A recent study published in Social Neuroscience has provided new insights into how alcohol use disorder (also known as alcoholism) interferes with the brain’s ability to process moral cues. The researchers found that when individuals with alcohol use disorder were shown moral images paired with alcohol-related distractions, their brains showed less activity in regions associated with moral decision-making. This new understanding could help explain some of the behaviors seen in individuals struggling with alcoholism.
Moral cognition—our ability to make decisions about right and wrong—is a crucial aspect of social behavior. It allows us to function within society, balancing personal goals against the needs of others. But for individuals with alcohol use disorder, the ability to process moral situations may be impaired, which could contribute to problematic or antisocial behavior.
Previous research has shown that individuals with alcohol use disorder tend to have altered brain activity when faced with emotional or moral dilemmas, but it was unclear how alcohol specifically might interfere with moral processing. The researchers hypothesized that alcohol cues could create a kind of “attention bias” that distracts the brain from processing moral information properly. In other words, when alcohol is present as a distraction, individuals with alcohol use disorder might have more trouble focusing on the moral content of a situation.
The goal of the study was to examine this potential “attention bias” by using a combination of alcohol-related and neutral cues while measuring brain activity. The researchers wanted to see how alcohol use disorder might disrupt the brain’s ability to process moral situations and whether this interference could be linked to specific patterns of brain activity.
“My background is in working with individuals involved in the justice system, many of whom have substance use disorders,” said study author Samantha J. Fede, an assistant professor of psychological sciences and head of the Social Cognition & Affective/Moral Processing Imaging Lab Research Lab at Auburn University.
“Substance use disorders are often quite harmfully and erroneously moralized in our society, so it’s a very delicate, nuanced question to ask what’s going on in the brain of an individual with a substance use disorder, like alcohol use disorder, that might contribute to socially harmful actions. It’s particularly important to demonstrate these processes are cognitive, and not specifically moral.”
To investigate this, the researchers recruited 60 participants—30 individuals with alcohol use disorder and 30 individuals without the disorder—from the Washington D.C. area. The two groups were matched for age and sex to make comparisons more reliable. The participants with alcohol use disorder were split between those who were in inpatient treatment and those who were not seeking treatment at the time of the study. All participants were screened for eligibility to ensure they had no other neurological conditions that could interfere with the results.
Participants were asked to perform a task while undergoing functional magnetic resonance imaging (fMRI), a brain scanning technique that measures activity in different regions of the brain. The task was designed to present two images at a time: one was a distractor (either alcohol-related or neutral), and the other was a cue with moral, emotional, or neutral content.
For example, a moral cue might depict a harmful social situation, like bullying, while a neutral cue might show a person watching television. Participants were asked to focus on identifying whether the scene was indoors or outdoors, but the researchers were primarily interested in how the participants’ brains reacted to the moral and emotional content.
The task was implicit, meaning that the participants were not told to focus on the moral or emotional content of the images. This design was chosen to avoid biasing their attention, allowing the researchers to see how their brains naturally responded to the cues and distractions.
The results showed that individuals with alcohol use disorder had reduced activity in certain regions of the brain when they were shown moral cues paired with alcohol-related distractions. Specifically, these individuals showed less engagement in the medial prefrontal cortex, a region associated with moral decision-making, and the left amygdala, which plays a role in processing emotional responses. This reduced activity was especially noticeable in younger individuals with alcohol use disorder.
This interference effect was seen only when moral cues were paired with alcohol-related distractions. When the distractions were neutral, the individuals with alcohol use disorder showed similar brain activity to the control group without the disorder. This suggests that the presence of alcohol cues specifically interferes with the brain’s ability to process moral information.
Across both groups, the researchers also noticed less activity in the middle and superior temporal gyri, regions involved in understanding social and emotional situations. This pattern indicates that alcohol-related distractions may generally reduce the brain’s ability to engage with social and moral content, even in people without alcohol use disorder, though the effect was much more pronounced in those with the disorder.
“Our results suggest that attention biases towards alcohol cues interfere with processing of sociomoral pictures,” Fede told PsyPost. “To use a metaphor, in individuals with alcohol use disorder, alcohol cues are so loud that they drown out any other inputs (like moral content). This is important, because psychologists already have interventions to improve attention biases that might be used to address this problem in the future.”
Interestingly, the effect of alcohol-related distractors on brain activity in response to moral cues was more pronounced in younger individuals with alcohol use disorder. Specifically, younger participants in this group showed reduced activity in the medial prefrontal cortex and the left amygdala when viewing moral cues alongside alcohol distractions.
The researchers also found that female participants with alcohol use disorder had a stronger interference effect compared to males. Female participants showed reduced activity in the medial prefrontal cortex and the dorsomedial prefrontal cortex when moral cues were paired with alcohol-related distractions.
“We saw important interactions with age and sex, but it’s difficult to say exactly what those mean,” Fede explained. “Previous studies have shown that people with alcohol use disorder vary in terms of whether or not they have a strong alcohol attention bias. In any case, it’s an important reminder that our results aren’t going to apply to everyone with alcohol use disorder.”
In terms of future directions, the study opens up several interesting avenues for further investigation. One key question is whether treatments that target attention bias, such as cognitive behavioral therapy or attentional bias modification training, could help restore normal moral processing in individuals with alcohol use disorder or other substance use disorders. By reducing the strength of substance-related distractions, these therapies might allow individuals to focus more effectively on the social and moral consequences of their actions.
“My goal is to extend these findings to other substance use disorders and to give individuals with substance use disorders a tool to reduce the impact of their use on others,” Fede said.
The study, “Alcohol attention bias modulates neural engagement during moral processing,” was authored by Samantha J. Fede, Mallory A. Kisner, Sarah F. Dean, Emma Buckler, Robin Chholak, and Reza Momenan.
