Emotion-Word Processing Difficulties in Abstinent Alcoholics With and Without Lifetime Externalizing Disorders

Background Evidence suggests that abstinent alcoholics have difficulties processing a variety of emotion‐laden stimuli, and some of these difficulties may not fully resolve with long‐term abstinence. The current study examined whether emotion‐word processing difficulties were present in long‐term abstinent alcoholics (LTAA; 18+ months of sobriety) with and without a previously diagnosed externalizing (EXT; antisocial personality disorder and/or attention‐deficit/hyperactivity disorder diagnosis) disorder. Methods Subjects (N = 121) completed an affective go/no‐go (AGNG) task with positive, negative, and neutral emotion‐word stimuli, and a lexical decision‐making (LDM) task with nonemotion word and nonword stimuli. Nonsubstance abusing controls (NSAC; n = 38, 50.0% women, mean age = 48 ± 7.8), LTAA with EXT (n = 32, 41% women, mean age = 47.1 ± 6.6), and LTAA without EXT (n = 51, 47% women, mean age = 49.7 ± 6.5) were compared between signal discriminability (d′) and mean response times (RT) for correct responses (mcRT). Results In the LDM task, LTAA had lower (d′) values and slower mcRT than NSAC. In the AGNG task, LTAA and NSAC did not differ in AGNG task mcRT. LTAA had lower (d′) values than NSAC, and this effect was partially associated with group differences in LDM task (d′) values. In LTAA, lower AGNG (d′) values also were associated with an earlier age of first drink, greater lifetime alcohol use, and a history of EXT disorder. Conclusions Our findings suggest that detecting the emotional content of words is impaired in LTAA, and this impairment is over and above LTAA's more general lexical processing difficulties. Results also suggest that specific emotion processing impairments in LTAA may be exacerbated by greater lifetime alcohol use burden and other comorbid EXT diagnoses.