A New Take on Alcoholics

Jordan Bailey

Photo by Lynda Giddens

A recent study contradicts previous evidence that decreased ERN, the brain’s response to making an error, is a general characteristic of substance abuse. In previous studies and experiments, researchers concluded that those who suffer from substance abuse generally have a lower ability to detect when they have made a behavioral error, thus explaining why substance abuse patients often engage in erratic or dangerous behavior that is typically avoided by sober people. But a recent study shows that alcoholic patients who suffer from one or more additional psychological disorders differ from those who have alcoholism and no other disorders. This study has found that alcoholics who also have anxiety disorders display a greater ability to control behavioral errors than those who do not have anxiety disorders. The study suggests that sub-groups of alcohol dependent patients exist and need to be further researched.


This study focuses specifically on alcohol abusers who have co-occurring psychological disorders. An observational study was done on 44 male participants aged 18-55. Twenty-one of which were alcoholics, eight were alcoholics with anxiety disorders, and 15 participants were healthy controls. To account for confounding variables, the study excluded men who were on medication that has been shown to affect ERN, those who have had recent significant changes in their medical history, and those with psychotic symptoms.


The men were given a series of choice reaction tests. In this type of test, participants are asked to perform one action for a certain stimulus, and perform a different action for another. For example, participants are asked to push one button if a light turns red, and push another if they are shown a yellow light. These tests are graded based on skill, accuracy, and speed. Choice reaction test results revealed alcoholics scoring higher in harm avoidance, reward dependence, and persistence categories. Participants were also given Eriksen Flanker tests, a group of tests designed to measure the ability of patients to avoid impulses that are inappropriate for the context. In these tests, alcoholics exhibited longer reaction times but equivalent accuracy.


Test results, along with ERN amplitudes and personality characteristics, were compared between alcoholics and non- alcoholics. Additionally, the study explored the relationship between ERN amplitude and psychological disorders in alcoholics. The study’s findings are based largely on ERN measurements. Increased ERN, or a greater ability to control one’s behavior, is generally exhibited in those who have anxiety disorders. Decreased ERN, a lower ability to control one’s behavior, is often seen in patients with disorders such as ADHD or borderline personality disorder. ERN amplitudes, or the extent to which participants are aware of their errors, were increased for alcoholics and for alcoholics with anxiety disorders. These findings are in contrast with existing research on substance abusers.


Scientists previously thought that decreased ability to process error contributed to alcoholism, but this study shows that reduced action monitoring is in fact not a general component of substance abuse. Alcoholics who suffer from additional psychiatric disorders therefore create a novel category of alcoholics who exhibit different symptoms and therefore require different methods of treatment. These findings demand further research for patients addicted to other substances with psychological disorders.






Work Cited:
Schellekens, Arnt, Ellen de Bruijn, Christa van Lankveld, Wouter Hulstijn, Jan Buitelaar, Cor de Jong, and Robbert Verkes. "Alcohol dependence and anxiety increase error-related brain activity." Addiction Research Report 105.11 (2010): 1928-34. EBSCOhost. Web. 05 Feb 2012. <http://ehis.ebscohost.com/ehost/detail?vid=4&hid=101&sid=06e4be1d-6d23-49f8-92f5-9ebc55fc68c6@sessionmgr110&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl