Autobiographical memory problems in alcohol rehab

Evidence based addiction treatment can be used to help individuals in alcohol rehab to achieve sobriety. In a non 12 step approach to recovery, individualized treatments plans can be created to meet the needs of a specific person. An example of evidence based addiction treatment includes cognitive behavioral therapy in which this article describes in further detail.

Depressed individuals and other clinical populations exhibit difficulty in recalling specific autobiographical memories, according to previous studies. (A “specific” memory refers to those about a single event lasting less than a day.) Typically this difficulty in recalling specific autobiographical memories is associated with poor psychological functioning, poor problem solving, and increased hopelessness. Researchers in London examined specific autobiographical memory function among individuals with alcohol use disorders (Whiteley et. al., 2009).

The researchers recruited 26 detoxified dependent drinkers from an alcohol rehab program along with 29 non-dependent drinkers from the community. Measures included the Severity of Alcohol Dependence Questionnaire and the Autobiographical Memory Test, as well as measures of everyday memory performance, estimates of pre-morbid intelligence, and current symptoms of depression.

The results showed that dependent drinkers produced significantly fewer specific autobiographical memories compared to non-dependent drinkers across 18 trials for each participant. Dependent drinkers were specific for first recalled memory for 50.8 percent of cues, compared to 76.2 percent for non-dependent drinkers, and dependent drinkers were slower at producing specific memories. Dependent drinkers also showed higher depression scores, but group differences in autobiographical memory remained after controlling for depression.

The researchers suggest that over-general (non-specific) autobiographical memory may lead to a state of “psychological entrapment” where lack of memory leads to decreased problem solving skills and increased hopelessness. This could lead to a vicious cycle where over-general memories promote low mood and poor decision making, and low mood and poor decision making lead to the maintenance of alcohol use. Autobiographical memory problems among those in alcohol rehab may also have implications for alcohol treatment interventions.

“As a cognitive style, over-general autobiographical memory is relevant in any cognitively based intervention,” the authors point out. “Intervention strategies such as challenging dysfunctional beliefs may be impaired by limitations in retrieving specific alternative events. Where unhelpful cognitive styles remain, relapse to drinking maybe more likely. Given the importance placed on [cognitive-behavioral therapy]-based interventions such as Relapse Prevention in the effective treatment of alcohol problems, an understanding of the various cognitive styles in this population is clinically important. Further investigation of specificity of autobiographical memory in problem drinkers should determine how different treatment outcomes may be associated with differential changes in specificity of autobiographical memory.”

Evidence suggests that cognitive-behavioral therapy (CBT) is effective in alcohol rehab. However, the individual in alcohol treatment must have a certain level of cognitive ability in order to benefit from the therapy — and, unfortunately, chronic drinking impairs cognitive ability. Alternative approaches may need to be developed for those who lack the cognitive ability to benefit from cognitive-behavioral therapy.

Cognitive-behavioral therapy is one method that can be used for individuals in alcohol rehab who desire a non-12-step approach to recovery.

Reference

Whiteley C, Wanigaratne S, Marshall J, Curran HV. Autobiographical memory in detoxified dependent drinkers. Alcohol and Alcoholism. 2009; 44(4): 429-430.

http://alcalc.oxfordjournals.org/cgi/content/full/44/4/429