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Licensed Unlicensed Requires Authentication Published by De Gruyter December 21, 2013

Cognitive control in alcohol use disorder: deficits and clinical relevance

Claire E. Wilcox EMAIL logo , Charlene J. Dekonenko , Andrew R. Mayer , Michael P. Bogenschutz and Jessica A. Turner


Cognitive control refers to the internal representation, maintenance, and updating of context information in the service of exerting control over thoughts and behavior. Deficits in cognitive control likely contribute to difficulty in maintaining abstinence in individuals with alcohol use disorders (AUD). In this article, we define three cognitive control processes in detail (response inhibition, distractor interference control, and working memory), review the tasks measuring performance in these areas, and summarize the brain networks involved in carrying out these processes. Next, we review evidence of deficits in these processes in AUD, including both metrics of task performance and functional neuroimaging. Finally, we explore the clinical relevance of these deficits by identifying predictors of clinical outcome and markers that appear to change (improve) with treatment. We observe that individuals with AUD experience deficits in some, but not all, metrics of cognitive control. Deficits in cognitive control may predict clinical outcome in AUD, but more work is necessary to replicate findings. It is likely that performance on tasks requiring cognitive control improves with abstinence, and with some psychosocial and medication treatments. Future work should clarify which aspects of cognitive control are most important to target during treatment of AUD.

Corresponding author: Claire E. Wilcox, Department of Psychiatry, 1 University of New Mexico, MSC 09-5030, Albuquerque, NM 87131, USA, e-mail:

The writing of this article was supported by the National Institute on Alcohol Abuse and Alcoholism-funded grant K23 AA021156-01A1, awarded to Dr. Claire Wilcox, who is being mentored by, among others, Drs. Michael Bogenschutz and Andrew Mayer, both co-authors on this work.


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Received: 2013-11-17
Accepted: 2013-11-27
Published Online: 2013-12-21
Published in Print: 2014-02-01

©2014 by Walter de Gruyter Berlin Boston

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