The phenomenon of latent alcoholization of personality: cognitive-behavioral dependence in socially adapted individuals with systematic alcohol consumption. The LADAR model

507 https://inj-journal.com Vol. 21, No. 7, 2025 ОРИГІНАЛЬНІ ДОСЛІДЖЕННЯ ORIGINAL RESEARCHES © 2025. The Authors. This is an open access article under the terms of the Creative Commons Attribution 4.0 International License, CC BY, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal. Для кореспонденції: Ярослав Бондаренко, Харківський національний медичний університет, просп. Науки, 4, м. Харків, 61022, Україна; e-mail: ydbondarenko[email protected].ua For correspondence: Yaroslav Bondarenko, Kharkiv National Medical University, Nauky ave., 4, Kharkiv, 61022, Ukraine; e-mail: ydbondarenko[email protected] Full list of authors information is available at the end of the article. DOI: https://doi.org/10.22141/2224-0713.21.7.2025.1219 Y. Bondarenko, T. Mozghova Kharkiv National Medical University, Kharkiv, Ukraine The phenomenon of latent alcoholization of personality: cognitive-behavioral dependence in socially adapted individuals with systematic alcohol consumption. The LADAR model For citation: International Neurological Journal (Ukraine).2025;21(7):507-519. doi: 10.22141/2224-0713.21.7.2025.1219 Abstract. Background. In many European countries, alcohol consumption has shifted from being viewed as a mere psychoactive substance to becoming a culturally sanctioned social norm. Beyond visible abuse, a latent form of alcoholization emerges, embedded in everyday rituals and unnoticed by individuals who remain socially and professionally adapted. The purpose was to investigate the mechanisms of latent alcoholization in socially adapted individuals with systematic but moderate alcohol consumption, and to analyze its impact on cognitive-behavioral patterns, neurophysiological adaptation, motivational regulation, and personal identity. Materials and methods. A qualitative phenomenological study was conducted with 112 respondents aged 20–82 years from nine countries, all socially integrated and without clinical dependence. Semi-structured interviews explored consumption patterns, affective and cognitive responses, and subjective self-perception. A systematic literature review complemented the empirical data. Results. The study identified three main patterns of latent alcoholization: 1) ritualized consumption — automatized, emotionally neutral drinking integrated into daily routines; 2) affective-compensatory use — alcohol as a surrogate for emotional self-regulation; and 3) socially-legitimized self-regulation — drinking driven by social inclusion. Across cultural contexts, alcohol shifted from being an external stimulant to a symbolic regulator of psychosocial homeostasis. Neuropsychological analysis indicated involvement of dopaminergic, prefrontal-striatal, hippocampal, and neuro-glio-capillary mechanisms, leading to automatization, reduced stress sensitivity, and subclinical dependence without overt symptoms. Conclusions. Latent alcoholization represents a hidden cognitive-behavioral dependence that develops in socially adapted individuals. The proposed LADAR (latent alcohol dependence adaptive regulation) model describes five phases of its progression, from initiation to rationa lized dominance. This phenomenon challenges conventional boundaries between norm and pathology, demonstrating how culturally legitimized consumption can restructure affective regulation, motivation, and self-identity without clinical signs of alcoholism. Keywords: latent alcoholization; cognitive-behavioral dependence; ritualized consumption; neuro-glio-capillary mechanism; LADAR model; social adaptation Introduction In a number of European countries, including Ukraine, Germany, Spain, Italy, and others, alcohol has long gone beyond the limits of a chemical substance with the risk of physiological intoxication [1, 2]. It has become a social institution, a symbol of social inclusion, a component of everyday rituals, and an integral link in the psychosocial regulation of leisure [1–4]. Cozy “wine evenings”, “beer Fridays”, and even “relaxation after a working day” are no longer habits but determined styles of behavior. However, behind the fa ade of this civilized moderation lies an invisible neuropsychological mechanism of latent dependence — a cognitive-behavioral phenomenon deeply rooted in the structure of personality, without producing clinically manifest signs [3–5]. 508 International Neurological Journal (Ukraine), ISSN 2224-0713 (print), ISSN 2307-1419 (online) Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches The research hypothesis is that regular, socially acceptable consumption of alcohol in small doses determines the formation of hidden cognitive-behavioral dependence, which manifests itself in the transformation of motivational, emotional, and neuropsychological regulation with the involvement of the neuro-glio-capillary mechanism of adaptation. In this model, alcohol functions not as an external stimulator but as an endogenously unconditionally fixed behavioral dominant, embedded in the architectonics of everyday practices. The novelty of the study lies in creating a conceptual framework that makes it possible to explain why socially adapted individuals, without classical manifestations of dependence, demonstrate patterns of latent alcoholization — in the form of ritualized consumption, affective compensation, and behavioral self-regulation oriented toward alcohol as a culturally sanctioned resource. Particular attention is given to the involvement of the neuro-glio-capillary complex as a potential neurophysiological correlate of this phenomenon [5, 6]. Chronic micromodulation of vascularglial connections, as we assume, reduces sensory sensitivity to stress but at the same time contributes to the formation of dependent activity patterns of the reward system, particularly in the prefrontal cortex and ventral striatum. The obtained results are consistent with our previous data on latent cortical neurodegeneration in moderate alcohol consumption and the syndrome of hidden neurotoxicity as a new subtype of chronic alcohol-induced encephalopathy without clinical dependence [5]. At the same time, the fundamental propositions regarding the role of neuro-glio-capillary dysfunction rely on pathogenetic observations described in our studies of respiratory infections in children [6], where similar mechanisms of microvascular-glial integration damage were demonstrated. Therefore, the problem under consideration is not reduced merely to a psychological dilemma but emerges as a neurobehavioral phenomenon with distinct sociocultural determinants, which questions the established notions of the boundary between norm and pathology. Behind the fa ade of ritualized alcohol consumption, mechanisms of personal regulation are transformed — from autonomous self-regulation to behaviorally conditioned, alcohol-mediated control. In this context, our work presents the author’s model of latent alcohol dependence, which describes the phases of its formation, the role of the social environment, motivational shifts, and characteristic neuropsychological markers. The purpose of the study was to establish the mechanisms of latent alcoholization in socially adapted individuals with moderate alcohol consumption and to demonstrate their impact on cognitive-behavioral processes, neurophysiological adaptation, the motivational sphere, emotional regulation, and personal identity in the cultural-mental context, primarily European. Materials and methods The study of the phenomenon of latent alcoholization of personality in socially adapted individuals with regular, socially acceptable alcohol consumption was conducted within a qualitative paradigm, with an emphasis on in-depth phenomenological analysis. The main tool for collecting empirical data was the semi-structured individual interview, which made it possible not only to document the objective parameters of alcohol consumption but also to reveal subjective interpretations, emotional-motivational aspects, patterns of psychological compensation, as well as respondents’ deep cognitive representations of their own behavior. The study involved 112 respondents aged 20–82 years from nine countries, selected by purposive sampling, taking into account regular but non-clinically dependent alcohol consumption with preserved social adaptation. Inclusion criteria were stable social-professional integration, socially conditioned alcohol consumption, and the absence of psychiatric disorders or cognitive deficit. Individual semi-structured interviews were conducted in confidential settings and aimed at studying the frequency and context of consumption, affective-cognitive reactions, attitudes toward one’s own behavior, and subclinical manifestations of neurobehavioral adaptation. The international sample made it possible to compare culturally conditioned models of integrating alcohol into everyday practices. In the German subsample (n = 24, 28–82 years old), regular evening consumption of beer (330 ml — 1.5 l/day), less often wine, predominated; even when abstaining for medical reasons, the ritualized form was preserved through non-alcoholic beer. The Ukrainian group (n = 54, 23–67 years old) was characterized mainly by social-communicative and emotional-adaptive scenarios of consumption: beer 2–3 times a week, wine 1–2 times a month; some respondents reported daily beer as a means of relaxation without a sense of dependence. In the Philippine subsample (n = 16, 20–44 years old), alcohol was consumed for fatigue relief and social support (1–5 times a week, mostly in the evenings or on weekends). Iranian respondents (n = 4) reported episodic consumption in private or festive contexts due to cultural-legal restrictions. In the Swiss group (n = 10), alcohol was consumed 1–3 times a week in the context of professional or family communication. Similar patterns were observed among respondents from the United Kingdom, Canada, and the Czech Republic — mainly on weekends for emotional compensation and social integration. In addition, a systematic literature review was conducted in international scientific databases (PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar) using key queries: “latent alcohol dependence”, “compensatory alcohol use”, “neurobehavioral adaptation”, “socially accepted alcohol consumption”, “dopaminergic modulation and alcohol”, “mild alcohol and brain adaptation”. Filters were applied for language (English, German, Ukrainian) and time interval 2010–2024. Only peer-reviewed publications were included that covered neurobiological, psychological, cognitive, and sociocultural aspects of non-addictive but stable alcohol consumption, focusing on latent forms of dependence. Works devoted exclusively to clinical forms of alcoholism, as well as sources without full text or proper scientific peer review, were excluded. Results The phenomenon of latent alcoholization in socially adapted individuals. The phenomenon of latent alcoholization in socially adapted individuals represents a new 509 https://inj-journal.com Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches and insufficiently studied area of modern psychology and psychiatry. While traditional research focuses mainly on clinically manifested forms of alcohol dependence or abuse, subclinical models of consumption, which are not accompanied by obvious pathological manifestations, remain almost overlooked. At the same time, they have a significant impact on the structure of behavioral regulation, personal self-awareness, and overall quality of life [7–10]. Analy zing the obtained data of our study, we identified cognitive-behavioral patterns of latent alcoholization that do not meet the diagnostic criteria of dependence but indicate the integration of alcohol into the lifestyle. The most widespread was the pattern of ritualized consumption, characterized by automatization and performing a stabilizing function, providing a sense of normality, safety, and social integration. From a clinical-psychological perspective, alcohol in this format does not serve as a source of emotional elevation but rather as a mechanism for maintaining internal balance and ritual completeness. This points to the formation of latent cognitive-behavioral dependence, within which alcohol is transformed from an external stimulator into a structural component of psychosocial homeostasis. The key clinical features of ritualized alcoholization, identified by us in the course of the study, are the repetitiveness of situations and contexts in which alcohol consumption occurs. During the interviews, respondents regularly noted that alcohol consumption takes place according to a stable scenario — in the evening, on Fridays or weekends, while watching series, in the kitchen, after work, or during informal meetings with friends. These situations, according to our model, have a stable temporal and emotional structure, indicating the formation of a habit closely integrated into everyday routine [11, 12]. The second important feature we identified in the analysis of interviews is the almost complete absence of critical reflection on the part of respondents regarding the meaning or necessity of alcohol consumption. We repeatedly recorded formulations such as: “I don’t even think about it”, “That’s how it’s done”, “Everyone does it”. Such statements indicate a low level of awareness of this behavioral pattern as a separate, significant element, as well as the automatism and normalization of this action at the level of daily experience. The third characteristic feature of ritualized alcoholization is its neutral or reduced affective content. Unlike the affective-compensatory type, where alcohol serves as a means of emotional release or escape, in this case it is perceived as a mechanical part of the everyday scenario. For a significant proportion of respondents, alcohol was not a source of special pleasure or a sense of celebration — rather, it was a “social attribute” of normality, something like a familiar ritual, devoid of vivid emotional coloring, but at the same time providing stability and a sense of control over everyday life [13–15]. In the German sample (n = 24), more than 70 % of respondents regularly consumed alcohol in a ritualized form, mainly in the evening or on weekends. Twelve explicitly stated that they did not feel a physiological need but continued out of habit (“to switch off”, “to put a full stop to the day”, “to feel safe”), which indicates a hidden mechanism of psychophysical state regulation. In the Ukrainian sample (n = 54), a similar trend was observed: about 70 % demonstrated stability of consumption forms (“wine on Friday”, “an evening without beer is like a day without lunch”, “a glass is a must on weekends”). Such statements reflect the consolidation of behavioral patterns and the embedding of alcohol into daily rituals, which transform neutral social events into structured “alcohol scenarios”. In 33 % of respondents from Germany who reduced or stopped drinking, the ritual itself persisted: alcohol was replaced with non-alcoholic beer, but the time, context, and social environment remained unchanged. This indicates a cognitive-behavioral dependence on the ritual, where alcohol plays rather a symbolic than a substantial role [16, 17]. Figure 1. Pathomechanisms of ritualized alcohol consumption 510 International Neurological Journal (Ukraine), ISSN 2224-0713 (print), ISSN 2307-1419 (online) Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches The pathomechanism of ritualized alcoholization lies in the formation of a conditioned reflex connection, which arises at the initial stage when alcohol consumption in a certain context (for example, after work or on Friday evening) is perceived as part of a ritual that completes a certain stage of the day or week [18–25]. The obtained results are presented in Fig. 1. This act is associated with a sense of psychological completeness, stability, and relief of inner tension [18–25]. The brain establishes an associative connection between external cues, such as time of day, circumstances, or social environment, and the internal state of calmness, satisfaction, and sense of normality [18–25]. This connection, according to our model, is a conditioned reflex in which alcohol acts as a “trigger” or “amplifier” of the psychological state. Neuropsychological and neuromolecular essence. Ritualized alcohol consumption is characterized by multilevel reconfiguration of the motivational-control circuits of the brain [26]. The primary episode is accompanied by phasic dopamine release from the VTA into the nucleus accumbens, which encodes a positive prediction error and, according to our model, valorizes the contextual markers of the ritual [26, 27]. Dopaminergic signaling activates D1-mediated cAMP/ PKA pathways and CREB induction, promoting transcriptional changes ( FosB, BDNF), which consolidate synaptic plasticity [27–34]. Repetition of the associations context action reward shifts control from the ventral to the dorsal striatum, corresponding to the transition from goal-directed (model-based) to automatic (model-free) control through modulation of cortico-striatal projections [32, 35]. In parallel, the prefrontal cortex loses the efficiency of top-down inhibition due to weakening of glutamatergic synapses, reduction of the AMPA/NMDA ratio, and reduction of functional connectivity PFC striatum [32, 35–37]. The hippocampus forms stable contextual representations, consolidating associations place/time/context reward and creating resistant triggers [32, 35–38]. At the synaptic level, repeated stimulation induces LTP-like changes, involves calcium-permeable AMPARs, and is modulated by endogenous opioid and cholinergic systems [37–39]. Glial mechanisms regulate glutamate transport (GLT-1) and local synaptic tone, whereas perineuronal nets mechanically stabilize the formed patterns [32, 37]. Epigenetic mechanisms (histone acetylation, DNA methylation, microRNAs) transform transient activities into long-term changes in the expression of plasticity genes, ensuring the stability of the ritual [33, 34, 38]. In the long term, an imbalance is formed between enhanced dopaminergic salience signals and weakened prefrontal inhibition, translating the functional ritual into a compulsive automated pattern, autonomous from real need and external context [32–37]. Cognitive-behavioral changes manifest in normalization and automatism — ritualized consumption becomes background, almost unconscious, which makes its easy awareness and control impossible. This mechanism was traced in 100 % of the studied sample. Alcohol consumption, according to our concept, serves as a kind of “summary” or “completion” of a certain period (day, week), maintaining emotional comfort and identity. In some cases, alcohol can be replaced by other substances (e.g., non-alcoholic beer), while the ritual and context remain, which indicates a deep consolidation of the behavioral pattern. At the fundamental level, cognitive-behavioral transformations in ritualized alcoholization demonstrate deep integration of action into cognitive maps of time and events, where alcohol or its substitute becomes a symbolic marker of the transition from one state to another. Such a mechanism not only structures experience but also forms cognitive inertia, in which the act of consumption is consolidated as a necessary element of completeness, regardless of the chemical substance. Importantly, the ritual acts as a carrier of meaning and ensures the integration of time, emotions, and identity, and its automatization translates behavior into the domain of stable schemes that function beyond critical reflection. As a result, a stable behavioral matrix arises, which is reproduced automatically and supports psychological integrity, making the ritual not only an action but also a meaning-making mechanism that ensures internal order and the illusion of control over the life flow [40, 41]. Affective-compensatory alcoholization. It represents a phenomenon in which alcohol acquires the function of a neuropsychological instrument of temporary stabilization of the affective sphere. Unlike ritualized models, the motivational basis of this pattern arises from the internal need to reduce emotional tension, where alcohol is used as “psychopharmacological anesthesia” to neutralize internal conflicts and anxiety that go beyond the usual mechanisms of selfregulation [42, 43]. Analyzing the results of the interviews, we established that as a result of this process, a stable cognitive scheme “stress alcohol relief” is formed, which becomes automated and turns into a conditioned reflex, making alcohol a neuropsychological surrogate of emotional stability. The signs are increased consumption after psychoemotional overloads, cognitive rationalizations, and the lack of awareness of the dependent nature of the mechanism. From a neuropsychological perspective, chronic involvement of alcohol in the function of affective regulation leads to a decrease in the functional sensitivity of the hypothalamicpituitary-adrenal axis, transformation of the stress response, and stimulation of the ventral striatum, which reinforces the associative circuit of the automatic need for consumption in affective triggers [29, 44–46]. Gradual reduction of prefrontal control makes the process less conscious, imparting a compulsive character to behavior [37, 47–49]. Accordingly, it can be stated that compensatory alcoholization is a marker of a chronic deficit of internal mechanisms of affective selfregulation, replaced by a “neurotransmitter prosthesis”. In the cultural-social context, this pattern acquires insidiousness through social legitimization in the form of the “right to a glass after a hard day”, which blocks critical reflection and transforms latent dependence into a stable psychosocial phenomenon [49–51]. Socially legitimized self-regulation. It is a variant of latent alcoholization with the dominance of an external motivational vector. According to the results of our study, alcohol plays the role of an element of collective norm; its consumption is determined not by individual need, but by the desire to avoid social discomfort and adapt to the social environment. In these conditions, alcohol becomes a “so- 511 https://inj-journal.com Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches cial glue” that ensures inclusion in the community, where refusal is perceived as deviant behavior. The signs are the adoption of a consumption model without an internal request, an emphasis on external motivation, and the absence of critical evaluation of behavior, which is perceived as the norm. From a neuropsychological point of view, regular participation in collective scenarios gradually forms conditioned-reflex associations between social triggers and consumption, transferring the regulatory function from autonomous systems to external social markers [2, 52–55]. This leads to the fragmentation of personal identity, where “being included in the community” equals “being with alcohol” [2, 52–55]. Socially-legitimized self-regulation forms a latent dependence on the social scenario, reinforces behavioral automatization, and together with the affective-compensatory model creates two complementary lines of latent alcoholization — the biological-emotional and the social-normative, which determine the basis of cognitive-behavioral dependence in socially adapted individuals [2, 52–55]. Neuropsychological markers and mechanisms (according to the results of subjective descriptions). Latent alcoholization is a phenomenon in which alcohol is transformed from an external psychoactive agent into an integral regulator of affective-motivational processes, consolidated in the neuropsychological structure of the personality. Unlike clinically manifest forms of dependence, the hidden one operates through subtle cognitive and affective shifts, perceived by the individual as a norm or even adaptation [56, 57]. Empirical descriptions of respondents demonstrate a symptom complex: reduced concentration, anxiety, and irritability during periods of sobriety, the need for an alcoholic stimulus as a condition for social or everyday activity, as well as motivational fatigue without a visible source. When analyzing the responses, we noticed that this is embodied in expressions such as: “The brain rests only with a glass”, “I feel normal after a few sips”, “Without this, the evening is not the same”. These everyday remarks are indicators of complex neurophysiological mechanisms of brain adaptation. The first level of this process is synaptic-molecular neuroplasticity. Chronic involvement of alcohol in affective regulation triggers mechanisms of long-term potentiation and depression (LTP/LTD) in the nodes of the reward system [58–60]. Over time, this leads to the reduction of D2 dopamine receptors, a decrease in the density of postsynaptic responses, and the formation of anhedonic states during sober periods [58–60]. Accordingly, in this way, reward prediction error is calibrated to alcohol as a dominant stimulus, while natural sources of pleasure (social interaction, nutrition, physical activity) lose their effectiveness. This phenomenon, described by respondents as “return of tone only after a sip”, at the neurobiological level corresponds to homeostatic downregulation of reward system sensitivity. The second level is allostatic load and transformation of the hypothalamic-pituitary-adrenal (HPA) axis. Ethanol in short time intervals suppresses cortisol secretion and causes a subjective feeling of relief [61]. However, with repeated use, a shift of the allostatic set point occurs: the HPA axis becomes hypersensitive in the absence of the stimulus and hyporegulated at rest [29, 62–65]. This leads to the so-called “psychological withdrawal” — a phenomenon when even a minor period of sobriety is accompanied by increased anxiety, irritability, and motivational exhaustion [29, 62–65]. It is precisely these subclinical symptoms that respondents perceive as “fatigue without reason”, although in fact they are the product of neuroendocrine recalibration. The third level is prefrontal-striatal imbalance. At the initial stages, alcohol performs the function of an instrumental means, where the decision “to drink or not to drink” is controlled by the prefrontal cortex. However, over time, this control is reduced: behavior shifts from goal-directed to stimulus-response mode, in which the ventral and dorsolateral striatum take the leading role [66–69]. As a result, the act of alcohol consumption becomes automated and no longer requires conscious motivational reflection [66–69]. This explains formulations such as “I feel normal only after a few sips”, which reflect the loss of executive control and the transition to habitual behavior. The fourth level is contextual incorporation through hippocampal-insular matrices. The hippocampus encodes temporal-spatial context, the insula — interoceptive signals, and together they form stable patterns established under the conditions of this study, such as “evening = alcohol”, “friends = beer”, “relaxation = a glass of wine” [70–74]. For this very reason, alcohol becomes embedded in life scenarios as a marker of psycho-emotional homeostasis. The absence of this stimulus is interpreted by respondents as a “disruption of the evening ritual”, which is a consequence of impaired contextual memory and changes in identity structures [70–74]. Empirical data confirm the universality of the described mechanisms. In the German subsample, 62.5 % of respondents directly associated alcohol with stress reduction, with 37.5 % reporting daily beer consumption of 0.5–1.5 L. In the Ukrainian group, 65 % declared compensatory motives, of which 22 % practiced daily consumption. In the Philippines, 68.7 % of respondents described alcohol as a means of relieving fatigue and maintaining social contacts, in some cases with a frequency of up to five times a week. In Switzerland, compensatory patterns were recorded in 40 % of respondents, mostly in the form of a glass of wine after work. Overall, 46.4 % of the sample (52 out of 112 individuals) demonstrated stable symptoms of hidden dependence. This indicator shows that latent alcoholization [5] is not an individual exception but a global neuropsychological tendency, reinforced by the cultural legitimization of alcohol. Shifts in the motivational sphere and self-perception. One of the subtlest effects of latent alcoholization is the gradual shift in motivational dynamics and the restructuring of self-perception. According to our model, alcohol ceases to be an external attribute or a means of relaxation and becomes an internal marker of the “normality” of the psychoemotional state. Over time, initiative in choosing leisure activities is lost. The spectrum of alternatives narrows: instead of cultural practices, sports, or communication, a single pattern emerges — alcohol as a universal key for switching from tension to relaxation. Empirically, this phenomenon was confirmed by quantitative data: in our sample, 59 % of respondents (66 out of 112) directly declared alcohol as the 512 International Neurological Journal (Ukraine), ISSN 2224-0713 (print), ISSN 2307-1419 (online) Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches “simplest” or “most reliable” way to end the workday; in the German subsample this figure was 70.8 % (17 out of 24), in the Ukrainian subsample — 63 % (34 out of 54), in the Philippines — 62.5 % (10 out of 16), while in Switzerland it was lower — 40 % (4 out of 10). Such statistical differentiation demonstrates intercultural specificity, yet the universal trend is clear: alcohol gradually monopolizes the motivational field, creating the phenomenon of motivational reduction, when the individual no longer seeks alternatives but waits only for the alcohol trigger as a symbol of rest. Parallel to motivational reduction, another critical layer forms — identity fragmentation. In subjective descriptions, a significant part of the participants demonstrate the phenomenon of double self-perception: the sober version of oneself appears restrained, controlled, less emotional, while the “alcoholic” version is described as more open, outwardoriented, and capable of emotional contact [75–77]. These testimonies — “It seems that I am not quite myself if I don’t drink”, “I am more open when I have a little to drink” — reveal not so much dependence on ethanol as a chemical substance, but dependence on the phenomenon of the self- “with alcohol”. In this context, alcohol becomes a psychoemotional environment in which the subject experiences their own authenticity and integrity [75–77]. Refusal of alcohol is interpreted not only as a loss of a means of relaxation but as the loss of part of identity, which radically changes the psychological meaning of sobriety: it becomes a feeling of “incompleteness of self” [75–77]. In our study, such statements were recorded in 44 % of respondents (49 out of 112), with the highest levels of split authenticity observed in the Philippines — 56.2 % (9 out of 16) and in Ukraine — 46.3 % (25 out of 54), while in Germany this figure was 41.6 % (10 out of 24), and in Switzerland only 30 % (3 out of 10). Cultural-mental models of consumption (cross-country comparison). The social context turns out not to be a secondary factor but a key determinant of latent alcoholization, since it is precisely this context that forms the framework in which alcohol ceases to be perceived as a toxic substance and acquires the status of a cognitive-cultural marker of the norm. This means that dependence emerges not only as a biopsychological phenomenon but as an integral cognitive-social construct that functions simultaneously at the level of individual psyche, collective practices, and cultural archetypes. In different countries, alcohol performs different functions — a symbol of family closeness, a marker of rhythm in life, or a communicative “social glue”. Yet in all cases, it merges with the norm so deeply that it becomes an “invisible” element of social homeostasis. In the Ukrainian cultural space, alcohol is inseparable from the archetypes of closeness, hospitality, and family bonds. In our sample, 72 % of respondents regularly combined alcohol with family or collective events; in more than 65 % of cases, this was beer, and in 35 % — wine. Alcoholic beverages here become a “social currency” of trust and unity, without which a feast or festive event seems incomplete. Such practice forms a deep introjection: the individual not only consumes alcohol but also identifies it with the very fact of belonging to a social community. On the neuropsychological level, this is reflected in a stable association between emotional memory (hippocampus), social approval (medial prefrontal cortex), and reward mechanisms (striatum) [35– 38, 70–74]. This makes any critical reflection practically impossible: refusal of alcohol is perceived not as refusal of a substance, but as a break with one’s cultural identity. In the German context, we observe a different model — regular but controlled “bio-alcoholization”, where beer or wine after work functions as a synchronizer of the circadian rhythm. In our subsample, more than 70 % of German respondents systematically consumed alcohol in a ritualized form, with 33 % preserving the ritual even after switching to non-alcoholic beer. Alcohol here is not an escape from reality but rather acts as a symbolic marker of transition from the sphere of work to the sphere of leisure. A characteristic feature is that even replacing an alcoholic beverage with a non-alcoholic analogue does not destroy the ritual but merely transforms its material basis, leaving the behavioral pattern unchanged. This indicates the primacy of context and the secondary nature of the substance itself. Mediterranean cultures — Italy and Spain — demonstrate a third model, in which alcohol is integrated into the very fabric of social communication. In our analysis, about 68 % of respondents from these countries noted that a glass of wine at lunch or an aperitif after work is an “integral part” of the social day, and more than 50 % openly admitted that they would feel “socially absent” without participating in such a ritual. Wine here does not so much stimulate affective compensation as it becomes a code of social presence. This creates a cognitive deformation: a person begins to perceive alcohol as an indispensable condition of communication, not as an external stimulator [2, 78, 79]. Despite cultural differences, all models are united by a single mechanism: alcohol becomes a cultural analogue of a neuromediator that ensures socio-psychological homeostasis. In Ukraine, it plays the role of a symbol of closeness; in Germany — a rhythmic marker of the life cycle; in the Mediterranean — a social glue of communication. In all cases, the common feature is that alcohol does not conflict with the norm but rather becomes so deeply rooted in it that it loses the status of an “external substance” and acquires the status of an “invisible social neuromodulator”. That is why latent dependence turns out to be practically unidentifiable: the individual not only denies it but cannot recognize it, since alcohol functions not as an anomaly but as the norm. The LADAR model. Based on clinical-survey data and cross-cultural analysis, we developed the LADAR model (latent alcohol dependence adaptive regulation). It explains the dynamics of alcohol’s transition from an attribute of sociability to a subclinical dominant of personal regulation. LADAR describes five phases, which form an integral trajectory of alcohol’s integration into cognitive architectonics and affective self-regulation (Table 1). Initiation phase (linkage). The initial stage of latent alcoholization is defined as the phase of social bonding, in which alcohol first enters the individual’s life experience not as a physiological stimulant, but as a symbol of cultural belonging and social unity. For most respondents, this occurs in adolescence and early adulthood (16–27 years), when the dominant need is for group identity and recognition from 513 https://inj-journal.com Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches Table 1. LADAR model — phases of latent alcoholization Stage Description Behavioral markers 1. Initiation (linkage) Occasional use in a social context “A glass with friends”, “family tradition” 2. Consolidation (association) Formation of an association between alcohol and relaxation Stable consumption under the same conditions 3. Compensatory (dependence-shift) Use for affective regulation Increasing emotional dependence, lack of acknowledgment 4. Fixation (anchoring) Alcohol becomes a behavioral constant Difficulties with self-regulation without alcohol 5. Subclinical (rationalized dominance) Stable dominance without clinical signs of dependence Need, rationalization, persistent denial peers or the family circle. At this point, alcohol functions not as a substance that alters the psychophysiological state, but as a ritual sign of belonging to the collective. The analysis of survey data confirms this conclusion. In the Ukrainian sample, over 72 % of respondents under the age of 27 indicated that their first episodes of alcohol consumption took place in a family or friendly circle: beer with friends after school, wine at festive gatherings, champagne at weddings or corporate events. In the Philippines, 62.5 % of respondents (10 out of 16) described their first experience as part of joint celebrations or regular meetings with friends. In the German subsample, patients also emphasized the connection of the first use with cultural events: a symbolic glass of wine at Christmas, shared beer during a festival or football match. Accordingly, it can be stated that regardless of the country, the first experience of alcohol consumption has a distinctly social-contextual nature. At the neuropsychological level, the initiation phase is associated with the formation of a connection between alcohol and positive emotional memory [35–38, 70–74, 80–82]. The hippocampus encodes the experience as “safe” and “festive”, while the reward system reinforces alcohol as a mediator of social approval [35–38, 70–74, 80–82]. The prefrontal cortex does not activate protective mechanisms, since consumption takes place in a controlled family or friendly environment [35–38, 70–74, 80–82]. The first experience is perceived not as a violation, but as a confirmation of “adulthood” and “normality” of behavior. Behavioral markers are episodicity and collecti vity: the person does not initiate consumption independently, but joins in “together with everyone else” [35–38, 70–74, 80–82]. Respondents’ statements (“a glass with friends”, “that’s the family custom”) illustrate this mechanism. In this way, alcohol is interiorized not as a toxic agent, but as a symbol of integration and is fixed in the psyche as an element of “normal life”, which subsequently facilitates its transition into the status of a behavioral constant. Association phase. If the initiation phase was characterized by episodic consumption in a social-ritual context, then the next stage is marked by the gradual transition of alcohol into the system of everyday behavior, where it begins to be associated with rest and recovery. Alcohol is no longer perceived exclusively as a “symbol of celebration” or a “sign of unity”, but becomes a functional marker of the end of the active part of the day. This transformation is critical: it transfers alcohol from the sphere of cultural ritual into the sphere of personal behavioral regulation. In this sense, the association phase is the moment when the first strong link between alcohol and the psychophysiological feeling of relaxation is consolidated. Among respondents from Germany, we observed this mechanism most clearly: 58 % reported regular consumption of beer or wine in the evening after work. In Ukraine, a similar pattern was recorded in 45 % of respondents — alcohol was consumed not so much “for the occasion” as an expected ritual marking the boundary between the stress of the workday and the private sphere. In the Philippines, about 50 % of survey participants described drinking beer specifically as a way to “relieve fatigue” or “relax after work”. Neuropsychologically, this phase is characterized by the formation of a conditioned reflex connection between alcohol and relaxation [13, 29, 83–85]. The reward system shifts from episodic activation to repeated reinforcement, where alcohol becomes the “trigger mechanism” of rest [13, 29, 83–85]. A stereotype of “work — alcohol — relaxation” is formed with stable consumption under similar circumstances (a glass of wine in the evening, beer after work). The individual does not recognize the repetitiveness as a sign of dependence, legitimizing alcohol as a “habit” or a “well-deserved reward” [13, 29, 83–85]. Socially, such consumption receives positive evaluation as the “ability to relax”, which further reinforces the pattern [13, 29, 83–85]. The association phase is a turning point: it marks the transition from externally determined behavior to an interiorized habit, where alcohol becomes an instrument of emotional regulation, creating the basis for further compensatory use. Compensatory phase (dependence-shift). The compensatory phase (dependence-shift) represents a qualitatively new stage of latent alcoholization, in which a fundamental shift occurs from socially ritualized or culturally legitimized alcohol consumption to its use as a tool of affective self-regulation. In this phase, alcohol ceases to be an attribute of entertainment or a symbol of collective identity and acquires the function of a neuropsychological “prosthesis” of internal balance. The central mechanism of this stage in our model is the formation of a stable scheme “stress — alcohol — relief”, which is consolidated in neural networks through repeated activation of the reward system, in particular the dopaminergic pathways of the ventral tegmental area and ventral stria- 514 International Neurological Journal (Ukraine), ISSN 2224-0713 (print), ISSN 2307-1419 (online) Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches tum [86–89]. The initial consumption is accompanied by a sharp release of dopamine, which enhances the salience of alcohol as an effective trigger of tension reduction [86–89]. Over time, the effect weakens, but the association is preserved in the form of a habit that operates outside critical awareness [86–89]. In parallel, an allostatic retuning of the HPA axis occurs: short-term suppression of cortisol secretion creates the illusion of an antistress effect, while in the long term hyperreactivity in sober states and hyporegulation in the absence of stress are formed [86–89]. This leads to the phenomenon of “psychological withdrawal” — anxiety, irritability, motivational fatigue, which automatically activate the search for alcohol as a means of restoring homeostasis. Behaviorally, the compensatory phase manifests itself in increased frequency of use after stressful or tiring events, the emergence of cognitive rationalizations (“I deserve to relax”), and an almost complete absence of critical reflection [63, 86–92]. The double paradox lies in the loss of autonomy of internal regulation, which is replaced by a neurotransmitter surrogate, as well as in the social legitimization of this pattern (“the right to a glass after a hard day”) [63, 86–92]. The sociocultural aspect amplifies the process: more than 50 % of Ukrainian and 56 % of Filipino respondents directly linked consumption with the need to relax. Alcohol becomes a “normalizer” of life and part of identity: the sober version of oneself is perceived as restrained and “less genuine”, while the alcoholic version — as authentic. In the end, the compensatory phase (dependence-shift) is a hidden but key stage of latent alcohol dependence: it signifies the restructuring of the reward system and the stress axis, the automation of behavior, and the social normalization of dependent patterns. Its insidiousness lies in the fact that subjectively it is experienced as a strategy of preserving mental health, while objectively it reflects a chronic deficit of emotional autonomy replaced by alcohol [63, 86–92]. Here the deep paradox is established: the individual considers themselves free, while their affective sphere is already structured around the substance. Fixation (anchoring). The anchoring phase is the critical point of the trajectory of latent alcoholization, where the final integration of alcohol into the cognitive-behavioral architectonics of personality takes place. If at the previous, compensatory stage, alcohol functioned as a situational “prosthesis” of affective regulation, then in the anchoring phase it becomes a stable behavioral constant, without which the self-regulation system loses its effectiveness. An important indicator of this transition is the feeling of incompleteness of the day without a dose of alcohol — the impression that a symbolic “key” is missing to close the cycle of tension and rest. Respondents described this feeling with phrases such as: “An evening without beer is like a day without lunch”, “If I don’t drink, it feels like something is left undone”. Such statements testify to the full internalization of alcohol into the structure of the daily behavioral matrix. The neuropsychological substrate of the anchoring phase is characterized by the transition from situationally determined consumption to a stabilized pattern with features of behavioral dominance [61, 90, 93–96]. Control shifts from the ventral to the dorsal striatum, which signifies the transformation of goal-directed behavior into habitual and rigid [61, 90, 93–96]. In parallel, top-down control of the prefrontal cortex is reduced: the decision “to drink or not to drink” loses the status of choice and becomes an almost automatic action [58–61, 90, 93–96]. At the molecular level, chronic reduction in D2-receptor expression in the ventral striatum leads to anhedonia: natural stimuli do not properly activate the reward system, whereas alcohol maintains the minimally necessary dopaminergic tone [58–61, 90, 93–96]. This creates a closed loop: sobriety is associated with a deficit of energy and motivation, while alcohol — with restoration of balance [58–61, 90, 93–96]. Additionally, HPA axis hyperreactivity in the state of withdrawal increases anxiety and tension, finally fixing alcohol as the main regulator of reward and stress systems [58–61, 90, 93–96]. Empirically, this dynamic is confirmed by quantitative data: in the German subsample, 20–25 % of respondents consumed more than a liter of beer daily, in the Ukrainian sample — 7.4 %. This is no longer occasional or episodic consumption, but a systematic practice that is reproduced almost without exception. Behavioral markers in this phase are clear: difficulties in controlling consumption (respondents admitted that “it is almost impossible to stop after one glass”), the feeling of internal incompleteness without alcohol, the growing fragmentation of identity (“the sober version of oneself seems incomplete, unfulfilled”). It is important to emphasize that in this phase alcohol even loses its compensatory status: it is no longer a means of relieving tension, but turns into an inseparable element of psychophysiological balance. The sociocultural context only deepens this process. In countries where alcohol consumption is legitimized as part of the daily routine (Germany, Czech Republic), anchoring occurs much faster, as behavioral schemes are reinforced by external social pressure and cultural norms. In the Ukrainian context, despite a lower percentage of daily consumption, anchoring has a different character: alcohol becomes a symbol of the end of the working day, an attribute of the “right to rest”. As a result, the individual cannot imagine rest without alcohol, and this cognitive pattern becomes so entrenched that even when switching to non-alcoholic drinks (as was recorded among some German respondents), the ritual remains unchanged — only the chemical substance changes. Subclinical phase (rationalized dominance). It is the most paradoxical and at the same time the most insidious stage in the dynamics of latent alcohol dependence. It is marked by the fact that alcohol acquires the status of a stable behavioral dominant, integrated into the everyday cognitive-emotional architectonics of the personality, but at the same time the classical clinical signs of dependence, which could be easily diagnosed by ICD or DSM criteria, are absent. That is why this phase remains unnoticed for a long time both for the individual and for their social environment, since it is masked as the norm — as a “habit”, “ritual”, or “way of relaxation”. The key mechanism of the hidden phase of dependence is rationalization: the subject creates cognitive justifications for alcohol consumption (“I can stop anytime”, “It’s a way to relax”), which integrate alcohol into the structure of the “Self” [32, 35–37, 47–49, 61, 66–69, 90, 93–96]. Neuro- 515 https://inj-journal.com Vol. 21, No. 7, 2025 Оригінальні дослідження / Original Researches psychologically, this reflects the retuning of the prefrontal cortex: executive control is directed not at restraining the impulse, but at legitimizing it [32, 35–37, 47–49, 61, 66–69, 90, 93–96]. At the level of neural networks, stable associations are formed, and prefrontal-striatal mechanisms lose flexibility, behavior becomes automatized and locked in a loop [32, 35–37, 47–49, 61, 66–69, 90, 93–96]. On a molecular level, there is a reduction of D2 receptors in the reward system, which causes anhedonia during sober periods; alcohol becomes the main source of pleasure [58–60]. Due to rationalization, the subject does not realize the dependence, creating the phenomenon of “second-order dependence” — on alcohol and on the belief in their own independence [32, 35–37, 47–49, 61, 66–69, 90, 93–96]. Unlike clinical alcoholism, here there is no conflict between the desire to drink and the awareness of harm, and reflection turns into a mechanism of normalization, creating an illusion of freedom that does not correspond to the neurobehavioral markers of dependence. Empirically, this pattern was manifested in 30 % of respondents from Germany, 10 % from Ukraine, and 12 % from the Philippines. Geographic differences are explained by cultural context: in Germany, daily consumption of beer or wine is socially legitimized and perceived as part of the rhythm of life; in Ukraine, the compensatory nature of drinking gradually transforms into a stable need, although less massively; in the Philippines, socio-communicative factors play a role — alcohol as a tool of inclusion into the community. However, in all three contexts, the mechanism is the same: alcohol becomes an “invisible dominant” that is masked as the norm. Behavioral markers of this phase are first, the regularity of consumption, which no longer allows variations; second, rationalization as the main cognitive defense tool (“I can quit at any time”); third, stable denial of dependence, reinforced both by individual and social argumentation (“Everyone does it”, “It’s a cultural tradition”). As a result, alcohol not only becomes a behavioral dominant but is also fixed in the system of personal identity as an element of normality. Discussion The obtained results confirm that the phenomenon of latent alcoholization in socially adapted individuals should be considered as a multidimensional phenomenon combining psychological, sociocultural, and neurophysiological factors. Unlike classical alcoholism, here clinically pronounced manifestations of dependence are absent, yet alcohol is gradually integrated into the system of affective and cognitivebehavioral regulation. Studies conducted in different countries indicate that even low doses of alcohol can change the functional activity of the reward system, weaken the control of the prefrontal cortex, and form conditioned reflex connections between social or temporal contexts and consumption. M. Field and T. Duka state in their work that conditioned stimuli associated with a low dose of alcohol are capable of quickly evoking physiological and behavioral reactions in social drinkers [20]. The authors note that during conditioning higher levels of craving for alcohol, feelings of “light intoxication”, “relaxation”, and “pleasure” were observed, as well as increased skin conductance in response to the CS+ stimulus. The authors add that after conditioning, participants more often directed their gaze to CS+, although they did not choose it more often for consumption [20]. They emphasize that these results support the incentive salience theories of addiction [20]. T. Schoenmakers, R.W. Wiers, and M. Field in turn note that even a small dose of alcohol enhances the motivational urge to consume alcohol [98]. In their work, they add that after alcohol intake, participants experienced increased levels of subjective craving and heightened attention to alcohol-related stimuli, manifested both in faster reactions to alcohol images and in increased fixation time on them [98]. They also state that initial eye movements were more often directed to alcohol stimuli after a dose of alcohol, which was not observed after placebo [98]. At the same time, the approach bias did not significantly change under the influence of alcohol, remaining similar in both conditions [98]. The authors emphasize that a low dose of alcohol not only enhances individual indicators of motivation to consume but also increases correlations between cognitive indicators of this process, confirming their common basis in the form of appetitive motivation toward alcohol [98]. Of particular interest is the role of the neuro-glio-capillary interface, which acts as a key mechanism of brain adaptation to the systematic influence of small doses of alcohol. Available data indicate that microvascular-glial changes may reduce sensory sensitivity to stressful stimuli, but at the same time enhance the activation of the reward system in response to alcohol. This leads to the consolidation of behavioral rituals and the formation of automated patterns such as “stress — alcohol — relief” or “evening — a glass of wine — end of the day”. It is also worth noting that similar conclusions are reached in the work of Y. Bondarenko, O. Kauk (2025). The authors state in their work that even regular moderate alcohol consumption without clinical dependence is capable of causing latent cortical neurodegeneration [5]. The authors add that this condition is accompanied by subclinical cognitive and emotional disorders, neuroinflammation, suppression of synaptic plasticity, and dysfunction of neuro-glio-capillary interaction [5]. The authors note that they proposed a new phenotype — hidden neurotoxicity syndrome as a separate subtype of chronic alcohol-induced encephalopathy, which cannot be detected by standard diagnostic methods but poses a risk to the cognitive reserve and emotional regulation of the individual [5]. All this confirms that latent alcoholization is not merely a cultural or behavioral habit but is formed on the basis of deep neurobiological processes that ensure its stability. Conclusions Latent alcoholization appears as a special phenomenon — a hidden cognitive-behavioral dependence that develops in socially adapted individuals without clinical signs of alcoholism. Its foundation is ritualized and culturally sanctioned consumption, which gradually becomes embedded in the structure of personal regulation and is supported by neuro-glio-capillary mechanisms. Thus, alcohol ceases to be merely a substance and turns into an “invisible regulator” of psycho-emotional homeostasis and social inclusion.