Longitudinal cognitive control performance in binge drinkers measured via remote online assessment


Background:Binge drinking – and the significantly amplified risk of injury and illness that accompany it – is a major public health problem in Australia and internationally. Compared to healthy controls, both binge and heavy drinkers are typified by impulsive decision-making and impaired cognitive control. The current study examined the reliability and validity of using online measures of cognitive control (Stop-signal Task, Delay Discounting Task) to identify deficits associated with binge drinking and tracking these effects longitudinally to examine their relationship to alcohol-related harms and changes in use behaviour.

Methods:One hundred and thirty-one participants (Mage=23.63, 67% female) completed measures of Alcohol use (AUDIT, AUQ, ASSIST, TLFB), cognitive control (stop-signal, DDT) and mood: anxiety (GAD-7), depression (PHQ-9), via web-based platform programmed in HTML (v5) and JavaScript. The mean duration between baseline and follow-up was 350 days (SD 202.2, range = 86-641 days)

Results:Binge (n= 43; AUQ_Binge Score 32.9, AUDIT 12.4) and non-binge drinker groups were determined using the binge drinking criteria from López‐Caneda et al., (2012). Overall, there was a significant decline in binge drinking over the period of observation (no moderation by group), for example the Binge groups’ AUQ-Binge (T1: 29.8, T2: 25.7) and AUDIT scores (T1: 12.4, T2: 9.3) both dropped significantly. A comparison of SSRT performance by group across time showed no significant main effect of group (p= .34) or time (p= .07) and no significant interaction effect (p= .55). DDT performance showed no group effect, but both time (p = .008) and interaction effects (p = .04) were significant, wherein binge drinkers’ discounting rate increased from T1 to T2.

Consistent with Paz et al. (2018) analysis approach to within participant change, participants with a positive or negative change in AUQ Binge score > 1 were compared, demonstrating a positive relationship between decreased binge drinking and improved cognitive control on both the SST and DDT.

Conclusion:Consistent with recent mixed findings from laboratory-based self-control tasks in community samples (Carbia et al., 2018), online versions of the Stop-signal and Delay Discounting tasks did not differentiate binge drinkers from a control group across two timepoints. The tasks, particularly the Delay Discounting Task, did show a level of within-participant sensitivity to change in binge drinking behavior, with decreases in bingeing resulting in improved cognition. Given the high level of test-retest reliability of the tasks (in control participants), increased frequency of testing and online real-time feedback may be opportunities to increase the sensitivity of our approach, particularly for the purposes of augmenting online interventions for binge drinking


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