Alcohol, Gender, and Brain Activity

New research exploring the reasons that men seek out alcohol to regulate difficult emotions compared to women suggests distinct motives and long-term effects on brain structures due to alcohol abuse. This important, but still preliminary research, indicates a need to tailor gender-specific treatment plans for men and women recovering from alcohol use disorders (AUDs).

Gender Plays a Role in Dysfunctional Emotional Processing

Individuals who inaccurately interpret emotional information (facial expressions) and/or who find it difficult to regulate painful emotions (fear, stress, or anxiety) are more prone to develop AUDs. In other words, compelling evidence shows a strong relationship between impaired processing of emotions/emotional information and the development of AUDs.

Neuroscientists have also found that in general men and women process emotions differently and develop distinct affective and/or personality disorders. For example:

  • Women react more strongly to emotional stimuli (negative or positive)
  • Women are more emotionally expressive
  • Men are more likely to repress emotional responses
  • Women are more accurate in their interpretations of the emotions of others
  • Men are 2 times more likely to develop antisocial personality disorders
  • Women are 2-3 times more likely to develop affective disorders such as anxiety or depression

Neuroimaging and Emotional Dysregulation

In addition to identifying gender differences in emotional processing, neuroimaging has enabled researchers to pinpoint the specific brain regions responsible for evaluating and processing emotions. They are also able to monitor changes in brain activity in those regions – whether tracking more intense or more muted reactions to emotional stimuli. For example, using fMRI technology (which measures changes associated with blood flow to specific regions of the brain), a neuroscientist can identify when an individual exhibits a stressful emotional reaction to negative emotional content, such as a gruesome photo. Researchers can also detect when an individual reacts inappropriately to the same content – that is, an individual may show very little emotional reaction to a photo most people would consider gruesome or disturbing.

Given a body of evidence of gender differences in emotional processing and the ability to monitor the brain regions involved in those processes, researchers have begun to look for gender differences in the patterns of brain activation related to emotional processing.

Gender and Alcohol Consumption Patterns

Research shows emotional processing abnormalities may serve as a reliable predictor of which individuals will develop AUDs. And, because dysfunctions regarding emotional processing differ between women and men, collaborating researchers from the Boston University School of Medicine and VA Boston Healthcare System set out to determine whether AUDs give rise to gender-specific brain abnormalities and gender-specific motivations for alcohol abuse.

Since women are more likely to react in painful ways to stressors as well as more commonly deal with anxiety or depression, the Boston-area researchers predicted women seek out alcohol for its depressant effects. The researchers further theorize that men, on the other hand, who are more likely to repress highly charged emotions, may seek out the stimulant effects of alcohol.

Typically, alcohol is considered a depressant and thus associated with reducing tension and alleviating anxiety. But it can produce stimulant effects, including a sense of well-being and euphoria. This dual effect of alcohol may support a view that men and women consume alcohol in search of different effects. Men may drink in order to overcome emotional numbness – seeking out its stimulant effects. Women, on the other hand, may drink to alleviate painful, stressful emotional reactions.

Emotional Numbness vs. Hypersensitivity

Using fMRIs and sophisticated, evidence-based tests for eliciting and measuring responses to negative, positive, and neutral emotional stimuli, researchers found evidence supporting a view that men and women develop AUDs for different reasons. They also reported that the long-term damage among individuals recovering from AUDs appears to be gender-specific as well.

The men and women participating in this study who were diagnosed with an AUD had been abstinent for a period of time – the average period of abstinence was 7 years. The brain activity of these abstinent men and women was then compared to control subjects – men and women who do not have a history of alcohol abuse.

Researchers did find evidence that men recovering from AUDs were more likely to show very little brain activation or emotional response to positive or negative emotional stimuli. In fact, they showed even less emotional response than men who do not abuse alcohol. Men recovering from AUDs were effectively more emotionally numb than men without a history of AUDs, women without a history of AUDs, and women recovering from AUDs.

Women who had abused alcohol, on the other hand, showed greater sensitivity – most notably negative reactions – to disturbing emotional stimuli, compared to women without a history of AUDs, men without a history of AUDs, and men recovering from AUDs.

Future Directions on Gender-Specific Brain Abnormalities and Emotional Processing

What’s still not known is whether the changes in emotional sensitivity – greater numbness or hypersensitivity among recovering men and women respectively – pre-existed the AUDs or whether these emotional processing deficits were a consequence of the AUDs. Researchers have already demonstrated that the very existence of emotional numbness and emotional sensitivity is a predictor of developing and maintaining AUDs. However, it is still not clear whether a tendency to develop an AUD – either among men or women – is the main cause of the emotional processing abnormalities still present in abstinence.

Also, important for further research is to determine if the gender-specific presence of emotional numbness and emotional hypersensitivity can be targeted in order to reduce or alleviate the harm from these emotional patterns. A concern is that the persistence of numbness in men recovering and hypersensitivity in women may lead to relapse.

Overall, this research offers one clear direction for the future: developing treatment plans that are sensitive to gender differences in the motivations for developing AUDs as well as the emotional processing challenges that pose obstacles to lasting recovery.