Binge drinking and sex: effects on mood and cognitive function in healthy young volunteers

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Abstract

This study compared the mood and cognitive performance of male and female teetotal and binge drinking students. The binge drinkers had significantly lower self-ratings of trait anxiety and depression and of state alertness at the time of testing than did the teetotallers. The females had significantly higher ratings of trait and state anxiety, but there were no Sex×Bingeing interactions on mood. The binge drinkers made significantly fewer correct responses in a test of sustained attention and recalled fewer line drawings. There was a significant Sex×Binge interaction in a spatial recognition task because the male, but not the female, binge drinkers were slower to make correct responses. Males performed better than females in both the spatial and pattern recognition memory tasks. There were three tests of executive function. In a spatial working memory task, males performed better than females, but there were no effects of binge drinking. There were no effects in a test of mental flexibility. However, in a test of planning, the binge drinkers were significantly slower than the teetotallers were. Thus, compared with a group of teetotallers, the binge drinkers had lower trait anxiety and depression and poorer performance in tests of sustained attention, episodic memory and planning ability.

Introduction

Surprisingly, only 30–60% of adult alcoholics have been found to have neuropsychological impairments (Grant et al., 1984). Drinking variables, such as amount consumed and duration of drinking, cannot account for the cognitive deficits of alcoholics, and Parsons and Stevens (1986) suggested that they might be related to the number of withdrawal episodes. Several studies suggest that the pattern of drinking is an important factor. Hunt (1993) suggested that the risk of developing brain damage was greater in binge drinkers, and Wechsler et al. (1994) found that alcohol-related problems were related to a pattern of binge drinking. Glenn et al. (1988) found that the number of withdrawals was linked to poor memory in adult alcoholics. Alcohol-dependent adolescents had significant impairments of long-term nonverbal memory that was linked to the number of withdrawals, especially in boys.

A decade ago, we surveyed the drinking and lifestyle habits of 774 medical and dental students in London (File et al., 1994). One third of the male students in Years 1–3 were drinking above the government guidelines of safe drinking (>21 units/week), and 12–22% of the female students drank >15 units/week. By the fifth year, the percentage of males drinking >21 units/week had risen to 59%. In the group of male students identified as drinking at dangerous levels (>40 units/week), there was a clear pattern of binge drinking, with 100% of them drinking >10 units on one or more occasions per week and at least half of their total alcohol intake occurring at weekends. Of this group, 65% had been physically hurt or had hurt others as a result of their drinking, and 30% drank at lunchtime more than once a week. In recent years, there has been an increase in the incidence of binge drinking, and this has been particularly marked in young women (Office for National Statistics, London, 2002). In a recent study, Weissenborn and Duka (2003) compared student bingers and nonbingers and found that the bingers showed significantly worse performance in a test of spatial working memory and in a pattern recognition task. No other differences in cognitive performance were found. The purpose of the present study was to compare the mood and cognitive performance of a group of teetotal students with that of a group of binge drinkers and to determine whether there were any sex differences. The cognitive test battery included tests of sustained attention, memory and executive function.

In addition to government definitions of binge drinking, we calculated binge scores as defined by Townshend and Duka (2002) on the basis of the information ‘drinks/h’, ‘times being drunk in the last 6 months’ and ‘percentage of time getting drunk when going out’, as extracted from the Alcohol Use Questionnaire (AUQ; Mehrabian and Russell, 1978). This binge score is derived from the relationship between alcohol intake and drinking patterns and thus provides an overall view of habitual alcohol use. For example, a participant with a high binge score may have a similar weekly intake of alcohol with those with a lower binge score but would consume the majority of the alcohol in a single session. In a study of 61 university students, Townshend and Duka (2002) found that the relationship between these ‘binge scores’ and alcohol intake showed little correlation (r=.23; n.s.), whereas a highly positive correlation (r=.58; P<.01) was seen between number of drinks/h and the amount of alcohol consumed, indicating that the binge score is unrelated to the amount of alcohol drunk. As bingeing behaviour may be a key factor for increased alcohol dependency and cognitive impairment Hunt, 1993, Stephens, 1995, it is important to distinguish between alcohol intake and patterns of drinking.

Section snippets

Methods

The test order is given in Table 1.

Volunteer characteristics

It can be seen from Table 2 that the four groups did not differ in age [F(1,23)=1.8, n.s.], verbal IQ, BMI, smoking or caffeine intake (F<1.0 in all cases, n.s.).

Alcohol consumption

Table 3 shows that the male and female binge drinkers did not differ significantly in their typical weekly alcohol consumption (F<1.0, n.s.), their previous week's consumption (F<1.0, n.s.) or in their binge drinking score [F(1,12)=1.4, n.s.].

Hospital anxiety and depression scale

The female students had significantly higher anxiety ratings than did the males [F(1,23)=18.4,

Discussion

The students in the present study were mainly third year students, and whilst the typical weekly alcohol consumption of the males was similar with the mean found 10 years ago, the intake in the female students in the present study is about 2.5 times higher. Although this could be an artefact of the small sample in the present study, the indication of increased alcohol consumption in female binge drinkers is in agreement with findings in a recent survey by the Office for National Statistics,

Acknowledgements

This study was supported by a grant from the Dunhill Medical Foundation. We are indebted to Professor Theodora Duka for her encouragement and help with this study.

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