The aim of this project is to uncover mechanisms that would account for impairments in cognitive functioning in neuropsychiatric disorders, particular in syndromes that are associated with alcohol abuse. A cognitive neuroscience prospective is used to consider how alterations in cognitive functioning in alcoholics is involved in the development and maintenance of alcohol addiction and abuse. To this end our current research efforts have been concerned with selective impairments in reflective cognitive operations (in contrast to data, or stimulus-driven cognitive operations) in detoxified alcoholics. A variety of cognitive functions, ranging from perception to attention to memory, can be categorized as requiring reflective information processing in contrast to more stimulus driven automatic cognitive operations. Reflective functions, sometimes termed top-down, goal directed, or controlled functions, operations that require cognitive capacity, conscious mediation, are interruptable, and are relatively flexible in functionality. Operations in which subjects track, monitor and evaluate their cognitive performance, inhibit """"""""inappropriate"""""""" responses, plan, strategically allocate cognitive resources are all examples of reflective functions. Conversely, stimulus-driven functions, also termed bottom-up or automatic functions, require little or no cognitive capacity, happen without awareness or conscious intervention, run to completion once initiated, and are inflexible. Studies have been designed to characterize alterations in reflective cognitive operations in alcoholic patients, in other populations of drug abusers as well in normal aging, in several populations of neuropsychiatric disorder patients as well as in response to different classes of drugs that mimic the cognitive deficits that are expressed in some of these disorders.. Some of the questions that we have attempted to address and answer include: 1) Do alcoholics express specific deficits in reflective cognitive operations and to what extent are these cognitive changes distinct from the types of cognitive changes apparent in other populations (i.e., other neuropsychiatric disorders and normal aging); 2) What are some of the conditions that potentiate and attenuate underlying impairments in reflective cognitive functions; 3) What neurobiological and behavioral mechanisms, determinants, may account for and be associated with impairments in reflective cognitive functions; 4) What are some of the clinical and therapeutic implications of this type of cognitive impairment.
