Impact of the hormonal milieu on the neurobiology of alcohol dependence and withdrawal

Alcoholism, or alcohol dependence, is a complex disorder with withdrawal symptoms that are often problematic for those trying to recover from their dependence. As researchers attempt to elucidate the neurobiological underpinnings of alcohol dependence and withdrawal, it is becoming clear that numerous factors, including the hormonal environment, impact the manifestations of this disorder. Of particular interest is the observation that women have fewer and less severe withdrawal symptoms than do men even though they tend to suffer greater physiological harm from excessive alcohol consumption. In this article, the authors present an overview of their understanding of how gonadal and stress hormones interact with alcohol, which results in differential neurobiological responses between males and females. Thus far, data generated from representative animal models have shown significant differences between the sexes in behavioral responses and neuroadaptations to chronic alcohol consumption and withdrawal. Accumulating evidence suggests that treatment of alcoholism, including withdrawal, should be tailored to the patient's gender and hormonal status.     

Electrolyte disorders, EEG changes and epileptic seizures in alcohol withdrawal delirium

For 180 patients suffering alcohol-withdrawal induced delirium, electrolytic concentration in the serum of Na, K, Ca, and Mg was determined in the early withdrawal phase, and the electroencephalograms of 95 delirium patients evaluated in respect of local and diffuse changes and epileptic activity, and compared in delirium patients with and without initial seizures. Delirium patients who had initial seizures suffered significantly longer-lasting periods of delirium and significantly more frequent electrolytic changes in the form of hypomagnesemia and hypopotassemia (hypokalemia). There was no significant difference in the EEG changes. A temporary metabolic disorder in the initial phase of the two-phase withdrawal process should be assumed to be the cause of seizures during alcohol withdrawal, and the pathogenetic significance of hypomagnesemia and hypopotassemia should be taken into consideration.     

Current status of knowledge on the changes in the hypothalamo-hypophyseo-adrenal cortex system and their effects in chronic alcohol use and withdrawal

The results of investigations into the changes in the function of the hypothalamus-hypophysis-renal gland system in chronic alcoholics are collated. The review shows that the activity of the hypothalamus-hypophysis-renal gland system is below-normal in at least some alcoholics, but due to conflicting results, it is not possible to decide whether the hypofunction of the adrenal gland is a primary of a secondary effect. The interrelationship between glucocorticosteroids and catecholamines is described and its importance for the adaptability of the organism is stressed. On the basis of the review it may seem advisable to introduce corticosteroid treatment into the therapeutic schema for delerious alcoholic patients and also to apply it on patients with the alcohol withdrawal syndrome if tests show that the function of their hypothalamus-hypophysis-renal gland systems is impaired.     

Clinical issues in the assessment of adolescent alcohol and other drug use

Clinicians working with adolescents are routinely faced with the issue that alcohol and other drug (AOD) involvement may be part of the clinical picture either as a primary problem or a contributing factor to other problems or disorders. Fortunately, assessment research in this area has produced several behaviorally oriented and psychometrically sound tools from which to choose for problem identification, referral and treatment of youth suspected of AOD abuse. The aim of this paper is to provide an overview of several issues related to the clinical utility of such assessment tools.     

A detection model of college withdrawal

Many students during their college careers consider withdrawing from their respective college or university. Understanding why some students decide to withdraw yet others persist has implications for both the well being of students as well as for institutes of higher education. The present study develops a model of the decision to withdraw drawing on theories of voluntary employee turnover from organizational psychology and signal detection theory from the cognitive sciences. The model posits that precipitating events or shocks (e.g., changes in tuition) lead students to consider withdrawing from the university. If the evidence surpasses a criterion then the student decides to withdraw. The model was used to identify shocks students were sensitive to and to test hypotheses about the underlying decision process. The theoretical implications of this model in terms of understanding and predicting student withdrawal decisions and voluntary employee turnover decisions are discussed.     

Children's judgements of social withdrawal behaviours

Ding et al. (Brit. J. Dev. Psychol., 2015; 33, 159–173) demonstrated that Chinese children discriminate between the three subtypes of social withdrawal: Shyness, unsociability, and social avoidance. This commentary on the Ding et al.'s paper highlights the need to further explore the following: (1) children's understanding of the implications of being shy, unsociable, or socially avoidant, including assessing these which we know are associated with outcomes for socially withdrawn children; (2) what additional subtypes might exist naturally within the Chinese culture; and (3) consider the implications of social withdrawal on children's developing social skills.     

Correlates of professional versus organizational withdrawal cognitions

Using a more rigorous research design than previous studies, results generally supported the discriminant validity of professional withdrawal cognitions (PWC) versus organizational withdrawal cognitions (OWC). The sample consisted of 226 medical technologists tracked over a five year period, and the research design used pre- and post-measures of PWC and OWC. Attitudinal professional commitment had a stronger negative relationship to subsequent PWC versus OWC, while gender discrimination and organizational support had stronger relationships to subsequent OWC versus PWC.     

Modification of social withdrawal through symbolic modeling

The present experiment was designed to test the efficacy of symbolic modeling as a treatment to enhance social behavior in preschool isolates. Nursery school children who displayed marked social withdrawal were assigned to one of two conditions. One group observed a film depicting increasingly more active social interactions between children with positive consequences ensuing in each scene, while a narrative soundtrack emphasized the appropriate behavior of the models. A control group observed a film that contained no social interaction. Control children displayed no change in withdrawal behavior, whereas those who had the benefit of symbolic modeling increased their level of social interaction to that of non-isolate nursery school children.     

Effects of ethanol withdrawal on muricidal behavior

When naive rats of our colony were individually housed for 1 month with free access to laboratory chow and water as drinking fluid, 6% exhibited muricidal behavior. When naive rats of the same colony were similarly housed but received ethanol 20% in water as the sole source of drinking fluid (ll.5 g ethanol/kg/day), the percentage of killer rats was the same. However, when the rats were housed in similar conditions and submitted to a 1-day ethanol withdrawal, the percentage of muricidal rats increased to 25%. Ethanol intake in the same conditions as described above did not change muricidal behavior of spontaneous killers and did not induce killing behavior in nonkiller animals. GABA-mimetic agents administered IP blocked ethanol withdrawal-induced killing behavior as well as spontaneous muricidal activity.     

Contemplative withdrawal in the Hellenistic age

I reject the traditional picture of philosophical withdrawal in the Hellenistic Age by showing how both Epicureans and Stoics oppose, in different ways, the Platonic and Aristotelian assumption that contemplative activity is the greatest good for a human being. Chrysippus the Stoic agrees with Plato and Aristotle that the greatest good for a human being is virtuous activity, but he denies that contemplation exercises virtue. Epicurus more thoroughly rejects the assumption that the greatest good for a human being is virtuous activity. He maintains that the greatest good for a human being is the tranquility that virtuous activity always and contemplative activity sometimes brings about.

Smoking withdrawal dynamics in unaided quitters

Considerable research shows that withdrawal severity is inconsistently related to smoking cessation outcomes. This may result from measurement problems or failure to scrutinize important dimensions of the withdrawal experience. Two recent studies demonstrated that withdrawal elevation and variations in the time course of withdrawal were related to relapse in smokers treated with the nicotine patch (T. M. Piasecki, M. C. Fiore, & T. B. Baker, 1998). This article reports a conceptual replication and extension of those findings in unaided quitters. Evidence for temporal heterogeneity was found across different types of withdrawal symptoms. Patterns or slopes of affect and urge reports over time predicted smoking status at follow-up, as did mean elevation in withdrawal symptoms. These results suggest that affect and urge withdrawal symptoms make independent contributions to relapse and that relapse is related to both symptom severity and trajectory.