Alcoholism (also known as Alcohol Use Disorder) refers to problematic drinking behaviours involving alcohol consumption. Alcoholism is present if diagnostic criteria, as identified in the Diagnostic and Statistical Manual of Mental Disorders (Fifth edition; DSM-5), is met. See Figure 1 for details.
Alcohol use can affect all parts of the body but particularly the brain, heart, liver, pancreas, and immune system. This can result in mental illness, an irregular heart beat, liver failure, and an increased risk of cancer, among other diseases.
THE ROLE OF NEUROFEEDBACK
Neurofeedback is regarded, by a large number of researchers, as a safe, comfortable way to dramatically reduce an individuals’ vulnerability to relapse when they are suffering from alcoholism. Neurofeedback is helpful in not only treating the neural bases of alcoholism, but also in treating the neural bases of other co-morbid issues such as depression, anxiety, insomnia, and trauma.
In 2017, Dalkner and colleagues conducted 12 sessions of neurofeedback on males with alcohol use disorder. They found evidence to suggest that neurofeedback enhancing and increasing alpha and theta waves could reduce the avoidance and stress-related personality traits common in alcoholism.
In 2015, Karch and colleagues found that patients with an alcohol use disorder were able to regulate their neuronal activities in an individualised cortical region of interest, whereas healthy subjects achieved no significant reduction. After the neurofeedback sessions, individual craving was also slightly reduced compared to baseline.
In 2008, Sokhadze and colleagues concluded that, based on published clinical studies, alpha theta training, either alone for alcoholism or in combination with beta training for stimulant and mixed substance abuse and combined with residential treatment programs, is probably efficacious.
In 2008, Calloway and Bodenheimer-Davis investigated the use of the Peniston protocol with a variety of substance use disorders including alcohol, marijuana, prescription medication, and polysubstance use with alcohol and another drug. 16 participants from a university-based clinic underwent the Peniston Protocol. This was compared to 24 control participants. Results indicated that 13 members from the Peniston protocol group were abstinent at follow-up between 74 and 98 months after treatment, which is a higher rate of long-term abstinence than conventional treatments for substance dependence.
In 2005, Trudeau concluded that neurofeedback is a promising treatment option for adolescents, especially those with stimulant abuse and attention and conduct problems.
In 2004, Quinn and colleagues noted that there has been growing evidence for the efficacy of therapies that teach self-regulation of biopsychological processes for alcoholism (particularly neurofeedback therapy), including reports of high success rates. However, there is a gap between practice and knowledge, with neurofeedback therapy been rarely used for the treatment of alcoholism.
In 2002, Egner and colleagues noted that alpha/theta neurofeedback training has in the past successfully been used a complementary therapeutic relaxation technique in the treatment of alcoholism. They also found that accurate alpha/theta neurofeedback effectively facilitates production of higher within-session theta/alpha ratios than do non-contingent feedback relaxation.
In 1998, Graap and Freides conducted a review of five papers that look at the efficacy of alpha-theta EEG biofeedback treatment for alcoholism. They question whether the samples studied were independent, what was the clinical status of the participants prior to treatment, and what treatment did the participants actually receive.
In 1997, Kelley used the Peniston protocol with a group of subjects who were members of the Navajo Nation and alcohol dependent. 40 neurofeedback sessions were given in addition to the treatment received during a 33-day inpatient abuse program. The results at a 3-year follow-up indicated that 12 of the subjects had sustained partial remission, four had sustained full remission, and three remained dependent on alcohol. A significant decrease in Beck Depression Inventory scores at post-test was also see.
In 1995, Saxby and Peniston used the protocol by Peniston and Kulkosky with a group of alcohol dependent patients from an outpatient treatment program. They found that compared to pre-rest, participants had significantly lower Beck Depression Inventory scores and significantly decreased personality variable scores on the Million Clinical Mulitaxial Inventory across schizoid avoidance, dependent, histrionic, passive-aggressive, schizotypal, borderline, anxiety, somatoform, hypomanic, dysthymic, alcohol abuse, drug abuse, psychotic thinking, and psychotic depression scales. At a 21-month follow-up, it was reported that only one of the 14 subjects relapsed.
In 1989, Peniston and Kulkosky found that alpha-theta EEG training with participants from the Topeka Veterans Affairs hospital inpatient program led to significant increases in alpha and theta activity and alpha rhythm amplitude, as well as improvements in sustained abstinence. This was true regardless of whether they had or did not have alcohol dependency.
Calloway, T. G., & Bodenheimer-Davis, E. (2008). Long-term follow-up of a clinical replication of the Peniston Protocol for chemical dependency. Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience, 12(4), 243–259.
Egner, T., Strawson, E., & Gruzelier, J. (2002). EEG signature and phenomenology of alpha/theta neurofeedback training versus mock feedback. Applied Psychophysiology Biofeedback, 27(4). 261-270.
Graap, K., & Freides, D. (1998). Regarding the database for the Peniston alpha-theta EEG biofeedback protocol. Applied Psychophysiology Biofeedback, 23(4), 265-272.
Karrch, S., Keeser, D., Hummer, S.,…, Ertl-Wagner, B., & Pogarell, O. (2015). Modulation of craving related to brain responses using real-time fMRI in patients with alcohol use disorder. PLoS ONE, 10(7), e0133034.
Kelley, M. J. (1997). Native Americans, neurofeedback, and substance abuse theory: Three year outcome of alpha/theta neurofeedback training in the treatment of problem drinking among Dine’ (Navajo) People. Journal of Neurotherapy, 2(3), 24–60.
Peniston, E. G., & Kulkosky, P. J. (1989). Alpha-theta training and beta endorphin levels in alcoholics. Alcoholism: Clinical and Experimental Research, 13(2), 271–279.
Quinn, J., Bodenhamer-Davis,E.,. & Koch, D. (2004). Ideology and the stagnation of aoda treatment modalities in America. Deviant Behaviour, 25(2), 109-131.
Saxby, E., & Peniston, E.G. (1995). Alpha-theta brainwave neurofeedback training: An effective treatment for male and female alcoholics with depressive symptoms. Journal of Clinical Psychology, 51(5), 685–693.
Sokhadze, T., Cannon, R., & Trudeau, D. (2008). EEG biofeedback as a treatment for substance use disorders: Review, rating of efficacy and recommendations for future research. Journal of Neurotherapy, 12(1), 5-43.
Trudeau, D. (2005). Applicability of brain wave biofeedback to substance use disorder in adolescents. Child and Adolescent Psychiatric Clinics of North America, 14(1), 125-136.