Impairments in affect regulation, or the ability to manage emotions, have been implicated in the development and maintenance of alcohol dependence. The construct of affect regulation, which has been defined in varying ways, generally refers to internal processes that allow one to keep emotions within tolerable levels so that they can be used as sources of information to be acted upon accordingly. It has been theorized that alcoholics drink in order to deal with distressing emotions, either because they have a greater amount of negative emotion than others, or because they lack the internal resources to deal with negative emotion. However, there has been little empirical study of affect regulations in alcoholics, partly due to the lack of adequate measures for affect regulation. Alcoholics report experiencing negative affect more than non-alcoholics, and tend to experience their emotions as overwhelming and intolerable. They have difficulty recognizing or expressing emotions (alexithymia), and have little ability to modulate their distress. In theory, excessive use of alcohol may represent a compulsive attempt to regulate negative emotion. If specific impairments in affect regulation can be identified that are related to alcohol dependence, treatment and prevention might be improved by incorporating specific training in affect regulation based on this empirical research. Preliminary studies in a sample of alcoholics and their family members (n=321) suggest a strong relationship between variables related to affect regulation, such as negative emotionality and insecure attachment, and alcohol dependence, that is modified by gender and age. We will develop a new measure of affect regulation designed to fill the gaps left by current measures and to capture impairments in affect regulation most strongly related to alcohol dependence. We will supplement with other available instruments that measure constructs associated with affect regulation, including negative emotionality, alexithymia, negative mood regulation expectancies, object relations, defenses, and components of emotional intelligence to determine the relationship of affect regulation to alcohol dependence. Subjects will be selected from a population of alcoholics and their family members participating in an ongoing study on the genetics of alcoholism. A structured interview will be used to diagnose alcohol and other drug dependence, and the MMPI-2 will be administered. Hypotheses regarding the relationships between affect regulation factors and presence, severity, subtype, family history and other components of alcohol dependence will be tested. How these relationships are modified by age, gender and substance dependence will be explored. In addition, the relationship between duration of abstinence in recovering alcoholics and affect regulation will be determined. Measure development will proceed using a rational- empirical approach to test construction, with an expert panel consulting on item development. The new measure will be tested in normative and clinical populations, including the sample of alcoholics in the genetic study. Findings will advance our understanding of personality impairments underlying alcohol dependence, refine the definition and measurement of affect regulation, and possibly provide a point of intervention for treatment of alcohol dependence.
