success in interpersonal/social interactions, and emotional insight and awareness of social dysfunctions (i.e., accurate metacognition).

Conclusions: The present review highlights the need to account for emotional processing and social cognition in the evaluation and rehabilitation of alcohol-related neurocognitive disorders and to consider psychotherapeutic treatment involving remediation of emotional and social skills as implemented in psychiatric and neurological disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Figure 1

Emotional and social cognitive functions affected in chronic alcoholism compromising efforts to initiate and maintain abstinence by potentially hampering efficacy of clinical treatment and potentially obstructing efforts in enabling other higher-order abilities such as emotional self-regulation, motivation to change, success in interpersonal/social interactions, and emotional insight and awareness of social dysfunctions (i.e., accurate metacognition). Blue arrows with question mark = Need of further investigation on how emotional and social cognition processes interact and potentially affect the higher-order abilities. Arrow 1 = Need of further investigation on how component episodic memory and executive processes interact and potentially influence emotional and social cognition processes. Arrow 2 = Need of further investigation on whether social cognition disorders are the untoward consequences of excessive alcohol consumption or a premorbid risk factor for addiction. Arrow 3 = Need of further investigation on the dynamic course of recovery with abstinence or on the negative influence of multiple relapses/detoxifications on emotional and social cognitive impairment. Arrow 4 = Need of further investigation on emotional social cognitive deficits as predictors for relapse.