Intellectual impairment in alcoholics: persistent issues.

Intellectual impairment in sober intermediate stage alcoholics has been well established. However, a number of persistent issues remain to be explored. Three of the most important concern 1) variability in cognitive-perceptual functioning in samples of alcoholics, 2) differential vulnerability of cognitive-perceptual functions to alcohol abuse and 3) the relationship of cognitive-perceptual impairment to treatment behaviour and benefit. Consideration of these issues resulted in the following conclusions. There is a substantial minority of alcoholics who do not manifest impairment on any given cognitive test. Variability of findings with different samples of alcoholics may be, in part, a function of family history of alcoholism and/or severity of alcoholism. Verbal and rote learning functions are less sensitive to alcohol abuse than non-verbal, or complex verbal, abstracting/problem-solving skills. Alcoholics' impersonal and interpersonal problem-solving abilities are both impaired but appear to be uncorrelated. Impairment in cognitive-perceptual functioning in alcoholics does predict therapists' ratings of treatment behaviour and benefit.