The cognitive determinants of alcohol use, abuse and dependence

Hubbard, Lucy Jane (1998) The cognitive determinants of alcohol use, abuse and dependence. University of Southampton, Doctoral Thesis.

Abstract

There is a general consensus that there is a lack of comprehensive, multi-factorial causation models of alcohol problems. This paper focuses on two potential causative factors that have been relatively neglected in such multi-factorial models - the cognitive process and content that underpin alcohol abuse and dependence. The paper draws on the more extensive literature concerning cognitive processes and content in the related impulse control disorder of bulimia nervosa, in order to develop hypotheses in the alcohol field. Specifically, the cognitive processing of disorder-related material is considered, as well as the cognitive processing of more general self-esteem threats. The literature is discussed in relation to the escape models of bulimia and alcohol abuse/dependence. A causation model is proposed that integrates the cognitive processing of disorder- and threat-related concepts in both alcohol abuse/dependence and bulimia. Comparisons are then made between the cognitive content in these two disorders. Finally, the clinical implications of these ideas are discussed, as well as areas for future research.

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