Alcoholism Alters Women’s Decision-Making Abilities

Alcoholism Alters Women’s Decision-Making AbilitiesWomen participate in heavy drinking less often than men. However, when they do drink heavily, women commonly experience alcohol-related harm more rapidly than their male counterparts. In a study scheduled for publication in 2014 in the journal Addiction Biology, researchers from Indiana University looked at what happens to the decision-making processes of women who develop the symptoms of alcoholism. These researchers concluded that alcoholic women lose a substantial portion of their ability to efficiently make choices when faced with situations that require them to assess the risks of their alcohol intake-related decisions.

The Basics

Alcoholism is defined by a physical dependence on alcohol’s brain effects, as well as such things as a repeated craving for alcohol, symptoms of withdrawal when alcohol intake runs low or stops, and the adoption of a daily routine that stresses the importance of alcohol-related actions (obtaining alcohol, consuming alcohol and recovering from bouts of drinking). Many of the personal and social problems associated with alcoholism also occur in alcohol abusers who don’t have a physical dependence on drinking. For this reason, the American Psychiatric Association considers alcoholism and alcohol abuse as two facets of a single condition called alcohol use disorder.

Women and Alcohol

Alcohol is toxic to human health, and the body must break this toxin down in order to effectively reduce any risks for serious short- or long-term damage. Compared to men, women break down the alcohol in their systems relatively slowly; in addition, they typically weigh substantially less than men. For these reasons, women usually have a lower threshold for drunkenness than men and also experience drinking-related harm from lower levels of alcohol intake than men. In accordance with these facts, public health guidelines recommend that women keep their daily and weekly alcohol intake well below the amounts allowable for men. Women and men who exceed the gender-specific recommended daily or weekly totals for alcohol consumption significantly increase their chances of developing diagnosable symptoms of alcohol abuse or alcoholism.

The National Institute on Alcohol Abuse and Alcoholism lists a number of gender-specific health problems that are linked to alcoholism and alcohol abuse in women. Prominent examples of these problems included heightened risks for developing serious alcohol-related liver disease, heightened chances for developing breast cancer and heightened risks for developing heart problems related to habitual drinking. Female alcoholics are also more susceptible to serious alcohol-related brain dysfunction than their male counterparts.

Impact on Decision-Making Abilities

In the study published in Addiction Biology, the Indiana University researchers used modern brain scanning technology called functional magnetic resonance imaging (fMRI) to compare the ways that women affected by alcoholism make alcohol-related choices to the ways that women unaffected by drinking issues make such choices. This project involved 16 women with a diagnosis for alcoholism, as well as 15 women not touched by alcoholism. While undergoing fMRI scans, the women in each of these groups were asked to make alcohol-related decisions in fairly low-risk situations (such as consuming a drink or two with friends), as well as alcohol-related decisions in clearly high-risk situations (such as drinking five or six drinks in a very brief span of time).

When they compared the two groups of women, the researchers came to several important conclusions. First, they found that, when faced with high-risk drinking situations that could potentially produce seriously negative consequences, women affected by alcoholism “turn off” pathways in their brains that make them more likely to consider alcohol consumption as a viable option. At the same time, women not impacted by alcoholism “turn on” pathways in their brains that allow them to frame their current decisions in the context of future outcomes. Conversely, the researchers concluded, women affected by alcoholism simultaneously “turn on” the brain pathways that favor more drinking, as well as the pathways that allow them to see their actions in a broader context. In essence, this means that women affected by alcoholism can’t think clearly when faced with high-risk drinking situations, and therefore can’t decide what to do. By default, this lack of decision-making leads to a continuation of the current pattern of behavior; that is to say, it leads to more drinking.

Significance and Considerations

The authors of the study published in Addiction Biology undertook their work, in part, because most of the research conducted on alcoholism-related issues focuses on men, not women. They consider the current study part of an ongoing series of projects touching on the decision-making abilities of women impacted by alcohol use disorder.


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