By Drs. Sharon Cox and Chris Chandler
Could you describe the aim of this study?
Over recent years, a growing number of studies which have shown that long-term chronic alcohol dependence can cause a range of problems in social cognition. Social cognition broadly refers to the processing of social and emotional information, such as deciphering social interactions, understanding another’s intentions and thoughts and processing one’s own feelings and states. Our study examined the effect that alcoholism would have on the ability to take the visual perspective of another. Visual-spatial processing is a key, yet automatic and implicit element in social interaction. A key feature of understanding other peoples’ perceptions lies in the ability to represent the world from the other person’s perspective, i.e. the world as your audience sees it.
What would you say are the key take-home messages from this study?
Problems in social cognition are still relatively underexplored in research, and there is little understanding of the extent and long-term effects of social cognition on treatment outcomes.
One of the key findings from our study was that the alcohol dependent participants reacted differently to the faces than the non-alcohol dependent participants. The alcohol dependent person identifies faces that were neutral or fearful as the same as non-dependent participants. However, they do so with a greater processing time in alcohol-dependent participants for both neutral and fearful faces. Thus, they are slower at processing emotions of others (in this study neutral-negative emotions). The alcohol-dependent group was argued to be more responsive to a wide set of stimuli than the non-dependent group as seen in their increased processing times to neutral and negative stimuli. If we imagine that treatment settings are emotionally charged and labile environments then we must consider that impact of misinterpreting the emotions of other in the therapeutic community (e.g. fellow service users and therapists) and being slow to process those emotions.
Furthermore, social cognition is not independent of general cognitive skills, and therefore patients displaying problems of social cognition are further likely to be demonstrating dysfunction in day-to-day tasks that rely on executive function. Finally, alcoholic patients who experience problems with social and emotional interactions are likely to find the treatment environment harder as poor social skills are found to be a cause of relapse.
How would these findings impact clinical practice?
Although the knowledge of social cognition and its impact of substance misuse and alcoholism are sparse, the current data has the potential to feed into clinical practice. There are diagnostic tools that highlight problems in social cognition for dementia patients, and using these within the substance misuse field by trained clinicians will support and highlight the individual needs of patients.
What other studies could you recommend based on these findings?
This research is in its infancy and clearly more needs to be done to understand the long-term effect of social cognition on continual alcohol use, relapse, and abstinence. The impact on a range of emotions needs to be determined and also other expressions of emotion, e.g tone of voice. We also propose that more be done to understand which treatment settings are most effective or suitable for those with these deficits. One way to examine this would be to measure the outcomes of patients with and without social processing deficits who have experienced a range of treatments over a longer time frame.
See this article at http://www.sciencedirect.com/science/article/pii/S0376871616301533
Dr. Sharon Cox is a Research Fellow at London South Bank University. Her research specializes in alcohol and smoking addiction; she has a special interest in harm-reduction, the social concept of addiction and clinical practice. View her projects and articles at https://www.researchgate.net/profile/Sharon_Cox10
Dr. Chris Chandler is Head of Psychology at London Metropolitan University. His research focuses on the neuropsychology of addiction.