"AT-RISK" BRAINS OFFER CLUES ABOUT ALCOHOLISM,
ANTISOCIAL BEHAVIOR

Studies suggest that impaired function of the brain's frontal lobes contributes to a host of pathological behaviors ranging from hyperactivity to homicide (See Crime Times, Vol. 1, No. 1/2, Page 1 , Crime Times, Vol. 1, No. 4, Page 6 and Crime Times, Vol. 2, No. 3, Page 7 ). Now, A. Wallace Deckel et al. report evidence that frontal lobe dysfunction also is a risk factor for destructive drinking-and that this dysfunction may be detectable in at-risk individuals before they become problem drinkers. In addition, Deckel et al.'s research offers clues as to why alcoholism and sociopathic behavior often go hand-in-hand. Among their findings:

• Different people have different expectancies about how alcohol will affect them, with heavy drinkers expecting more positive effects than light drinkers. These expectancies, Deckel et al. say, "are important in both the initiation and maintenance of drinking," and are predictive of drinking habits during the teenage and adult years as well as the likelihood of success in alcohol treatment programs.

  Evaluating 91 young men at risk of developing alcoholism but with no histories of alcohol dependency, the researchers found that frontal lobe function was significantly related to the expectations subjects had about alcohol use. Neuropsychological tests and electroencephalogram (EEG) measurements of frontal/prefrontal functioning correlated with subjects' expectations about how alcohol would affect their overall mood and abilities, their sexual attractiveness and desire, and (to a lesser degree) their social assertiveness.

  These results, Deckel et al. say, "suggest that one risk factor of alcohol-related behavior-the expected effect of alcohol on one's behavior-may be, at least in part, biologically based and regulated by frontal systems."

• Testing the same subjects, Deckel et al. found that scores on tests measuring frontal and/or temporal neocortex functioning "predicted the age at which subjects took their first drink and their scores on the MAST [Michigan Alcoholism Screening Test]," and that tests of frontal functioning and memory predicted how often subjects drank to get drunk or "high." Furthermore, they say, "frontal left-hemisphere slow alpha EEG correlated both with the age at which drinking began and the frequency with which the subjects drank to get `high.' In both cases, lower levels of EEG activity (presumably reflecting decreased activation of this area) were associated with increased alcohol-related behaviors."

• Deckel et al. evaluated the performance of 104 young adult men and women, 66 of whom had a family history of alcoholism, on tests of frontal lobe functioning. The researchers also determined whether or not subjects had exhibited hyperactivity, impulsivity, and/or conduct problems during childhood.

  Three years later, Deckel et al. evaluated changes in their subjects' drinking patterns. The researchers found that childhood behavior problems predicted increasing drinking problems as measured by the MAST, and that poor scores on tests of "executive functions"-skills performed largely by the frontal lobes-were associated with increased alcohol use at follow-up, especially in subjects with family histories of alcoholism.

• Deckel et al. next examined data from 89 of their previous 91 male study subjects, to see if frontal lobe functioning correlated with antisocial personality disorder (ASP). Subjects had been recruited for this study on the basis of being at risk for ASP as well as alcoholism, and 34 of the men met criteria for ASP.

EEGs and neuropsychological test data, the researchers say, showed an association between impaired frontal lobe function, ASP, and childhood behavior problems. ASP and childhood conduct disorder and hyperactivity were associated with greater activation or right relative to left frontal EEG activity.

Their findings, the researchers say, suggest that disturbed frontal lobe function "may be one common biological ground" linking antisocial personality disorder and alcohol abuse.

"Behavioral and cognitive measurements predict scores on the MAST: a 3-year prospective study," A. Wallace Deckel and Victor Hesselbrock, Alcoholism: Clinical and Experimental Research, Vol. and anterior brain functioning in young men at risk for developing alcoholism," A. Wallace Deckel, Victor Hesselbrock, and Lance Bauer, Alcohol: Clinical and Experimental Research, Vol. 19, No. 2, April 1995, pp. 476-481; "Anterior brain dysfunctioning as a risk factor in alcoholic behaviors," A. Wallace Deckel, Lance Bauer and Victor Hesselbrock, Addiction, 90, 1995, pp. 1323-1334; and "Antisocial personality disorder, childhood delinquency, and frontal brain functioning: EEG and neuropsychological findings," A. Wallace Deckel, Victor Hesselbrock, and Lance Bauer, Journal of Clinical Psychology, Vol. 52(6), 1996, pp. 639-650. Address for all: A. Wallace Deckel, ARC, Department of Psychiatry, Mail Code 2103, University of Connecticut Medical School, 263 Farmington Avenue, Farmington, CT 06030, e-mail: Deckel@psychiatry.uchc.edu.

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