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본 연구는 폭음 대학생의 의사결정 결함을 아이오와 도박과제(Iowa Gambling Task: IGT)와 전망 유인가 학습(Prospect Valence Learning: PVL) 모델을 사용하여 알아보았다. 한국판 알코올 사용 장애 선별검사(The Korean version of the Alcohol Use Disorder Identification Test: AUDIT-K)와 알코올 사용 설문지(Alcohol Use Questionnaire: AUQ) 점수에 근거하여 폭음군(40명: 남 19명, 여 21명)과 비폭음군(40명: 남 6명, 여 34명)을 선정하였다. 의사결정 능력의 평가에 IGT가 사용되었는데, IGT는 이득보다 손실을 초래하는 불리한 카드(A와 B 카드)와 손실보다 이득을 초래하는 유리한 카드(C와 D 카드)로 구성되며, 총 네트점수(유리한 카드를 선택한 횟수에서 불리한 카드를 선택한 횟수를 뺀 점수)와 블록 네트점수(100시행을 5블록으로 구분하여 각 블록에서의 네트점수)로 의사결정 능력을 평가한다. PVL 모델은 IGT 수행의 기제를 이해하고자 개발된 인지 모델 중 하나로 IGT 수행이 피드백 민감성, 손실회피, 학습과 반응일관성 변수로 설명된다고 주장한다. IGT의 행동 자료를 분석한 결과 총 네트점수와 블록 3 네트점수에서 폭음군이 비폭음군에 비해 유의하게 낮은 점수를 보였고 카드선택 빈도의 경우 폭음군이 비폭음군에 비해 B카드, 즉 이득보다 손실을 초래하는 불리한 카드를 더 많이 선택하였다. 이에 덧붙여 PVL 분석 결과 폭음군이 비폭음군에 비해 피드백 민감성, 손실회피와 학습 변수에서 유의하게 낮은 점수를 보였으며, IGT 총 네트점수와 학습, 반응일관성, 손실회피와 피드백 민감성 사이의 정적 상관이 전체 연구대상자들에서 관찰되었다. 이 결과는 폭음을 하는 대학생이 의사결정의 결함을 가지고 있고, 이 결함이 각 카드의 유인가 기대값을 학습하지 못하고 장기적 결과보다는 즉각적인 보상에 더 큰 관심을 가지며 이전 시행에서의 이득/손실 경험을 추후 시행에 적용하지 못하는 것과 관련되어 있는 것을 시사한다.
This study investigated deficits in decision-making in binge drinking (BD) college students, using the Iowa Gambling Task (IGT) and the Prospect Valence Learning (PVL) model. Based on the Korean version of the Alcohol Use Disorder Identification Test (AUDIT-K) and Alcohol Use Questionnaire (AUQ) scores, BD (n = 40, 19 males and 21 females) and non-BD (n = 40, 6 males and 34 females) groups were determined. The IGT consisted of four cards, with two disadvantageous cards (A and B) resulting in a net loss, and two advantageous cards (C and D) resulting in a net gain. Decision-making ability was measured by the total net score and block net scores of the IGT. The PVL parameters, including feedback sensitivity, loss aversion, learning and response consistency, were estimated with the Markov chain Monte Carlo (MCMC) sampling scheme using OpenBUGS software in the BRugs package, which works from within R. The Mann-Whitney U-test was then used to analyze PVL parameters. The BD group exhibited a significantly lower total net score and block net score in the third block of the IGT, and selected the B card more frequently than the non-BD group. Additionally, the BD group had significantly lower values for feedback sensitivity, loss aversion, and learning parameters of the PVL model. Significant positive correlations between the total net score of the IGT and the values of the four PVL parameters were observed in all participants. These results indicated that college students who engeged in BD experienced deficits in decision-making, possibly explained by their failure to learn the expected value of each card and apply the experiences of previous trials to the present trial.
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