Risk-taking and alcohol use disorders symptomatology in a sample of problem drinkers.

Abstract

The relationship between risk-taking behavior and alcohol use disorder (AUD) symptoms is poorly understood. This study employed a modified version of a behavioral measure of risk-taking, the Balloon Analogue Risk Task (BART), to examine its relationship to alcohol use and related symptoms in a community sample of individuals with or at risk for AUD. A total of 158 (71.9% male) participants completed a testing battery that included the BART, a structured diagnostic interview for AUD, and measures of alcohol use and related problems. Estimates of IQ and working memory were assessed as covariates. Results indicated that the relationship between risk-taking propensity, as assessed by the BART, and alcohol problems was significant and negative. Individuals with higher symptom count made fewer pumps per trial on the BART, indicating less risk-taking. Importantly, this relationship was attenuated when controlling for estimated IQ and working memory span. Further examination demonstrated that IQ and age mediated the relationship between risk-taking propensity and symptom count. The main negative relationship observed between risk-taking on the BART and alcohol use and AUD symptomatology in this sample stands in contrast to the positive relationships observed in adolescent and non-clinical samples. Together, these findings highlight the need to consider development and the course of addiction in order to fully elucidate the effects of risky-decision making on AUD liability. Furthermore, our results demonstrate the importance of inclusion of neurocognitive covariates (IQ) as well as demographic variables (age) when using this task.

Modeling behavioral reactivity to losses and rewards on the Balloon Analogue Risk Task (BART): Moderation by alcohol problem severity.

“…A subset of these participants (N 158) were included in a previous report on these data (Ashenhurst et al, 2011). Inclusion criteria were as follows: (1) age between 21 and 65; (2) self-identification of "problems with alcohol"; (3) telephone endorsement of consuming a minimum of 48 standard drinks per month.…”

“…In addition, this represents the first attempt to test whether severity of alcohol problems is associated with behavioral reactivity to bursts and cash outs of differing reward/loss magnitudes in the BART as assessed in a large community sample of heavy drinkers expressing a range of alcohol use problems. These analyses advance the literature by examining behavioral mechanistic explanations for the negative relationship between substance use problems and risk-taking in the BART in adults (Ashenhurst et al, 2011;Campbell et al, 2013;Ryan et al, 2013). This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

“…These control variables include demographic and neurocognitive indicators such as age, IQ, and working memory span (Ashenhurst et al, 2011). Furthermore, Dean et al (2011) have suggested that the negative relationship between substance use and risk-taking in the BART may be because of the risk-taking being confounded with delay discounting because greater amounts of reward-seeking on trials in the BART (the outcome typically associated with more risky decisions) requires persistence and patience for a future (often small) reward.…”

“…Research using this task to examine the role of risky decisionmaking in substance use and misuse has yielded a complex picture, particularly when examining individuals expressing differences in substance use problem severity (Ashenhurst et al, 2011) and across stages of substance use involvement. In subclinical and adolescent populations, increased risk-taking in the BART is associated with increased problematic alcohol and drug use (Fernie, Cole, Goudie, & Field, 2010;Lejuez, Aklin, Bornovalova, & Moolchan, 2005;Lejuez et al, 2002;MacPherson et al, 2010).…”

“…With sufficient sampling, healthy participants learn to select the advantageous decks more than the disadvantages ones. However, individuals with substance use disorders tend to behave similarly to patients with prefrontal cortex damage; they fail to learn to select the advantageous decks, and demonstrate enhanced reward reactivity as well as diminished loss sensitivity, resulting in a risk-taking temperament with reduced economic utility in the IGT (Bechara & Damasio, 2002;Bechara et al, 2001;Stout, Busemeyer, Lin, Grant, & Bonson, 2004) Thus, the primary aim of this study was to implement a detailed trial-by-trial analysis of behavior in the BART to identify behavioral mechanisms that may explain why participants at greater levels of alcohol problem severity take less risk in the BART (Ashenhurst et al, 2011). In most analyses of the BART, data is tabulated as means across trials (calculating mean pumps on nonburst trials for a given administration of the BART), which fails to capture the trial-by-trial reactivity and learning that is occurring during the progression of the task.…”