Linking Anxiety, AUD & GABAB

Research Paper Title

The influence of anxiety symptoms on clinical outcomes during baclofen treatment of alcohol use disorder: A systematic review and meta-analysis.


Given the high coexistence of anxiety symptoms in people with alcohol use disorder (AUD), the researchers aimed to determine the influence of anxiety symptoms on outcomes in patients with AUD treated with GABAB receptor agonist baclofen.


A meta-analysis of 13 comparisons (published 2010-2020) including baseline and outcome data on alcohol consumption and anxiety after 12 weeks was undertaken.


There were significantly higher rates of abstinent days in patients treated with baclofen compared to placebo (p = 0.004; high certainty evidence); specifically in those with higher baseline anxiety levels (p < 0.00001; high certainty evidence) compared to those with lower baseline anxiety levels (p = 0.20; moderate certainty evidence). The change in anxiety ratings over 12 weeks did not differ between those treated with baclofen or placebo (p = 0.84; moderate certainty evidence).


This may be due to different anxiety constructs being measured by scales not validated in this patient group, or that anxiety is not a biobehavioural mechanism by which baclofen may reduce alcohol drinking. Given the prevalence of anxiety symptoms in AUD all these factors warrant further research.


Agabio, R., Baldwin, D.S., Amaro, H., Leggio, L. & Sinclair, J.M.A. (2021) The influence of anxiety symptoms on clinical outcomes during baclofen treatment of alcohol use disorder: A systematic review and meta-analysis. Neuroscience and Biobehavioural Reviews. doi: 10.1016/j.neubiorev.2020.12.030. Online ahead of print.

On This Day … 01 January

People (Births)

  • 1946 – Claude Steele, American social psychologist and academic.

Claude Steele

Claude Mason Steele (born January 1, 1946) is a social psychologist and emeritus professor at Stanford University, where he is the I. James Quillen Endowed Dean, Emeritus at the Stanford Graduate School of Education, and Lucie Stern Professor in the Social Sciences, Emeritus.

Formerly he was the executive vice chancellor and provost at the University of California, Berkeley. He also served as the 21st provost of Columbia University for two years. Before that, he had been a professor of psychology at various institutions for almost 40 years.

He is best known for his work on stereotype threat and its application to minority student academic performance. His earlier work dealt with research on the self (like self-image and self-affirmation) as well as the role of self-regulation in addictive behaviours.

In 2010, he released his book, Whistling Vivaldi and Other Clues to How Stereotypes Affect Us, summarising years of research on stereotype threat and the underperformance of minority students in higher education.


He enrolled at Hiram College in Hiram, Ohio, where he earned a B.A. in psychology in 1967.

At Hiram College, Steele’s passion for reading novels led to an interest in how the individual faces the social world. After being fully immersed in the Civil Rights Movement and the issues of racial equality, rights, and the nature of prejudice as a child, Steele formed a desire to study the topics in a scientific manner. He was especially keen to discover their effects on social relationships and quality of life. Steele was inspired by African-American social psychologist Kenneth Clark’s TV appearance discussing the psychological implications of the 1964 race riots in Harlem, New York City, which led to doing behavioural research. Steele conducted early experimental research at Hiram College in physiological psychology (looking at behavioural motives in Siamese fighting fish) and social psychology (studying how African-American dialect among kids maintains ethnic/racial identity), where he worked under the mentorship of social psychologist, Ralph Cebulla.

In graduate school, he studied social psychology, earning an M.A. in 1969 and a Ph.D. in 1971 at Ohio State University, with a minor in statistical psychology. His dissertation work, with faculty adviser Tom Ostrom at Ohio State, focused on attitude measurement and attitude change.


Throughout his academic career, his work fell into three main domains of research under the broad subject area of social psychology: stereotype threat, self-affirmation, and addictive behaviours. Although separate and distinct, the three lines of research are linked by their shared focus on self-evaluation and how people cope with threats to their self-image and self-identities.

  • Addictive Behaviours:
    • Although many people primarily associate Steele with his significant contributions in the development of stereotype threat research, the 14 years of his post-doctoral academic career that he spent at the University of Washington were focused on addictive behaviours and the social psychology behind alcohol use and addiction.
    • He was interested in the role of alcohol and drug use in self-regulation processes and social behaviour.
    • Among his major findings were that alcohol myopia, the cognitive impairment by alcohol use, reduces cognitive dissonance, leads to more extreme social responses, increases helping behaviour, reduces anxiety when it is combined with a distracting activity, and enhances important self-evaluations.
  • Self-Affirmation:
    • While studying the effects of alcohol use on social behaviour, Steele was formulating a theory about the effects of self-affirmation.
    • Developed in the 1980s, self-affirmational processes referred to the ability to reduce threats to self-image by stepping back and affirming a value that is important to self-concept.
    • Steele often uses the example of smokers who are told that smoking will lead to significant negative health outcomes.
    • The perception that they may be evaluated negatively by their willingness to engage in negative behaviours threatens their self-image.
    • However, affirming a value in a domain completely unrelated to smoking but important to one’s self-concept: joining a valued cause, or accomplishing more at work, will counter the negative effects of the self-image threat and re-establish self-integrity.
    • Self-affirmation theory was originally formulated as an alternative motivational explanation for cognitive dissonance theory that threats to the self led to a change in attitudes rather than psychologically inconsistent ideas, and self-affirmational strategies can reduce dissonance as effectively as attitude change.
    • His research on self-affirmation and its effects demonstrated the power of self-affirmation to reduce biased attitudes, lead to positive health behaviours, and even improve the academic performance of minority students.
  • Stereotype Threat:
    • Steele is best known for his work on stereotype threat and its application to explain real-world problems such as the underperformance of female students in mathematics and science classes as well as Black students in academic contexts.
    • Steele first began to explore the issues surrounding stereotype threat at the University of Michigan, when his membership on a university committee called for him to tackle the problem of academic underachievement of minority students at the university.
    • He discovered that the dropout rate for Black students was much higher than for their white peers even though they were good students and had received excellent SAT scores.
    • That led him to form a hypothesis involving stereotype threat.
    • Stereotype threat refers to the threat felt in particular situations in which stereotypes relevant to one’s collective identity exist, and the mere knowledge of the stereotypes can be distracting enough to negatively affect performance in a domain related to the stereotype.
    • Steele has demonstrated the far-reaching implications of stereotype threat by showing that it is more likely to undermine the performance of individuals highly invested in the domain being threatened and that stereotype threat can even lead to Black people having significant negative health outcomes.
    • The theories of stereotype threat can be applied for better understanding group differences in performance not only in intellectual situations but also in athletics.
    • Steele has spearheaded many successful interventions aimed at reducing the negative effects of stereotype threat, including how to provide critical feedback effectively to a student under the effects of stereotype threat, inspired by the motivating style of feedback of his graduate school adviser, Ostrom, and how teacher practices can foster a feeling of identity safety.
    • That would improve performance outcomes by elementary school minority students.

On This Day … 11 November


  • 1934 – Bill Wilson, co-founder of Alcoholics Anonymous, takes his last drink and enters treatment for the final time.

People (Deaths)

  • 1966 – Augusta Fox Bronner, American psychologist, specialist in juvenile psychology (b. 1881).
  • 1979 – James J. Gibson, American psychologist and author (b. 1904).

Bill Wilson

You can find an outline of Bill Wilson here.

Augusta Fox Bronner

Augusta Fox Bronner (22 July 1881 to 11 December 1966) was an American psychologist, best known for her work in juvenile psychology. She co-directed the first child guidance clinic, and her research shaped psychological theories about the causes behind child delinquency, emphasizing the need to focus on social and environmental factors over inherited traits.

James J. Gibson

James Jerome Gibson (27 January 1904 to 11 December 1979), was an American psychologist and one of the most important contributors to the field of visual perception. Gibson challenged the idea that the nervous system actively constructs conscious visual perception, and instead promoted ecological psychology, in which the mind directly perceives environmental stimuli without additional cognitive construction or processing.

A Review of General Psychology survey, published in 2002, ranked him as the 88th most cited psychologist of the 20th century, tied with John Garcia, David Rumelhart, Louis Leon Thurstone, Margaret Floy Washburn, and Robert S. Woodworth.

On This Day … 26 November

People (Births)

  • 1895 – Bill W., American activist, co-founded Alcoholics Anonymous (d. 1971).
  • 1936 – Margaret Boden, English computer scientist and psychologist.

People (Deaths)

  • 1987 – J. P. Guilford, American psychologist and academic (b. 1897).

Bill Wilson

William Griffith Wilson (26 November 1895 to 24 January 1971), also known as Bill Wilson or Bill W., was the co-founder of Alcoholics Anonymous (AA).

AA is an international mutual aid fellowship with about 2 million members worldwide belonging to approximately 10,000 groups, associations, organizations, cooperatives, and fellowships of alcoholics helping other alcoholics achieve and maintain sobriety.

Following AA’s Twelfth Tradition of anonymity, Wilson is commonly known as “Bill W.” or “Bill.” In order to communicate among one another, members of “AA” will often ask those who appear to be suffering or having a relapse from alcoholism if they are “friends of Bill”. Although this question can be confusing, because “Bill” is a common name, it does provide a means of establishing a rapport with those who are familiar with the saying and in need of help. After Wilson’s death in 1971, and amidst much controversy within the fellowship, his full name was included in obituaries by journalists who were unaware of the significance of maintaining anonymity within the organisation.

Wilson’s sobriety from alcohol, which he maintained until his death, began 11 December 1934. In 1955 Wilson turned over control of AA to a board of trustees. Wilson died of emphysema complicated by pneumonia in 1971. In 1999 Time listed him as “Bill W.: The Healer” in the Time 100: The Most Important People of the Century.

Margaret Boden

Margaret Ann Boden, OBE, ScD, FBA (born 26 November 1936) is a Research Professor of Cognitive Science in the Department of Informatics at the University of Sussex, where her work embraces the fields of artificial intelligence, psychology, philosophy, and cognitive and computer science.

Boden was appointed lecturer in philosophy at the University of Birmingham in 1959. She became a Harkness Fellow at Harvard University from 1962 to 1964, then returned to Birmingham for a year before moving to a lectureship in philosophy and psychology at Sussex University in 1965, where she was later appointed as Reader then Professor in 1980. She was awarded a PhD in social psychology (specialism: cognitive studies) by Harvard in 1968.

She credits reading “Plans and the Structure of Behaviour” by George A. Miller with giving her the realisation that computer programming approaches could be applied to the whole of psychology.

Boden became Dean of the School of Social Sciences in 1985. Two years later she became the founding Dean of the University of Sussex’s School of Cognitive and Computing Sciences (COGS), precursor of the university’s current Department of Informatics. Since 1997 she has been a Research Professor of Cognitive Science in the Department of Informatics, where her work encompasses the fields of artificial intelligence, psychology, philosophy, and cognitive and computer science.

Boden became a Fellow of the British Academy in 1983 and served as its vice-president from 1989 to 1991.[9] Boden is a member of the editorial board for The Rutherford Journal.

In 2001 Boden was awarded an OBE for her services in the field of cognitive science. The same year she was also awarded an honorary Doctor of Science from the University of Sussex. She also received an honorary degree from the University of Bristol. A PhD Scholarship that is awarded annually by the Department of Informatics at the University of Sussex was named in her honour.

J.P. Guildford

Joy Paul Guilford (07 March 1897 to 26 November 1987) was an American psychologist best remembered for his psychometric study of human intelligence, including the distinction between convergent and divergent production.

Developing the views of L.L. Thurstone, Guilford rejected Charles Spearman’s view that intelligence could be characterised in a single numerical parameter. He proposed that three dimensions were necessary for accurate description: operations, content, and products. A Review of General Psychology survey, published in 2002, ranked Guilford as the 27th most cited psychologist of the 20th century.

Research: Bipolar Disorder and Alcohol Use Disorder: A Review

Research Paper Title:

Bipolar Disorder and Alcohol Use Disorder: A Review.

Author(s): Conor Farren, Kevin P. Hall, and Roger D. Weiss.

Year: 2012.

Journal: Current Psychiatry Reports.

DOI: 10.1007/s11920-012-0320-9.


Bipolar disorder and alcohol use disorder represent a significant comorbid population, which is significantly worse than either diagnosis alone in presentation, duration, co-morbidity, cost, suicide rate, and poor response to treatment.

They share some common characteristics in relation to genetic background, neuroimaging findings, and some biochemical findings.

They can be treated with separate care, or ideally some form of integrated care.

There are a number of pharmacotherapy trials, and psychotherapy trials that can aid program development.

Post-treatment prognosis can be influenced by a number of factors including early abstinence, baseline low anxiety, engagement with an aftercare programme and female gender.

The future development of novel therapies relies upon increased psychiatric and medical awareness of the co-morbidity, and further research into novel therapies for the comorbid group.

You can download a copy of the full paper here.

Book: Molecular Neurobiology of Addiction Recovery

Book Title:

Molecular Neurobiology of Addiction Recovery: The 12 Steps Program and Fellowship (SpringerBriefs in Neuroscience).

Author(s): Kenneth Blum, John Femino, Scott Teitelbaum, John Giordano, Marlene Oscar-Berman, and Mark Gold.

Year: 2013.

Edition: First (1st).

Publisher: Springer.

Type(s): Paperback and Kindle.


Since Alcoholics Anonymous was founded in 1935, its 12 step programme of spiritual and character development has helped individuals overcome addiction.

This book takes a systematic look at the molecular neurobiology associated with each of the 12 steps.

Book: Ferment – A Memoir of Mental Illness, Redemption, and Winemaking in the Mosel

Book Title:

Ferment – A Memoir of Mental Illness, Redemption, and Winemaking in the Mosel.

Author(s): Patrick Dobson.

Year: 2020.

Edition: First (1st).

Publisher: Skyhorse Publishing.

Type(s): Hardcover and Kindle.


A deeply moving account of one man’s return to the German town where he first pursued a career in winemaking, and his attempt to reckon with the mental illness, alcoholism, and enduring relationships that defined the most formative chapter of his life.

After an attempted suicide by hanging – with his son in the next room – author Patrick Dobson checks into a mental hospital, clueless, reeling from bone-crushing depression and tortuous, racing thoughts. A long overdue diagnosis of manic depression offers relief but brings his confused and eventful past into question.

To make sense of his suicide attempt and deal with his past, he returns to Germany where, three decades earlier, he arrived as twenty-two-year-old – lost, drunk, and in the throes of untreated mental illness – in search of a new life and with dreams of becoming a winemaker. The sublime Mosel vineyards and the ancient city of Trier changed his life forever.

Ferment charts his days in Trier’s vineyards and cellars, and the enduring friendships that would define his life. A winemaker and his wife become like parents to him. In their son, he finds a brother, whose death years later sends Dobson into a suicidal tailspin. His friends, once apprentices like himself, become leaders in their fields: an art historian and church-restoration expert, an art- and architectural-glass craftsman, a painter and photographer, and a theologian/journalist. The relationships he builds with them become hallmarks of a life well-lived.

In Ferment, Dobson reconnects with the people who stood by him through his dissolution and eventual recovery. In these relationships, he seeks who he was and how his time in Germany changed him. He peers into his memory to understand how manic depression and alcoholism affected who he was then and how his time in Germany made him who he’s become.

Book: The Economics Of Addictive Behaviours – Volume IV

Book Title:

The Economics Of Addictive Behaviours – Volume IV: The Private and Social Costs of Overeating and Their Remedies.

Author(s): John Joshua.

Year: 2017.

Edition: First (1ed).

Publisher: Palgrave Macmillan.

Type(s): Hardcover, Paperback, and Kindle.


This title offers an in-depth analysis of the psychological causes and consequences of, and proposed interventions for over-eating. The author examines the history of obesity and its distribution by social class and geography, the environmental effects of overconsumption and economic remedies such as the introduction of a sugar tax to reduce obesity. Joshua also considers the politics of corporate social responsibility of food and beverage corporations and how this could prevent poor health decisions.

This is the final title in a four volume series ‘The Economics of Addictive Behaviours’, consisting of three additional volumes on smoking, alcohol abuse and illicit drug abuse.

Book: The Economics Of Addictive Behaviours – Volume III

Book Title:

The Economics Of Addictive Behaviours – Volume III: The Private and Social Costs of the Abuse of Illicit Drugs and Their Remedies.

Author(s): John Joshua.

Year: 2017.

Edition: First (1ed).

Publisher: Palgrave Macmillan.

Type(s): Hardcover, Paperback, and Kindle.


This title offers an in-depth analysis of the causes, consequences and treatments of illicit drug abuse. The author examines the effects of existing drug policies and proposes drug use legalisation within a regulated market as a viable alternative. Joshua assesses the factors that make individuals vulnerable to drug abuse and the pathways they may follow. As well as exploring the physical and psychological effects on the individual, Joshua examines the social and economic consequences for society. He highlights the pitfalls of a purely legal approach to drug abuse, which is primarily a health matter, and questions whether special drugs courts could be used as an alternative to the present criminal justice system. This book adds to the debate on whether most drugs could be sold in a regulated market in the same way as other drugs are, such as alcohol or nicotine.

This is the third title in a four volume series ‘The Economics of Addictive Behaviours’, consisting of three additional volumes on smoking, alcohol abuse and overeating.

Book: The Economics Of Addictive Behaviours – Volume II

Book Title:

The Economics Of Addictive Behaviours – Volume II: The Private and Social Costs of Alcohol and Their Remedies.

Author(s): John Joshua.

Year: 2017.

Edition: First (1ed).

Publisher: Palgrave Macmillan.

Type(s): Hardcover, Paperback, and Kindle.


This title discusses the phenomenon of alcohol abuse as a behavioural disease and the associated costs. The author details alcohol’s status as a psychoactive drug; he notes, however, that in contrast to other psychoactive drugs, alcohol has been widely culturally accepted in Western countries and legally available, except in isolated incidents for a short period of time. Joshua considers which policies are being correctly utilised so as to reduce the abuse of alcohol, and how these policies may operate on a supply and demand model. Whereas programs of prevention and treatment operate on the demand side of alcohol abuse, legislation is directed at the supply side of alcohol; that is, dealing with marketing – product, promotion, point of sales and price.

This is the second title in a four volume series ‘The Economics of Addictive Behaviours’, consisting of three additional volumes on smoking, illicit drug abuse and overeating.