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.
김미례, 장환일, 김경빈 (1995). 한국어판 알코올중독자 자녀 선별검사(The Korean Version of the C hildren of the Childern of Alcoholics Screening Test; CAST-K) 의 개발: 신뢰도 및 타당도 연구, 신경정신의학, 34(4), 1182-1193.
김철환, 신호철, 오상우, 조비룡, 윤영호, 송상 옥 (2000). 우울증 선별 도구로서 Zung’s Self-Rating Depression Scales(SDS)의 타당성, Korean Journal of Family Medicine, 21(10), 1317-1329.
염태호, 박영숙, 오경자, 김정규, 이영호 (1992). K-WAIS 실시요강. 서울: 한국가이던스.
제갈정 (2011). 대학생의 음주실태와 개선방안. 대한보건협회 보건종합학술대회, 2011(0), 42-42
천성수, 김미경, 윤선미, 정현미, 유재현, 이상숙 (2009). 한국인의 문제음주 및 알코올사용장애 연구. 알코올과 건강행동연구, 10(2), 129-139.
한덕웅, 이창호, 탁진국 (1993). Spielberger 상태-특성 불안 검사의 표준화. 한국심리학회 학술대회 자료집, 1993(1), 505-512.
Ahn, W. Y., Busemeyer, J. R., Wagenmakers, E. J., & Stout, J. C. (2008). Comparison of decision learning models using the generalization criterion method. Cognitive Science, 32(8), 1376-1402.
Ahn, W. Y., Vasilev, G., Lee, S. H., Busemeyer, J. R., Kruschke, J. K., Bechara, A., & Vassileva, J. (2014). Decision-making in stimulant and opiate addicts in protracted abstinence: evidence from computational modeling with pureusers. Frontiers in Psychology, 5, 849.
Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for use in primary care, second edition. Geneva: World Health Organization (2001)
Baron-Cohen, S., Knickmeyer, R. C., & Belmonte, M. K. (2005). Sex differences in the brain: implications for explaining autism. Science, 310(5749), 819-823.
Bechara, A., Damasio, A. R., Damasio, H., & Anderson, S. W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50(1-3), 7-15.
Bechara, A., Damasio, H., Damasio, A. R., & Lee, G. P. (1999). Different contributions of the human amygdala and ventromedial prefrontal cortex to decision-making. Journal of Neuroscience, 19(13), 5473-5481.
Bechara, A., Dolan, S., Denburg, N., Hindes, A., Anderson, S. W., & Nathan, P. E. (2001). Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia, 39(4), 376-389.
Bechara, A., & Martin, E. M. (2004). Impaired decision making related to working memory deficits in individuals with substance addictions. Neuropsychology, 18(1), 152.
Bechara, A. (2007). Iowa gambling task. Psychological Assessment Resources.
Black, J. M. (2018). Binge Drinking Among College Students: Impacts of Gender, Socioeconomic Status, and Athletic Participation on Prevalence, Motivations, and Consequences. Honors Theses-All. 2089.
Blakemore, S. J., & Robbins, T. W. (2012). Decision-making in the adolescent brain. Nature Neuroscience, 15(9), 1184.
Bø, R., Billieux, J., & Landrø, N. I. (2016). Binge drinking is characterized by decisions favoring positive and discounting negative consequences. Addiction Research & Theory, 24(6), 499-506.
Bolla, K. I., Eldreth, D. A., Matochik, J. A., & Cadet, J. L. (2004). Sex-related differences in a gambling task and its neurological correlates. Cerebral Cortex, 14(11), 1226-1232.
Brand, M., Recknor, E. C., Grabenhorst, F., & Bechara, A. (2007). Decisions under ambiguity and decisions under risk: correlations with executive functions and comparisons of two different gambling tasks with implicit and explicit rules. Journal of Clinical and Experimental Neuropsychology, 29(1), 86-99.
Brown, E. C., Hack, S. M., Gold, J. M., Carpenter Jr, W. T., Fischer, B. A., Prentice, K. P., & Waltz, J. A. (2015). Integrating frequency and magnitude information in decision-making in schizophrenia: An account of patient performance on the Iowa Gambling Task. Journal of Psychiatric Research, 66, 16-23.
Busemeyer, J. R., & Stout, J. C. (2002). A contribution of cognitive decision models to clinical assessment: decomposing performance on the Bechara gambling task. Psychological Assessment, 14(3), 253.
Carbia, C., López-Caneda, E., Corral, M., & Cadaveira, F. (2018). A systematic review of neuropsychological studies involving young binge drinkers. Neuroscience & Biobehavioral Reviews, 90, 332-349.
Casey, B. J., Giedd, J. N., & Thomas, K. M. (2000). Structural and functional brain development and its relation to cognitive development. Biological Psychology, 54(1-3), 241- 257.
Chan, T. W. S., Ahn, W. Y., Bates, J. E., Busemeyer, J. R., Guillaume, S., Redgrave, G. W., & Courtet, P. (2014). Differential impairments underlying decision making in anorexia nervosa and bulimia nervosa: a cognitive modeling analysis. International Journal of Eating Disorders, 47(2), 157-167.
Conigrave, K. M., Hall, W. D., & Saunders, J. B. (1995). The AUDIT questionnaire: choosing a cut‐off score. Addiction, 90(10), 1349-1356.
Courtney, K. E., & Polich, J. (2009). Binge drinking in young adults: Data, definitions, and determinants. Psychological Bulletin, 135(1), 142.
Crone, E. A., Vendel, I., & van der Molen, M. W. (2003). Decision-making in disinhibited adolescents and adults: Insensitivity to future consequences or driven by immediate reward? Personality and Individual Differences, 35(7), 1625-1641.
Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135-168.
Doallo, S., Cadaveira, F., Corral, M., Mota, N., López-Caneda, E., & Holguín, S. R. (2014). Larger mid-dorsolateral prefrontal gray matter volume in young binge drinkers revealed by voxel-based morphometry. PLoS One, 9(5), e96380.
Dunn, B. D., Dalgleish, T., & Lawrence, A. D. (2006). The somatic marker hypothesis: A critical evaluation. Neuroscience & Biobehavioral Reviews, 30(2), 239-271.
Ernst, M., & Paulus, M. P. (2005). Neurobiology of decision making: a selective review from a neurocognitive and clinical perspective. Biological Psychiatry, 58(8), 597-604.
Fein, G., Landman, B., Tran, H., McGillivray, S., Finn, P., Barakos, J., & Moon, K. (2006). Brain atrophy in long-term abstinent alcoholics who demonstrate impairment on a simulated gambling task. Neuroimage, 32(3), 1465-1471.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1995). The structured clinical interview for DSM-III-R personality disorders (SCID-II). Part I: Description. Journal of Personality Disorders, 9(2), 83-91.
Fridberg, D. J., Queller, S., Ahn, W. Y., Kim, W., Bishara, A. J., Busemeyer, J. R., & Stout, J. C. (2010). Cognitive mechanisms underlying risky decision-making in chronic cannabis users. Journal of Mathematical Psychology, 54(1), 28-38.
Fortier, C. B., Steffen, E. M., LaFleche, G., Venne, J. R., Disterhoft, J. F., & McGlinchey, R. E. (2008). Delay discrimination and reversal eyeblink classical conditioning in abstinent chronic alcoholics. Neuropsychology, 22(2), 196- 208.
Goudriaan, A. E., Grekin, E. R., & Sher, K. J. (2007). Decision making and binge drinking: a longitudinal study. Alcoholism: Clinical and Experimental Research, 31(6), 928-938.
Gullo, M. J., &Stieger, A. A. (2011). Anticipatory stress restores decision-making deficits in heavy drinkers by increasing sensitivity to losses. Drug and Alcohol Dependence, 117(2-3), 204- 210.
Hartley, D. E., Elsabagh, S., & File, S. E. (2004). Binge drinking and sex: effects on mood and cognitive function in healthy young volunteers. Pharmacology Biochemistry and Behavior, 78(3), 611-619.
Howell, N. A., Worbe, Y., Lange, I., Tait, R., Irvine, M., Banca, P., & Voon, V. (2013). Increased ventral striatal volume in college-aged binge drinkers. PLoS One, 8(9), e74164.
Hooper, C. J., Luciana, M., Conklin, H. M., & Yarger, R. S. (2004). Adolescents’ performance on the Iowa Gambling Task: implications for the development of decision making and ventromedial prefrontal cortex. Developmental Psychology, 40(6), 1148.
Jones, J. W. (1983). The Children of Alcoholics Screening Test: A validity study. Bulletin of the Society of Psychologists in Addictive Behaviors, 2(3), 155-163.
Jones, S. A., Lueras, J. M., & Nagel, B. J. (2018). Effects of binge drinking on the developing brain: studies in humans. Alcohol Research: Current Reviews, 39(1), 87.
Kim, J. S., Oh, M. K., Park, B. K., Lee, M. K., & Kim, G. J. (1999). Screening criteria of alcoholism by alcohol use disorders identification test (AUDIT) in Korea. Journal of the Korean Academy of Family Medicine, 20(9), 1152-1159.
Kim, M. S., Kang, B. N., & Lim, J. Y. (2016). Decision-making deficits in patients with chronic schizophrenia: Iowa Gambling Task and Prospect Valence Learning model. Neuropsychiatric Disease and Treatment, 12, 1019.
Koss, W. A., Sadowski, R. N., Sherrill, L. K., Gulley, J. M., & Juraska, J. M. (2012). Effects of ethanol during adolescence on the number of neurons and glia in the medial prefrontal cortex and basolateral amygdala of adult male and female rats. Brain Research, 1466, 24-32.
Krawczyk, D. C. (2002). Contributions of the prefrontal cortex to the neural basis of human decision making. Neuroscience & Biobehavioral Reviews, 26(6), 631-664.
Kvamme, T. L., Schmidt, C., Strelchuk, D., Chang-Webb, Y. C., Baek, K., & Voon, V. (2016). Sexually dimorphic brain volume interaction in college-aged binge drinkers. Neuroimage: clinical, 10, 310-317.
Lee, B. O., Lee, C. H., Lee, P. G., Choi, M. J., & Namkoong, K. (2000). Development of Korean version of alcohol use disorders identification test (AUDIT-K): Its reliability and validity. J Korean Acad Addict Psychiatry, 4(2), 83-92.
Mazas, C. A., Finn, P. R., & Steinmetz, J. E. (2000). Decision‐making biases, antisocial personality, and early‐onset alcoholism. Alcoholism: Clinical and Experimental Research, 24(7), 1036-1040.
Mehrabian, A., & Russell, J. A. (1978). A questionnaire measure of habitual alcohol use. Psychological Reports, 43(3), 803-806.
Moreno, M., Estevez, A. F., Zaldivar, F., Montes, J. M. G., Gutiérrez-Ferre, V. E., Esteban, L., ...& Flores, P. (2012). Impulsivity differences in recreational cannabis users and binge drinkers in a university population. Drug and Alcohol Dependence, 124(3), 355-362.
Mota, N., Parada, M., Crego, A., Doallo, S., Caamaño-Isorna, F., Holguín, S. R., & Corral, M. (2013). Binge drinking trajectory and neuropsychological functioning among university students: a longitudinal study. Drug and Alcohol Dependence, 133(1), 108-114.
Mullan, B., Wong, C., Allom, V., & Pack, S. L. (2011). The role of executive function in bridging the intention-behaviour gap for binge-drinking in university students. Addictive Behaviors, 36(10), 1023-1026.
Naimi, T. S., Brewer, R. D., Mokdad, A., Denny, C., Serdula, M. K., & Marks, J. S. (2003). Binge drinking among US adults. Jama, 289(1), 70-75.
Oscar-Berman, M., Valmas, M. M., Sawyer, K. S., Ruiz, S. M., Luhar, R. B., & Gravitz, Z. R. (2014). Profiles of impaired, spared, and recovered neuropsychologic processes in alcoholism. In Handbook of clinical neurology (Vol. 125, pp. 183-210). Elsevier.
Parada, M., Corral, M., Mota, N., Crego, A., Holguín, S. R., & Cadaveira, F. (2012). Executive functioning and alcohol binge drinking in university students. Addictive Behaviors, 37(2), 167-172.
Park, S., & Kim, M. S. (2018). An event-related potential study of spatial working memory in binge drinking college students. PLoS One, 13(9), e0203696.
Pfefferbaum, A., Rohlfing, T., Pohl, K. M., Lane, B., Chu, W., Kwon, D., & Thompson, W. K. (2016). Adolescent development of cortical and white matter structure in the NCANDA sample: role of sex, ethnicity, puberty, and alcohol drinking. Cerebral Cortex, 26(10), 4101-4121.
Team, R. C. (2018). R Development Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria; 2014. Google Scholar.
Reavis, R., & Overman, W. H. (2001). Adult sex differences on a decision-making task previously shown to depend on the orbital prefrontal cortex. Behavioral Neuroscience, 115 (1), 196.
Squeglia, L. M., Spadoni, A. D., Infante, M. A., Myers, M. G., & Tapert, S. F. (2009). Initiating moderate to heavy alcohol use predicts changes in neuropsychological functioning for adolescent girls and boys. Psychology of Addictive Behaviors, 23(4), 715.
Squeglia, L. M., Tapert, S. F., Sullivan, E. V., Jacobus, J., Meloy, M. J., Rohlfing, T., & Pfefferbaum, A. (2015). Brain development in heavy-drinking adolescents. American Journal of Psychiatry, 172(6), 531-542.
Steingroever, H., Wetzels, R., & Wagenmakers, E-J. (2013). A comparison of reinforcement learning models for the Iowa Gambling Task using parameter space partitioning. The Journal of Problem Solving, 5(2), 2.
Townshend, J. M., & Duka, T. (2005). Binge drinking, cognitive performance and mood in a population of young social drinkers. Alcoholism: Clinical and Experimental Research, 29(3), 317-325.
US Department of Health and Human Services. (2004). National Institute of Alcohol Abuse and Alcoholism. NIAAA council approves definition of binge drinking. NIAAA Newsletter; US Department of Health and Human Services: Washington, DC, USA.
Webb, C. A., DelDonno, S., & Killgore, W. D. (2014). The role of cognitive versus emotional intelligence in Iowa Gambling Task performance: What’s emotion got to do with it? Intelligence, 44, 112-119.
Wechsler, H., & Nelson, T. F. (2001). Binge drinking and the American college students: What’s five drinks? Psychology of Addictive Behaviors, 15(4), 287.
Wood, S., Busemeyer, J., Koling, A., Cox, C. R., & Davis, H. (2005). Older adults as adaptive decision makers: evidence from the Iowa Gambling Task. Psychology and Aging, 20(2), 220.
Xiao, L., Bechara, A., Gong, Q., Huang, X., Li, X., Xue, G., ...& Jia, Y. (2013). Abnormal affective decision making revealed in adolescent binge drinkers using a functional magnetic resonance imaging study. Psychology of Addictive Behaviors, 27(2), 443.
Yechiam, E., Kanz, J. E., Bechara, A., Stout, J. C., Busemeyer, J. R., Altmaier, E. M., & Paulsen, J. S. (2008). Neurocognitive deficits related to poor decision making in people behind bars. Psychonomic Bulletin & Review, 15(1), 44-51.
Yoo, J. Y., & Kim, M. S. (2016). Deficits in decision-making and reversal learning in college students who participate in binge drinking. Neuropsychiatry, 6(6), 321-330.
