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Aims: Little is known about changes in the modulation of the startle reflex when patients go through an alcohol-dependence treatment in an outpatient facility. In the current study, the affective modulation of the cue-related startle reflex has been used to evaluate changes in the emotional processing of alcohol-related stimuli that occurred after a standard cognitive-behavioral intervention, and to assess the outcome of this intervention. We hypothesized a ‘normalization' of the startle inhibition for the alcohol-related cues during the period of treatment. We also assumed that higher startle inhibition at baseline elicited by alcohol cues would predict the relapse on alcohol consumption during treatment. Participants: A total of 98 alcohol-dependent subjects were included who fulfilled DSM-IV criteria for alcohol dependence. A control group of 72 subjects was selected to match demographic characteristics. Measurements: All patients received a standard cognitive-behavioral therapy once a week throughout the study period. Findings: Results show that the startle response differed significantly after 12 weeks of treatment for alcohol-related, neutral and aversive stimuli between alcohol-dependent patients and controls. Low startle responses at baseline to alcohol cues predicted relapse. Conclusions: These results may indicate that the startle reflex is referred to enduring and permanent processes of cue reactivity, and that the emotional processing of alcohol-associated cues assessed with the affect-modulated startle reflex is less altered by interventions attempting to influence explicit cognitions. Furthermore, lower values of the baseline startle reflex elicited by alcohol-associated stimuli were associated with higher probability of relapse on alcohol use.

Quality of language comprehension determines performance in all kinds of activities including academics. Processing of words initially develops as auditory, and gradually extends to visual as children learn to read. School failure is highly related to listening and reading comprehension problems. In this study we analyzed sex-differences in comprehension of texts in Spanish (standardized reading test PROLEC-R) in three modalities (visual, auditory, and both simultaneously: dual-modality) presented to 12–14-years old students, native in Spanish. We controlled relevant cognitive variables such as attention (d2), phonological and semantic fluency (FAS) and speed of processing (WISC subtest Coding). Girls’ comprehension was similar in the three modalities of presentation, however boys were importantly benefited by dual-modality as compared to boys exposed only to visual or auditory text presentation. With respect to the relation of text comprehension and school performance, students with low grades in Spanish showed low auditory comprehension. Interestingly, visual and dual modalities preserved comprehension levels in these low skilled students. Our results suggest that the use of visual-text support during auditory language presentation could be beneficial for low school performance students, especially boys, and encourage future research to evaluate the implementation in classes of the rapidly developing technology of simultaneous speech transcription, that could be, in addition, beneficial to non-native students, especially those recently incorporated into school or newly arrived in a country from abroad.

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