Page 107 - PhD GT

“It is unclear, however, whether the experience is truly one of losing control rather than one of deciding not to exercise control.” (Edwards and Gross 1976 p. 1060)
suggesting that drinking behaviour might vary according to several factors other than the presence or absence of alcohol itself and that, even where people had experienced loss of control, they did not necessarily do so every time they drank.
“Control is probably best seen as variably and intermittently ‘impaired’ rather than ‘lost’.” (Edwards and Gross 1976 p. 1060)
Just as Jellinek had done before them, Edwards et al. (1977a) went on to describe “impaired control over the drug ethyl alcohol” as a “leading symptom” of the alcohol dependence syndrome (Edwards et al. 1977a p. 17), the concept of a syndrome being one where not all symptoms are required to co-exist in the same degree or at all for its diagnosis to be made.
Theorising about the nature of impaired control has mirrored theorising about the nature of dependence itself; thus the shift from the assumption that loss of control is invariable, inevitable and absolute accompanied the challenge to the view that dependence is a discrete, all or none condition which follows an invariable course of deterioration if not treated. The inevitability of loss of control in the face of alcohol consumption or the presence of alcohol in people diagnosed as alcoholic was challenged in a number of experiments and follow-up studies. For example, Mello and Mendelson (1965) showed that, rather than drink all the alcohol they had access to, diagnosed alcoholics drank to a particular blood alcohol level which could be observed across different drinking situations, or refrained from drinking when offered alternative rewards to do so and that they were able to adhere to drinking limits even at high blood alcohol levels. These and other researchers demonstrated that alcoholics were able to pace their drinking in response to the same kinds of cues and reinforcers as normal drinkers are able to, albeit that they may set their limits at much higher levels. Outside of the laboratory similar implications were being discussed in the light of long term follow-up studies. Polich et al. (1981) followed up a cohort of people treated for alcohol dependence and misuse and showed that some of their sample were able to drink in moderation at four years after treatment; in other words, though once they could have been said to be drinking with impaired control, this fact did not necessarily imply that they would inevitably and
95