Blackout (alcohol-related amnesia)

A blackout is a phenomenon caused by the intake of alcohol in which long term memory creation is impaired. Blackouts are frequently described as having effects similar to that of anterograde amnesia. 'Blacking out' is not to be confused with the mutually exclusive act of 'passing out'. Research on alcohol blackouts was begun by E. M. Jellinek in the 1940s. Using data from a survey of Alcoholics Anonymous (AA) members, he came to believe that blackouts would be a good predictor of alcoholism. [ www.duke.edu/~amwhite/Blackouts/blackouts3.html ]

Alcohol and long-term memory

Various studies have proven links between general alcohol consumption and its effects on memory creation. [PARKER, E.S.; BIRNBAUM, I.M.; AND NOBLE, E.P. Alcohol and memory: Storage and state dependency. Journal of Verbal Learning and Verbal Behaviour 15:691-702, 1976.] Particularly, these studies had shown that associations made between words and objects when intoxicated are less easily recalled than associations made when not intoxicated. Later blackout-specific studies have indicated that alcohol specifically impairs the brain's ability to take short-term memories and experiences and transfer them to long-term memory. [ACHESON, S.; STEIN, R.; AND SWARTZWELDER, H.S. Impairment of semantic and figural memory by acute ethanol: Age-dependent effects. Alcoholism: Clinical and Experimental Research 22:1437-1442, 1998.] This was shown by the ability to recall associations made while intoxicated being affected over time; it is strongly indicated that memories can be easily recalled for 2-3 minutes before the permanent inability to recall them in the future.

Types of blackouts

Blackouts can generally be divided into two categories, "en bloc" blackouts, and "fragmentary" blackouts. En bloc blackouts are classified by the inability to later recall any memories from the intoxicated period, even when prompted. These blackouts are characterized also by the ability to easily recall things that have occurred within the last 2 minutes, yet inability to recall anything prior to this period. As such, a person experiencing an en bloc blackout may not appear to be doing so, as they can carry on conversations or even manage to accomplish difficult feats. It is difficult to determine the end of this type of blackout as sleep typically occurs before they end. [GOODWIN, D.W; CRANE, J.B.; AND GUZE, S.B. Alcoholic "blackouts": A review and clinical study of 100 alcoholics. American Journal of Psychiatry 126:191-198, 1969.] Fragmentary blackouts are characterized by the ability to recall certain events from an intoxicated period, yet be unaware that other memories are missing until reminded of the existence of these 'gaps' in memory. Research indicates that fragmentary blackouts are far more common than en bloc blackouts. [WHITE, A.M.; SIGNER, M.L.; KRAUS, C.L.; AND SWARTZWELDER, H.S. Experiential aspects of alcohol-induced blackouts among college students. American Journal of Drug and Alcohol Abuse, 2004 in press.]

Causes

Blackouts are quite often associated with the consumption of large amounts of alcohol, however surveys of drinkers who have experienced blackouts have indicated that blacking out is not directly related to the amount of alcohol consumed. Respondents reported they frequently recalled having "had drunk as much or more without memory loss," compared to instances of blacking out. [GOODWIN, D.W; CRANE, J.B.; AND GUZE, S.B. Alcoholic "blackouts": A review and clinical study of 100 alcoholics. American Journal of Psychiatry 126:191-198, 1969.] Subsequent research has indicated that blackouts are most likely caused by a rapid increase in a person's blood-alcohol concentration. One study, in particular, resulted in subjects being stratified easily into two groups, those who consumed alcohol very quickly, and blacked out, and those who did not black out by drinking alcohol slowly, despite being extremely intoxicated by the end of the study. [RYBACK, R.S. Alcohol amnesia: Observations in seven drinking inpatient alcoholics. Quarterly Journal of Studies on Alcohol 31:616-632, 1970.] Hence, in order to prevent a blackout, alcohol should not be consumed in large gulps, and should most likely not be drunk on an empty stomach.Fact|date=September 2008

Predisposition to blackouts

Research indicates that some users of alcohol, particularly those with a history of blackouts, are predisposed to experience blackouts more frequently than others. [HARTZLER, B., AND FROMME, K. Fragmentary and en bloc blackouts: Similarity and distinction among episodes of alcohol-induced memory loss. Journal of Studies on Alcohol 64(4):547-550, 2003b.] One such study indicated a link between prenatal exposure to alcohol and vulnerability towards blackouts, in addition to the oft-cited link between this type of exposure and alcoholism. [BAER, J.S.; SAMPSON, P.D.; BARR, H.M.; ET AL. A 21-year longitudinal analysis of the effects of prenatal alcohol exposure on young adult drinking. Archives of General Psychiatry 60:386-391, 2003.] Alternatively, another study has indicated that there appears to be a genetic predisposition towards blacking out, suggesting that some individuals are made to be susceptible to alcohol related amnesia. [ [http://archpsyc.ama-assn.org/cgi/content/abstract/61/3/257 Arch Gen Psychiatry - Abstract: Genetic Epidemiology of Alcohol-Induced Blackouts, March 2004, Nelson et al. 61 (3): 257 ] ]

Popular culture references

*In "The Simpsons" episode "Viva Ned Flanders", Homer Simpson and Ned Flanders go to Las Vegas and have an alcohol-related blackout while partying. The following morning, they find two strange women in their hotel room claiming to have married them. Homer and Ned are then shown a video that, to their surprise, corroborates this story.

References