Research shows risk-taking behavior precedes increased alcohol consumption, not vice versa

A new research study has revealed that increased risk-taking behavior in individuals with mild to moderate alcohol use disorder (AUD) often precedes higher alcohol consumption during the subsequent month, rather than the other way around. This longitudinal investigation, published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, offers the first prediction of real-life drinking fluctuations using gamified smartphone-based decision-making tasks.

The findings provide an opportunity for future targeted and timely interventions for those with AUD, a condition responsible for significant global disability and mortality. Previous cross-sectional studies have associated AUD with impaired cognitive control and heightened risk-taking, but the direction of these effects concerning drinking behavior remained unclear.

This study clarified the causal timeline of these relationships. Researchers conducted a one-year study involving individuals with mostly mild to moderate AUD, whose drinking habits can vary substantially over time. By tracking participants' alcohol consumption, cognitive control, and decision-making through smartphone assessments and gamified experiments, they discovered that fluctuations in decision-making, particularly increased risk-taking in mixed gambling contexts and decreased information sampling biases, were associated with higher alcohol consumption in the following month.

Conversely, higher risk-taking in loss-context scenarios and reduced information sampling were linked to lower alcohol consumption. Importantly, fluctuations in self-control and reward-driven behavior were not connected to changes in drinking. Dr. Hilmar Zech and Dr. Lorenz Deserno, co-lead investigators from the University Hospital Würzburg and Technische Universität Dresden, noted that this temporal relationship was specific and not observed in reverse, even after considering prior drinking levels.

Dr. Cameron S. Carter, editor-in-chief of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, highlighted the value of smartphone-based gamified tasks in accurately assessing real-life fluctuations in risk-taking and cognitive control, suggesting their potential for early detection and preventive interventions. While immediate treatment implications are not yet apparent, these results using innovative measurement methods could lead to the development of personalized support systems during high-risk periods, helping individuals with AUD manage their drinking more effectively.