Alcohol dependence: a biobehavioral perspective

Area of Science:

• Psychiatry
• Behavioral Science
• Addiction Research

Background:

• Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) differentiates alcohol abuse and dependence based on behavioral constructs.
• International Classification of Diseases, Ninth Revision (ICD-9) defines alcohol dependence syndrome following the Edwards and Gross model.
• World Health Organization (WHO) proposed alcohol dependence as a continuum of severity, distinct from alcohol-related disabilities.

Purpose of the Study:

• To review the evolution of alcohol dependence constructs.
• To contrast the disease model of alcoholism with behavioral and conditioning perspectives.
• To analyze scientific critiques of the biological disease model of alcohol addiction.

Main Methods:

• Review of diagnostic criteria from DSM-III and ICD-9.
• Examination of the WHO memorandum on alcohol-related problems.
• Analysis of behavioral research, including operant conditioning studies and longitudinal drinking practice studies.
• Evaluation of Pavlovian conditioning models applied to alcohol dependence.

Main Results:

• Behavioral research suggests drinking behavior is influenced by consequences and relapse is not inevitable, challenging the disease model.
• Operant studies provided evidence against a purely biological disease basis for alcohol addiction.
• Pavlovian conditioning models propose a link between alcohol desire and autonomic arousal.

Conclusions:

• Historical definitions of alcohol dependence have evolved, incorporating behavioral and severity-based perspectives.
• Behavioral science research has presented alternative explanations for alcohol addiction, questioning the traditional disease model.
• Conditioning models offer insights into the mechanisms underlying alcohol craving and dependence.