Social cognition in AUD recovery: Understanding trajectories, consequences, and mechanisms of change for deficits in emotion processing

Project Summary Alcohol Use Disorder (AUD) is characterized by attenuated capacities to recognize and interpret the emotional states of others. Extant cross-sectional studies have described these deficits and confirm their association with interpersonal difficulties. However, no current data adequately inform the capacity for change in emotion

processing during early abstinence, the putative cognitive/affective mechanisms underlying such change, or resultant impacts on treatment adherence, relapse, or other clinically-relevant recovery outcomes. The proposed project addresses these three critical gaps. The fundamental approach involves longitudinal assessment of emotion processing from treatment initiation to

discharge (~3 months). We will recruit recently-abstinent individuals in residential treatment for AUD. We will also recruit a matched sample of community controls, facilitating characterization of practice effects. In addition to longitudinal collection of emotion processing performance, indexed via multimodal computerized assessment

tasks, we will also interrogate non-affective cognitive functions (e.g., inhibitory control) and intrapersonal measures of affect processing (e.g., emotion regulation). In addition to surveillance of treatment adherence (e.g., dropout, readmission), treatment outcome indices will be provided by both patients and clinicians, and will include

post-discharge assessments of functioning (e.g., quality of life; resumption of use). We will delineate the growth function(s) indexing change in social cognition over the first three months of abstinence, allowing us to test the hypothesis that these functions improve, as well as describe what constitutes

normal vs. maladaptive rates of recovery. We will employ statistical models facilitating causal inference to test the hypotheses that alterations in executive functions, intrapersonal affect processing, and mood constitute underlying mechanisms of AUD-associated deficits in interpersonal emotion processing. We will test the

hypothesis that change in emotion processing will drive subsequent improvements in a range of clinically- relevant outcomes, and examine putative mediators (e.g., social support) of these relationships. Execution of the proposed project will provide actionable data guiding identification of at-risk patients for whom

intervention may be most impactful, as well as critical periods for intervention delivery. Results will directly contribute to the development of interventions designed to enhance emotion processing by facilitating selection of the most appropriate mechanistic targets. Resulting data will determine the breadth and magnitude of

clinically-relevant recovery outcomes impacted, facilitating estimation of potential intervention efficacy. Our laboratory has the requisite experience to execute these aims, the ongoing relationships with treatment facilities required to collect the data, and the expertise to translate findings into social cognitive interventions.