In a new study from Yale, researchers found interlinked changes in drinking behavior, mood, and the brain among women and men during recovery from alcohol use disorder (AUD).
AUD recovery was already known to be multidimensional, with behavioral changes—ranging from stopping heavy drinking to complete abstinence—accompanied by partial reversal of alcohol-induced brain damage.
The link between early abstinence (the “withdrawal phase”), negative mood, and sex-specific effects of alcohol on the brain’s “reward system” have been well-established.
But a growing body of evidence is showing that AUD individuals in long-term abstinence (greater than five years) report higher levels of happiness and emotional well-being, as well as a significantly lower risk of relapse.
In the study, the team involved sixty people from the Boston area with a clinical diagnosis of AUD, and a history of five or more years of heavy drinking.
Among this group, duration of abstinence ranged from 4 weeks to 38 years (average 6 years). An additional sixty people without AUD were recruited as controls.
The researchers found that, compared to the control group, the short- to mid-term abstainers exhibited lower positive mood and higher negative mood, both of which appeared to be related to structural differences of brain regions involved in pain processing and social emotions.
In contrast, long-term abstainers exhibited more normative mood profiles, with the exception of higher levels of depression, in conjunction with their own distinctive neural profile.
The researchers also found big differences between AUD men and AUD women with varying durations of abstinence.
Relative to men with AUD, women with AUD had much larger volumes of certain brain subregions, as well as greater positive mood scores for a given duration of abstinence.
The findings suggest that, for individuals in recovery from AUD, abstinence itself may represent its own type of behavioral intervention for changing the brain and, ultimately, changing the negative moods and emotions that frequently lead to relapse.
Additionally, these findings suggest that, for both men and women in early abstinence, negative feelings need not be interpreted as negative feedback, such that emotional discomfort represents something going “wrong” in recovery.
Rather, such feelings may be successfully anticipated and accommodated as necessary pathways to sustained remission and well-being.
Research into changes within individuals over time will be needed to substantiate the findings and their clinical relevance.
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The study is published in Alcoholism: Clinical and Experimental Research. One author of the study is Benjamin L. Thompson.
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