The Relationship Between Binge Drinking & Decision-Making in University Students

A correlational study proposal investigating how patterns of alcohol consumption shape risk-reward judgement in undergraduates at the University of Cape Town.

I · IntroductionA Problem on Campus

Binge drinking is a major problem in today’s world, and it is especially rife in the lives of university students. Many studies define it as the consumption of six or more units of alcohol for women and eight or more for men within a single session of about two hours (Maguire, 2016), followed by a period of abstinence (Carbia et al., 2017; Townshend et al., 2014; Yoo & Kim, 2016). There are many risk factors involved in binge drinking, especially among young adults, including psychological and neurocognitive effects. This is because the brain is still developing and is therefore much more vulnerable to the toxic effects of bingeing patterns of alcohol consumption. Recent research has shown that frequent binge drinkers engage in more risky behaviours such as unplanned sexual encounters and driving under the influence. It has also shown that there are increased levels of impaired decision-making amongst frequent binge drinkers (Townshend et al., 2014). This is the main reason our research study focuses on investigating whether there is a relationship between binge drinking and patterns of risky decision-making amongst university students.

Most of the literature on binge drinking and decision-making supports the claim that frequent binge drinking is not only linked to impulsivity but also impairs the decision-making processes involved in risk-taking, even when participants are sober. It is important to note that all but one of the studies reviewed found a negative relationship between bingeing patterns of alcohol consumption and executive functioning. The study conducted by Carbia et al. (2017) found no association between bingeing patterns of consumption and disadvantageous or risky decision-making. This contrast could potentially be accounted for by the fact that the study ran over four years, within which the Iowa Gambling Task (IGT) was repeated yearly. This is important to note because it is probable that participants became more aware of how the task worked and what was expected of them, as they were exposed to the test more than once, thus compromising the validity of the study.

Our research study will investigate the relationship between binge drinking and risky decision-making. We will utilise an adapted version of the Alcohol Use Disorders Identification Test (AUDIT) to allocate participants into one of three groups: binge drinkers (BDs), social drinkers (SDs), and non-drinkers (NDs). These allocations will be made on the basis of the scores participants obtain on the survey. We will also utilise the Iowa Gambling Task (IGT) to measure the patterns of decision-making across the three different groups. The IGT is designed to engage decision-making processes in the brain. It is sensitive to risk-reward-related decision-making — whether people make high-reward, high-risk choices or stable-reward, minimal-risk choices (Yoo & Kim, 2016) — and so participants must learn from previous picks to choose cards from advantageous decks (Xiao et al., 2009).

II · RationaleWhy This Matters

This research is important because binge drinking is a major problem, especially amongst university students. It has generally been found to have adverse effects on decision-making, which means that students are prone to making poor decisions that often result in them engaging in risky behaviours such as unplanned sexual encounters and driving under the influence. This is a significant problem because the consequences of these risky behaviours can be fatal.

Our study seeks to add to the growing body of research investigating the relationship between binge drinking and decision-making. We hypothesised that binge drinkers would make decisions that are more risky compared to social drinkers and non-drinkers. We assumed that binge drinkers would continue to choose from the ‘disadvantageous’ decks on the Iowa Gambling Task, suggesting that they have poorer decision-making skills. We hope that our findings will inform future research that may identify causal links between binge drinking and poor decision-making, and ultimately educate those who are at risk.

III · MethodsHow the Study Would Have Run

Design & Setting

We planned a correlational study at the Psychology Department of the University of Cape Town (UCT). The independent variable (IV) was the drinking behaviours of participants and consisted of three groups: binge drinkers (BDs), social drinkers (SDs), and non-drinkers (NDs). BDs were operationally defined as men consuming five units of alcohol and women consuming four units of alcohol in about two hours. We considered a unit of alcohol to be a drink with a concentration of about 10 ml of pure alcohol, equivalent to a standard glass of wine, half a pint of beer, or a single shot of gin, whiskey, or vodka. It is important to note that, for BDs, consumption needed to be followed by a period of abstinence for one to be classified as a binge drinker. SDs were operationally defined as people who had consumed alcohol in the past 30 days but in a quantity of less than five units in about two hours, while NDs were operationally defined as people who had not consumed alcohol in the past year and/or had never consumed alcohol before. Participants were allocated to these groups according to their scores on the Alcohol Use Disorders Identification Test (AUDIT). The dependent variable (DV) of this study was the decision-making pattern of the participants, measured using the Iowa Gambling Task (IGT).

Participants

We recruited 60 participants for our study: 30 males and 30 females. Participants were allocated to each of the three groups — BDs, SDs, and NDs — with an equal number of males and females in each group. They were registered undergraduate students for the 2020 academic year at UCT and were recruited using convenience sampling through the Student Research Participation Program (SRPP). This is a program in which undergraduate students registered for any Psychology course are required to participate in research studies in exchange for SRPP points, which are required to write the final exam. Students who are not registered for any Psychology courses were therefore automatically excluded from our study.

We excluded participants who (a) had a history of any psychiatric disorder, (b) had a neurological disorder, or (c) obtained a score above 26 on the AUDIT. The first two criteria were chosen because those disorders were potential extraneous variables that would have affected the validity of our findings. The last criterion was chosen because scores above 26 suggest alcohol dependency, so we needed to exclude those participants to ensure validity. Had any participants obtained scores above 26, we would have referred them to Student Wellness Services (SWS) to ensure they received the help they needed. They would also have been rewarded with 1 SRPP point for participating in the first half of our study.

Materials

We utilised an adapted version of the Alcohol Use Disorders Identification Test (AUDIT) for our study. This measure is a 10-item screening tool created by the World Health Organisation (WHO) to assess alcohol consumption and drinking behaviours. Participants were asked to reflect on the past year and to select the responses that best described their patterns of alcohol consumption. Each of the 10 items is scored from 0 to 4, so the maximum attainable score is 40. Although the WHO recommends a cut-off of > 8, researchers have suggested a cut-off of > 12 for added specificity (Yoo & Kim, 2016); we utilised the latter for this study. Participants who obtained a score of 8 or less were assigned to the non-drinkers (NDs) group; those scoring between 8 and 12 (exclusive) were assigned to the social drinkers (SDs) group; and those scoring between 12 and 26 (inclusive) were assigned to the binge drinkers (BDs) group. Participants scoring above 26 were excluded, as such scores indicate potential alcohol dependence (Yoo & Kim, 2016). The AUDIT has been found to be a valid screening tool for at-risk drinking behaviours amongst university students (Campbell & Maisto, 2018).

The Iowa Gambling Task (IGT) is a psychometric test that assesses an individual’s decision-making skills by introducing them to a novel task that simulates real-life decision-making (Bechara et al., 1994). This test was used to measure the DV in our study. Participants were asked to pick and reveal cards from four different decks (A–D). When they revealed each card, they either had to pay a penalty to the researcher or receive money from the researcher. Decks A and B were considered the ‘advantageous’ decks, as they had lower penalties but also lower gains, while decks C and D were considered the ‘disadvantageous’ decks, as they had high penalties as well as high gains (only the researcher knew which decks were advantageous and which were not). Participants had one practice trial before proceeding with the IGT, which consisted of forty ‘official’ trials. Participants who learned to choose cards from the advantageous decks (A and B) over the disadvantageous decks (C and D) were considered to have relatively good decision-making skills (Bull et al., 2015).

Procedure

Prior to the administration of the Iowa Gambling Task (IGT), there was an online screening phase that required participants to provide informed consent before completing the online AUDIT questionnaire. Those who obtained scores below 26 on the survey were allocated to one of the three groups — BDs, SDs, or NDs — according to their scores. They were then contacted to schedule a time to come in for the face-to-face session at the Psychology Department, UCT. Those who obtained scores above 26 were referred to Student Wellness Services (SWS) to receive the help they needed.

Upon arrival at the face-to-face session, participants were required to fill out another informed consent form. Once participants had provided consent, the administrator explained how the IGT worked. A practice trial was administered before the forty ‘official’ trials to ensure that participants had a clear understanding of how the task worked. Participants received a credit of 2,000 and had to pick cards from one of the four decks (A–D) placed in front of them to try to make as much profit as possible. The cards had positive and negative amounts on them, indicating whether participants made a profit or a loss. If the card picked had a positive amount, the administrator gave the indicated amount to the participant (profit). If the amount was negative, the participant had to give the money to the administrator (loss). There was no time limit when picking cards from each of the decks, and once the forty ‘official’ trials were completed, participants were debriefed about the IGT.

IV · ResultsWhat We Would Have Found

Due to the COVID-19 pandemic, we were unable to collect data for this project. Ideally, we would have utilised descriptive statistics to describe and summarise the data in each of the three groups — binge drinkers (BDs), social drinkers (SDs), and non-drinkers (NDs) — over the forty trials to help us identify any patterns. For example, the performance data of the NDs on the Iowa Gambling Task (IGT) would have been used to report the average number of selections for each of the four decks (A–D) to investigate whether they managed to discern between advantageous and disadvantageous decks, and to compare these results with the BDs and SDs. In addition, the average net scores of the BDs, SDs, and NDs after the 40 trials would have been compared. Tables and bar graphs would have been included in the report to visually represent these comparisons and make it easier for the reader to see the patterns.

Inferential statistics would have been utilised to make inferences about the data across the three groups. A one-way ANOVA would have been used to investigate whether there were statistically significant differences between the average number of selections from each deck and the average net scores of the BDs, SDs, and NDs. This test would have allowed us to conclude whether the differences observed (if any) were due to chance. It is important to note that a one-way ANOVA only shows that there are at least two group means that are significantly different, so we would have conducted Tukey’s Honestly Significant Difference (HSD) post hoc test afterwards to determine which groups had statistically different means. Finally, the Pearson correlation coefficient would have been utilised to determine the strength of the relationship between binge drinking and decision-making, if any. We provide the two assumptions below.

V · DiscussionWhat the Results Would Mean

VI · AcknowledgementsWith Thanks

We would like to acknowledge the guidance provided by our lecturer, Progress Njomboro, on how to conduct and report on our research. We would also like to add a special thanks to our tutor, Jade Mac Donnell, for providing guidance and support throughout our research. For further information about this research, feel free to contact us at researchstudy15b@gmail.com.