Introduction : For several years, addictions have aroused the interest of human sciences and of neurosciences scientists. Addictions, and alcoholism specifically, impair the individual’s psychic functions (e.g., feelings and emotions). They also reveal a major problem in the modern society. The emotional deficits observed in alcohol addiction and in multiple substances abuse can be the result of a failing emotional structuring built on a lack of feelings representation (depiction). This lack is specifically described by Lane & Schwartz (1987) in their concept of emotional awareness. Emotional awareness is defined as the skill to identify the emotional state for oneself and others people (Lane & Schwartz, 1987). An emotional awareness failure was already proved in the alcohol dependent population (Bochand & Nandrino, 2010), dependent to a psychoactive substance (Carton et al., 2010) and in multiple substances abusers (Jouanne, Edel & Carton, 2005).
Goal : The aim of this study is to demonstrate a deficit of emotional awareness in the alcoholic population and in multiple substances abusers as well as to study the possible increase of the emotional awareness alteration according to the multiplication of addictions.
Method : Our research took place in an addictology care center in Western France. The first step of this study was to recruit participant inside this center. To avoid understandings bias, all of the patients filled a cognitive assessment : the Montreal Cognitive Assessment (MoCA; Nasreddine, 2004). Only those who reported a score higher than 26 were invited to meet the intern. During this meetings, aims and process of the research were introduced. The intern evaluated all of the addictions and psychopathology during the life-span by using the Mini International Neuropsychiatric Interview (MINI; Lecrubier et al., 1998). This inventory is a diagnoses tool based on the DSM-IV, and it is used to situate the participant on his/her psychopathology story. This questionnaire enabled us to define two groups of patients: one group in which patients were only addicted to alcohol (n = 19) and a group of multiple substances abusers (n = 11). After this assessment, a book was given to the patients by the intern (myself). This book contained the French version of the Level of Emotional Awareness Scale (LEAS; Lane & Schwartz, 1990; French validation : Bydlowski et al., 2002), the Beck Depression Inventory in its French and short version (BDI-13; Beck & Beamesderfer, 1974; French version : Collet & Cottraux, 1986) and the State-Trait Anxiety Inventory in the Y and French version (STAI-Y; Spielberger, Gorsuch, Lushene, Vagg & Jacobs, 1983; French version : Bruchon-Schweitzer & Paulhan, 1993). The first scale (LEAS) measures the level of feelings depiction capacity for oneself and for others. This was the ground of our investigation. The BDI-13 was used to determine the level of depression and the STAI-Y was used to evaluate the level of anxiety. This two inventories was used to control an possible effect of depression and anxiety on our results. Finally, only 30 patients filled all the tests. Their answers were compared to a control group from the general population (n = 21), recruited through Internet protocols.
Results : The statistical analyses did not show significant difference between the three groups of the study concerning the three LEAS’s sub-scores (One, Others and Total), once the potentially parasitic variables were controlled. These results can be explained by the after care character of the care center where the patients were recruited for this research.. Their care, for a more or less long time (between three weeks and three months), allowed them to recover emotional skills, particularly emotional depiction skills. The global analysis of the sub-scores of the LEAS for sub-scores One and Others, any confused groups, shows a significant difference: it seems easier to represent themselves their own emotional states that those of others. However this significant difference is not observed within every group.
Conclusion : Our results do not correspond of the scientific literature which have proven emotional deficits in addict populations. However, they help to highlight the benefits brought by a cure to addict patients. An adapted treatment that could include psychotherapies, medication, and supports groups, can help patients to rebuild their emotional skills and attenuate the deficits that were induced by substances abuses on the emotional field. Futures research should evaluate the patients in the first step of their cure, in a longitudinal way, to determine a possible improvement of emotional awareness with a help of the treatment.
