Decisions to Attend and Drink at Party Events: The Effects of Incentives and Disincentives and Lifetime Alcohol and Antisocial Problems

A daily diary exploration of contexts and experiences associated with planned drinking decisions in young adults

OBJECTIVE

Despite the potential for negative consequences, young adults continually engage in heavy alcohol use. Unplanned (vs. planned) drinking has been of particular interest in several studies, as it is theoretically suggested to be related to poor behavioral regulation and negative consequences. Ecological momentary assessment and daily diary (DD) studies have been used to examine the contexts and consequences of planned and unplanned drinking specifically, resulting in somewhat mixed findings surrounding the factors contributing to and consequences of planned drinking. The present DD study adds to this literature by studying rewarding incentives and physical contexts of planned versus unplanned alcohol use, as well as the experiences, or consequences, of planned drinking events.

METHOD

Ninety-nine young adults took part in a mobile study investigating drinking decisions for the current day and day prior, reporting the rewarding incentives contributing to their decision, the context of drinking events, and the experience of each event.

RESULTS

Planned drinking was associated with being influenced by social/party and alcohol incentives, as well as being at a bar and pregaming. There was a positive relationship between planned drinking and subjective level of intoxication, but not negative or positive experience.

CONCLUSIONS

Planned drinking is likely associated with rewarding incentives and social contexts and may contribute to higher levels of subjective intoxication. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Making decisions one drink at a time and the "just one drink" effect: A fuzzy-trace theory model of harmful drinking

BACKGROUND

Understanding the decision factors that drive harmful alcohol use among young adults is of practical and theoretical importance. We apply fuzzy-trace theory (FTT) to investigate a potential danger that may arise from the arguably correct notion that a single drink carries no meaningful risk. Decisions that are mentally represented as one drink at a time could contribute to excessive drinking.

METHODS

College students (N = 351) made a series of decisions to take or decline eight hypothetical drinks presented one at a time. Outcome measures included each decision, recent alcohol consumption (weekly drinks, peak blood alcohol content, and binges), and alcohol-related harms (scores on the Brief Young Adult Alcohol Consequences Questionnaire and Alcohol Use Disorders Identification Test). Linear regression models predicted each outcome from sex, perceived risk of a single drink, perceived risk of heavy drinking, perceived consequences of drinking, and general health-related risk sensitivity.

RESULTS

Consistent with FTT, decisions to have a first drink and up to four additional drinks in short succession were each associated with lower perceived risk of one drink-a "just-one drink" effect-independent of perceived risks of heavy drinking, perceived consequences of drinking, and general risk sensitivity. Similarly, all measures of recent alcohol consumption and consequent harms were associated with perceived risk of one drink. Participants reporting "zero risk" of a single drink had worse outcomes on all measures than those reporting at least "low risk."

CONCLUSIONS

Results are consistent with the theoretically informed premise that consumption decisions are typically made one drink at a time rather than by deciding the total number of drinks to be consumed in a sitting. When decisions about alcohol use proceed one drink at a time, a perception of zero risk in a single drink may contribute to heavy drinking.

Do Subjective Effects from Alcohol and Cannabis Predict Simultaneous Use During a Decision-Making Task?

Background: Simultaneous alcohol and cannabis use is associated with negative outcomes, yet little is known about what motivates the decision of simultaneous use. One possibility is that early-episode subjective effects motivate simultaneous use to complement or replace the first substance's effects. The current study used a hypothetical decision-making task to test this hypothesis. Objectives: College students (N = 486) were presented eight scenarios characterized by alcohol/cannabis subjective effects (i.e., high/low arousal positive [e.g., excited, relaxed], high/low arousal negative [e.g., aggressive, dizzy]) and asked their likelihood of simultaneously using the other substance per scenario. Multilevel modeling tested whether subjective effect scenarios predicted a higher likelihood of simultaneous use and whether ordering moderated this association. Results: Task-based simultaneous use likelihood was associated with self-reported simultaneous use, showing task validity. Scenarios characterized by high/low arousal positive effects were associated with higher likelihood of simultaneous use, whereas high/low arousal negative scenarios were associated with lower likelihood. Alcohol vs. cannabis-first scenarios were associated with higher likelihood of simultaneous use, and significant interactions were observed for high/low arousal positive and high arousal negative effects. High arousal positive scenarios were associated with higher likelihood of simultaneous use when cannabis was used first, low arousal positive scenarios with higher likelihood when alcohol was used first, and high arousal negative scenarios with lower likelihood when cannabis was used first. Conclusions: Beginning-of-episode subjective substance effects may be a promising event-level predictor of simultaneous use, and just-in-time interventions may benefit from targeting the ordering and subjective experiences of alcohol and cannabis use.

Social incentives are stronger predictors of drinking decisions than alcohol incentives in young adults: The role of alcohol use disorder

This study investigated the influence of social incentives, alcohol incentives, and responsibility disincentives on decisions to attend and drink at party events in young adult college students (n = 82; 55 women, 27 men) where 36 (20 women; 16 men) had an Alcohol Use Disorder (AUD) and 46 (35 women; 11 men) were control participants without an AUD. In this within-subjects design, participants were presented with a series of hypothetical drinking event scenarios that varied in terms of social incentives (knowing many vs. few people), alcohol incentives (more vs. less alcohol available), and next-day responsibility disincentives (high vs. moderate vs. low). Participants were asked whether they would attend the event and how many drinks they would consume. Social incentives significantly predicted both decisions to attend party events and decisions about how much to drink for all participants. Participants were more likely to decide to attend and drink more at high social incentive party events (where they knew more people). However, while low social incentives generally discouraged attendance decisions, AUD participants were more likely than controls to decide to attend party events in low social incentive contexts. Alcohol incentives did not affect attendance decisions. However, alcohol incentives did increase drinking amount decisions for AUD participants. Finally, while disincentives decreased attendance and drinking amount decisions in general, AUD participants were less deterred by responsibility disincentives than controls. The results highlight the important influence of social rewards on drinking-related decisions and suggest individual differences in how incentives and disincentives affect drinking decisions in persons with an AUD.

The event-based influence of incentivizing and physical contexts on daily alcohol initiation and consumption

BACKGROUND

Young adults often decide to engage in heavy drinking. Learning more about the real-time factors that predict decisions to initiate a drinking episode and how much is consumed in any single drinking episode is necessary in developing our understanding of momentary alcohol use and discrete decisions surrounding alcohol use.

METHODS

The current study examined the association between contextual factors and decisions to initiate and consume alcohol in 104 young adult individuals over 2 weeks via mobile daily diary. Participants responded to daily notifications about decisions to drink or not and the contextual factors surrounding each event. The contextual factors included the situation (e.g., bar setting and pregaming) and incentives (e.g., alcohol, social, and mood enhancement).

RESULTS

Multilevel analyses revealed that incentives predicted both the initiation of drinking and the amount consumed. Event-based alcohol and mood incentives predicted the initiation of drinking, while alcohol, mood, and social/party incentives predicted how much was consumed at a specific event. However, context had a more complex association with drinking outcomes. Being in a bar, alone, or at a residence predicted decisions to initiate drinking, while being in a bar, pregaming situation, or other party situation with others who are drinking predicted how much a person drank.

CONCLUSIONS

The results highlight the importance of studying event-specific predictors of drinking decisions and the complex association between context/location and the type of drinking decision or outcome.

Slower rates of learning to inhibit behavior in alcohol use disorder

OBJECTIVE

Alcohol use disorder (AUD) is associated with passive avoidance learning (PAL) deficits. This study investigated PAL deficits in AUD by using a novel growth model approach to quantify patterns of PAL as changes in false alarms over time, rather than the typical index of total false alarms in a PAL task.

METHOD

Subjects, 112 (58 men; 54 women) with an AUD and 110 controls (44 men; 66 women), were administered a monetary incentive Go/No-Go task. Subjects could win $0.25 for a hit (response after a GO) or lose $0.25 for a false alarm.

RESULTS

PAL rate was quantified as the slope of initial learning phase (across the first 5 blocks) on the Go/No-Go task. The PAL curves indicated rapid learning in first 5 blocks followed by a later slower learning across blocks 6-9 (consolidation phase). A piecewise growth model with random intercepts indicated that AUD status was significantly associated with a slower initial PAL (i.e. learning phase), with B = -0.69, p < 0.001 for the control group and a PAL slope of 0.13 higher for the AUD group indicating a slower learning rate in the AUD group. This effect was not observed in the consolidation phase.

CONCLUSIONS

The results suggest that those with an AUD have greater difficulty learning to avoid negative consequences compared with controls. The results also suggest that measuring PAL rate by focusing on the rate of learning early in the task may be a better index of PAL learning than simply looking at overall false alarm rate. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mobile assessment of decisions to drink in young adults: Examining the role of incentives and disincentives

BACKGROUND

Research on decision-making (DM) biases in persons with alcohol use disorder have largely relied on behavioral economic DM tasks, which do not assess the dynamic multitude of factors associated with real-world decisions about drinking. The current study extends the literature on DM and alcohol use by using a mobile daily diary approach to investigate whether, and how, real-world incentives and disincentives are associated with actual drinking decisions in college students.

METHODS

We assessed current drinking and lifetime alcohol problems in 104 young adults (61.5% female, 84.5% White) who, for 14 days, used a mobile daily diary to respond to questions about drinking decisions from the day prior. Mobile prompts assessed daily data on the timing of drinking decisions, alcohol quantity initially decided to drink, quantity actually decided to drink, and the incentives that influenced drinking decisions.

RESULTS

Users of the app reported high usability, high compliance rates were observed, and incentive responses were reduced to three subtypes: alcohol, social/party, and mood. Daily mobile measures of drinking quantity were strongly correlated with self-reported drinking 2 weeks prior to the daily assessment. Lifetime alcohol problems were positively related to the average quantity decided to drink per event, drinking more than initially decided, and higher levels of self-reported drinking-decision incentives. "Alcohol" and "social/party" incentives were positively related to the quantity the participant decided to drink at drinking events. Mood incentives and disincentives showed little to no significant relationships with drinking decisions.

CONCLUSIONS

The results suggest that mobile data collection can be useful for assessing aspects of real-world drinking decisions and the influence of multiple drinking decision incentives.

The problems with delay discounting: a critical review of current practices and clinical applications

Delay discounting paradigms have gained widespread popularity across clinical research. Given the prevalence in the field, researchers have set lofty expectations for the importance of delay discounting as a key transdiagnostic process and a 'core' process underlying specific domains of dysfunction (e.g. addiction). We believe delay discounting has been prematurely reified as, in and of itself, a core process underlying psychological dysfunction, despite significant concerns with the construct validity of discounting rates. Specifically, high delay discounting rates are only modestly related to measures of psychological dysfunction and therefore are not 'core' to these more complex behavioral problems. Furthermore, discounting rates do not appear to be specifically related to any disorder(s) or dimension(s) of psychopathology. This raises fundamental concerns about the utility of discounting, if the measure is only loosely associated with most forms of psychopathology. This stands in striking contrast to claims that discounting can serve as a 'marker' for specific disorders, despite never demonstrating adequate sensitivity or specificity for any disorder that we are aware of. Finally, empirical evidence does not support the generalizability of discounting rates to other decisions made either in the lab or in the real-world, and therefore discounting rates cannot and should not serve as a summary measure of an individual's decision-making patterns. We provide recommendations for improving future delay discounting research, but also strongly encourage researchers to consider whether the empirical evidence supports the field's hyper-focus on discounting.

Neural Modulation in Approach-Avoidance Conflicts in Externalizing Psychopathology

Externalizing psychopathology (EXT) is characterized by poor decision-making in situations that involve simultaneous cues for approach and avoidance behavior (i.e. approach-avoidance conflicts). Previous studies of EXT have examined these deficits primarily using tasks involving decisions between positive reward and negative punishment, suggesting that EXT is characterized by a general bias towards high salience (e.g. temporally proximal or reward) cues relative to low salience (e.g. temporally distal or loss) cues. However, in order to better characterize decision-making in approach-avoidance conflicts, the present study utilized a novel task to examine neural activation in contexts involving both positive reward and negative punishment as well as positive punishment and negative reward by manipulating physical proximity of affective cues. Neuroimaging results indicated that EXT was associated with deficits related to cue prioritization based on salience, suggesting that failure to differentiate relevant from less relevant information contributes to poor decision-making among individuals with EXT.

Risky drinking decisions: The influence of party music and alcohol abuse in young adult women

Music is a ubiquitous feature of young adults' social drinking environments, yet no studies have assessed whether and how it impacts risky decisions to drink alcohol. Previous research on the influence of music on risky decisions is largely based around decision tasks with monetary incentives.

METHODS

To assess the impact of music listening on risky drinking decisions, the current study used visual alcohol cues paired with hypothetical risky drinking scenarios (e.g., "You do not have a safe ride home" for alcohol). Young adult women with a history of alcohol abuse (N = 34) and casual-drinking control women (N = 29) made hypothetical decisions about whether or not to drink alcohol, or eat food (an appetitive control condition), in risky contexts while personal "party music" (music chosen by participants for "going out") and "home music" (music chosen for "staying in") played in the background. The main dependent measure - likelihood of drinking - was reported on a 4-point scale where 1 corresponded to "very unlikely", and 4 to "very likely".

RESULTS

Listening to party music while making decisions increased the likelihood of making risky decisions, regardless of alcohol abuse history, while other personal music did not. Further, party music specifically increased the likelihood of risky drinking decisions relative to risky eating decisions. As expected, those with a history of alcohol abuse made more risky drinking decisions in general, regardless of the type of music heard.

DISCUSSION

The results suggest that party music is an important feature of the drinking environment associated with increased risky decisions about drinking alcohol in young adult women, regardless of their history of alcohol abuse. The finding that music plays an important role in risky drinking decisions indicates that further investigation into the real-world drinking environments of young adults is crucial, as it will aid in the development of a more complete picture of risky drinking decisions in young adults.

Disinhibited personality, incentives, disincentives, and drinking-related decisions

Disinhibited personality traits, such as impulsivity (IMP), excitement seeking (ES), and low harm avoidance (HA), are thought to reflect a basic vulnerability toward alcohol use disorder (AUD). However, the specific vulnerability mechanisms associated with each trait are not well understood and there are no studies of the association between disinhibited personality and drinking-related decisions. This study investigated individual differences in drinking-related decisions associated with each trait using a task that manipulated the effects of incentives and disincentives on decisions to attend and drink at different hypothetical drinking events in a sample of 430 young adults (237 men, 193 women, mean age 21.3 years), over 60% of whom had an AUD of varying severity. The results revealed each personality domain was differentially associated with different aspects of drinking decisions. Both IMP and low HA were associated with being more likely to decide to attend party events with moderate and high goal-related responsibility disincentives. We suggest that low HA is associated with reduced sensitivity to the negative consequences of not meeting a responsibility, while IMP is associated with increased discounting of future rewards (associated with meeting a responsibility) relative to the immediate reward of attending a party event. ES was associated with being more responsive to alcohol party incentives when making decisions about attending party events and deciding to drink more at events, with the highest reward potential suggesting that ES is related to a reward sensitivity decision bias. IMP appears to be associated with stronger approach that results in decisions to consume more alcohol regardless of context. The results suggest specific mechanisms by which different domains of disinhibited personality affect actual drinking-related decisions.

Sex Differences in Trait Anxiety's Association with Alcohol Problems in Emerging Adults: The Influence of Symptoms of Depression and Borderline Personality

OBJECTIVE

The co-occurrence of alcohol use disorder (AUD) and internalizing psychopathology, such as anxiety and depression, has been well documented. However, most studies of the association between alcohol problems and anxiety, and do not simultaneously consider depression or borderline personality, which covary strongly with both anxiety symptoms and AUDs. The current study examined sex differences in the association between alcohol problems and anxiety, while accounting for depressive and borderline personality (BPD) symptoms.

METHOD

A sample 810 (364 females) young adults aged 18-30 recruited from the community, who varied widely in lifetime alcohol problems, were administered diagnostic interviews and measures of a trait anxiety, depression, and BPD symptoms.

RESULTS

Analyses revealed that trait anxiety, depression, and borderline symptoms were all significantly associated with higher lifetime alcohol problems in both males and females. However, the association between trait anxiety and alcohol problems was significantly stronger for males compared with females, even when controlling for depression and BPD symptoms. There were no significant sex differences in the association between alcohol problems and symptoms of either depression or BPD symptoms.

CONCLUSION

This suggests specific sex differences in the mechanisms by which trait anxiety is associated with alcohol problems.

The effects of a working memory load on drinking-related decisions: The role of incentives, disincentives, and lifetime alcohol problems

BACKGROUND

This study extends this literature on effects of working memory (WM) load on impulsive and disadvantageous decision-making by investigating the impact of WM load on drinking-related decisions in different incentive and disincentive contexts in a large sample (n = 821, 373 women) of young adults, 558 of whom had an alcohol use disorder (AUD).

METHODS

Decisions to attend and drink at hypothetical party events that varied in terms of alcohol party incentives (high vs low) and next day responsibility disincentives (high vs moderate vs low) were assessed. Subjects were randomly assigned to either a WM load (n = 387) or no load condition (n = 434).

RESULTS

Analyses revealed that the WM load reduced the degree to which a high disincentive deterred attendance decisions; attendance decisions were more likely under WM load in the high disincentive contexts. This effect was not found in the moderate or low disincentive contexts. Additionally, a WM load increased the effects of high alcohol party incentives on both decisions to attend and drink. The WM load also resulted in faster attendance decision reaction times, suggesting that subjects were more impulsive under load.

CONCLUSIONS

These results suggest that a WM load had a general effect of disrupting the decision-making process, reducing the inhibitory effects of high disincentives, amplifying the facilitating effects of high party incentives on alcohol-related decisions, and reducing decision deliberation times (reaction times). This suggests that individuals under significant cognitive load engage in more impulsive and riskier decisions when deciding to attend and drink at party events.

Moderate alcohol consumption and depression - a longitudinal population-based study in Sweden

BACKGROUND AND AIMS

The interrelationship between alcohol consumption and depression is complex, and the direction of the association is unclear. We investigated whether alcohol consumption influences the risk of depression while accounting for this potential bidirectionality.

METHODS

A total of 10 441 individuals participated in the PART study in 1998-2000, 8622 in 2001-2003, and 5228 in 2010. Participants answered questions on their alcohol consumption, symptoms of depression, childhood adversity, and sociodemographic, socioeconomic, psychosocial, and lifestyle factors. A total of 5087 participants provided repeated information on alcohol consumption. We used marginal structural models to analyze the association between alcohol consumption and depression while controlling for previous alcohol consumption and depressive symptoms and other time-varying confounders.

RESULTS

Non-drinkers had a higher depression risk than light drinkers (≤7 drinks/week) (risk ratio: 1.7; 95% confidence interval 1.3-2.1). Consumers of seven-fourteen drinks/week had a depression risk similar to that of light drinkers. Hazardous drinking was associated with a higher risk of depression than non-hazardous alcohol consumption (risk ratio: 1.8, 95% confidence interval: 1.4-2.4).

CONCLUSION

Light and moderate alcohol consumption and non-hazardous drinking were associated with the lowest risk of subsequent depression after accounting for potential bidirectional effects. Hazardous drinking increased the risk of depression.

Assessing health service satisfaction among users with substance use disorders within the municipalities in Norway

BACKGROUND

The purpose of this study was to assess what is associated with health service satisfaction among adults with a substance use disorder receiving services provided within different municipalities in Norway. An additional aim was to examine demographic and municipality characteristics, mental health, and types of substance use associated with health service satisfaction.

METHOD

A cross-sectional partial explorative study was executed in 2017 among 491 service users with substance use disorders from 20 randomly selected municipalities. The sample consisted of 70% males. The sample majority were single and unemployed, and their main sources of healthcare were the general practitioner (78%), The Norwegian Labor and Welfare Administration (72%), and addiction counsellors (62%).

RESULTS

Overall satisfaction was negatively associated with age, size of municipality, Global Severity Index (GSI) and illicit substance use during the last 12 months. Satisfaction with practical help, such as housing, economy, work and education, was negatively associated with GSI and positively associated with onset of first alcohol intoxication. Satisfaction with personnel was positively associated with onset of first alcohol intoxication and negatively associated with municipality size, GSI and illicit use the last 12 months. The results showed that more than half of the respondents (54%) to a large or great extent were satisfied with the overall services provided. The services they were less satisfied with were related to housing, economy, getting started with exercise and establishing a social network.

CONCLUSION

The results show areas associated with satisfaction and domains where the municipalities can improve their services to meet the users' needs and increase service satisfaction.

Delay Discounting of Losses in Alcohol Use Disorders and Antisocial Psychopathology: Effects of a Working Memory Load

BACKGROUND

Alcohol use disorders (AUDs) are associated with increased discounting of delayed rewards and reduced executive working memory (eWM) capacity. This association is amplified when comorbid with antisocial psychopathology (AP). Furthermore, recent studies suggest that reduced WM capacity is associated with disinhibited decisions reflected by increased impulsive decision making on the delay discounting of rewards task. While discounting of delayed rewards is well studied, the discounting of delayed losses has received significantly less experimental attention.

METHODS

The current study investigated (i) the rate of discounting of delayed losses in individuals with AUD only (n = 61), AUD with comorbid AP (n = 79) and healthy controls (n = 64); (ii) the relationship between eWM capacity and discounting of delayed losses; and (iii) the effect of a WM load on discounting of delayed losses. Discounting performance was assessed using a computerized discounting of delayed losses task.

RESULTS

Results showed that the AUD-only and AUD-AP groups had higher rates of discounting of delayed losses and lower eWM capacity compared to the control groups. Lower individual eWM capacity was associated with increased discounting of delayed losses. However, WM load did not increase discounting rates overall.

CONCLUSIONS

These results support the hypothesis that greater discounting of delayed losses is associated with AUD and comorbid AP problems and lower individual eWM capacity.