Working Memory, Executive Functions and Negative Emotion-related Variables Among Alcohol-dependent Patients Undergoing Protracted Withdrawal

[Aims:] This study is part of a research project on the relationship between cognition, emotion and motivation for drinking in alcohol dependent subjects. In the present study, we examined the effects of protracted alcohol withdrawal on affectivity, central executive component of working memory and executive functions in alcohol dependent inpatients. [Methods:] Central executive (CE) component of working memory (The Brown- Peterson), reactive and spontaneous flexibility (Number-letter task and Verbal Fluences), inhibition of the prepotent response (Stroop Task), emotion-related variables (Depression state (BDI), affectivity state (PANAS) and alexithymia (TAS-20)), craving (OCDS) and their time-dependent improvement were assessed in alcohol-dependent patients (DSM-IV, N = 41), matched gender to non alcohol-dependent participants (N = 41) at the onset (T1: day 1 or 2) and at the end (T2: day 14 to18) of withdrawal. [Results:] Alcohol-dependent patients’ abilities to switch from one pattern to another, to inhibit irrelevant information were lower than those of control participants both at onset and end of a withdrawal, contrary to verbal fluency which was similar. No effect of time emerged from analyses for these EF deficits. Conversely, significant differences between T1 and T2 were observed for the CE component of working memory and affect scores indicating a recovery of working memory and a weakening of negative affect, depression, alexithymia among patients from onset to the end of cure. Positive relationships were found between the CE component of working memory task and EFs, and particularly among alcoholics at the end of the cure). Strong positive correlations were observed between the different negative emotion-related variables and working memory performances at both times in controls and at T2 for alcohol dependent subjects. [Conclusions:] Several control functions of the Supervisory Attentional System (SAS) (Norman and Shallice, 1986) were impaired among alcohol dependent patients and did not improve during withdrawal, whereas the CE component of working memory improved considerably during this period, in parallel with a recovery of negative mood, alexithymia and craving. Furthermore, working memory correlated with the affective factors