Comparison of Alcohol Abusers and have not Experienced Blackouts--论文代写范文精选

正如上面提到的,酒精导致的问题可能更普遍，对于认知障碍(潜在的大脑错乱),长期饮酒后的职业生涯中，并非所有的酗酒者患有智力障碍。有可能已经智力受损。可能反映了酒精对大脑的影响。下面的paper代写范文进行详述。

Abstract 
This study examined the proposition that the experience of alcoholic blackouts is related to other indices of cerebral involvement in the alcoholic process. In particular it was suggested that those who experience alcoholic blackouts would also show signs of the effects of alcoholic damage in the form of lower scores on cognitive functions vulnerable to the effects of long-term alcohol abuse. While some evidence was found linking the experience of blackout to severity of the alcohol problem no relationship was found between cognitive functioning and the experience of blackout. The possibility that different mechanisms may underlie the various cognitive sequelae of alcohol abuse is raised.

Introduction 
Blackouts, periods of time when intoxicated for which the person has little or no memory [1], are common among drinkers of all sorts, from those with relatively modest consumption to the severely alcoholic [2, 3, 4]. They are characterised by Lishman [1] as involving “ a dense amnesia for significant events which have occurred during a drinking episode, when at the time outward behaviour perhaps seemed little disordered” (p. 595). While they can occur early on in drinking careers [5, 6, 7], there are some indications that they become more frequent with severity of alcohol problems and duration of alcohol consumption [2, 4, 8, 9,10]. The mechanism underlying blackouts is unknown. 

There is some evidence that they may be related to the rapidity of the rise in blood alcohol level [11]. As mentioned above, blackouts may be more common among late stage drinkers and cognitive impairment (and presumably underlying cerebral derangement of some sort) is also more common among the same group [see e.g., 12]. However, not all heavy drinkers or the alcoholically dependent suffer from blackouts and not all suffer from intellectual impairment even after long drinking careers. It is possible that those already intellectually compromised may be more susceptible to blackouts. Or, it is possible that both reflect a greater cerebral sensitivity to the effects of alcohol. In either case there should be an association between blackouts and intellectual impairment. 

To the author’s knowledge, only one study has examined this proposition. Tarter and Schneider [8] compared alcoholics with high (N = 23) and low (N = 27) incidence of blackouts on four measures of learning and memory including the well known Wechsler Memory Scale [13] and found no difference between the groups. However, since this is the only study of its kind, it may be timely to revisit the question.

Method
The study was approved by the Institutional Ethics Committee of St. Patrick’s Hospital, Dublin and was in compliance with the Helsinki Declaration of 1975, as revised in 1983. The sample consisted of 67 alcohol abusing inpatients of an Irish private psychiatric hospital who had been referred for examination of suspected cognitive impairment secondary to alcohol abuse. All had received a firm diagnosis of the alcohol dependence syndrome (ADS) according to ICD-9 criteria [14]. The concept of alcohol dependence syndrome is very similar to alcohol dependence of DSM, for which it was a model. All patients were attending the hospital alcohol treatment program.

Discussion 
This study replicates some previous findings. The presence of blackouts was related to some measures of severity of problem – withdrawal symptoms and loss of control. However, contrary to the findings of some others [8, 9], blackouts were not related to duration of problem. The hypotheses that blackouts either reflect a general vulnerability to the cerebral consequences of alcohol abuse or are associated with other forms of more enduring cognitive impairment did not receive any support. In this finding the present study agrees with Tarter and Schneider [8], which to the author’s knowledge is the only other study to have examined this relationship. The lack of a relationship between duration of problem drinking and the presence of blackouts is interesting in the light of the finding that blackouts may occur early on in drinking careers [5, 7]. 

This, and the findings of the current study are consistent with Lishman’s [25] suggestion that there may be different and independent routes to the several forms of alcohol-related cerebral impairment. One possibility is that the locus of the short-term blackout effect is in the hippocampus [26, 27] whereas the cognitive inefficiencies frequently found among alcoholics [28] may be more related to enduring damage to the frontal cortex as a consequence of long term alcohol abuse [29]. The results are somewhat limited by methodological concerns. It could perhaps be argued that presence/absence of blackouts is a rather crude measure and information regarding age of onset; number, duration and intensity might have yielded more sensitive and powerful indices of blackout. 

Certainly, it would be useful to have such indices, but they were not included in the original coding. However, blackout is a phenomenon that does not occur in all heavy drinkers/alcoholics and a presence/absence measure is a defensible index of susceptibility. It is also possible that relationships between blackout and cognition might have been better demonstrated through more extensive and sophisticated examinations of cognitive functioning rather than the relatively brief and clinical measures used in this study. A further limitation is the relatively small number for the analysis of cognitive variables which would not have maximised power. Nonetheless the data presented here suggest that alcoholic blackouts and more enduring alcohol-related cognitive impairment are not closely related phenomenona. Blackouts are a remarkably under researched phenomenon and the author believes with Lishman [1] that “correlates of individual vulnerability (to blackout) remain an important question for further investigation.” (p. 595).

51Due网站原创范文除特殊说明外一切图文著作权归51Due所有；未经51Due官方授权谢绝任何用途转载或刊发于媒体。如发生侵犯著作权现象，51Due保留一切法律追诉权。(paper代写)
更多paper代写范文欢迎访问我们主页 www.51due.com 当然有paper代写需求可以和我们24小时在线客服 QQ:800020041 联系交流。-X(paper代写)