0145-6008/05/2903-0317$03.

00/0
ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH

Vol. 29, No. 3

March 2005

Binge Drinking, Cognitive Performance and Mood in a

Population of Young Social Drinkers
Julia M. Townshend and Theodora Duka

Background: Binge drinking may lead to brain damage and have implications for the development of
alcohol dependence. The aims of the present study were to determine individual characteristics as well as
to compare mood states and cognitive function between binge and nonbinge drinkers and thus further
validate the new tool used to identify these populations among social drinkers.
Methods: The lowest and the highest 33.3% from a database of 245 social drinkers binge scores derived
from the Alcohol Use Questionnaire (AUQ) were used as cutoff points to identify nonbinge drinkers and
binge drinkers in a further population of 100 young healthy volunteers. Personality characteristics, expectations of the effects of alcohol and current mood were evaluated. Cognitive performance was tested with
a Matching to Sample Visual Search task (MTS) and a Spatial Working Memory task (SWM) both from the
CANTAB battery, and a Vigilance task from the Gordon Diagnostic System.
Results: The binge drinkers had less positive mood than the nonbinge drinkers. In the MTS choice time on
an 8-pattern condition and movement time on an 8- and 4-pattern condition was found to be faster in the binge
drinkers compared to nonbinge drinkers. A gender by binge drinking interaction in the SWM and the Gordon
Diagnostic System task revealed that female binge drinkers were worse on both these tasks than the female
nonbinge drinkers.
Conclusions: These results confirm previous findings in binge drinkers and suggest that in a nondependent alcohol-drinking group, differences can be seen in mood and cognitive performance between those
that binge drink and those that do not.
Key Words: Alcohol Use Questionnaire (AUQ), Impulsivity, Repeated Withdrawal, Gender, Frontal
Lobe.

INGE DRINKING IN young people is on the increase

in Britain (Morgan et al., 1999), the United States
(Naimi et al., 2003) and increasingly in developing countries throughout the world (Parry et al., 2002). In a student
population, binge drinking has been shown to predict the
frequency with which alcohol related problems are experienced (Wechsler et al., 1994) and Hunt (1993) has suggested that binge drinkers may be more at risk of developing brain damage. Binge ethanol exposure in adult rats has
been shown to cause necrotic neurodegeneration after as
little as 2 days of exposure (Obernier et al., 2002a). In
addition Crews and colleagues (Crews et al., 2000) have
found that young adolescent rats show differential patterns
of brain damage after binge ethanol treatment compared to
adult rats. The associated frontal cortical olfactory regions
were damaged only in the adolescent rats. Further animal
studies have provided evidence of increased brain damage
From Laboratory of Experimental Psychology, University of Sussex,
Falmer, Brighton.
Received for publication March 15, 2004; accepted December 13, 2004.
This work was supported by MRC Grant No. G9806260.
Reprint requests: Dr. Theodora Duka, Psychology, University of Sussex,
Falmer, Brighton BN1 9QG; Fax: 44 1273 678058; E-mail: t.duka@
sussex.ac.uk
Copyright 2005 by the Research Society on Alcoholism.
DOI: 10.1097/01.ALC.0000156453.05028.F5
Alcohol Clin Exp Res, Vol 29, No 3, 2005: pp 317325

after multiple withdrawals from alcohol or when repeatedly

high amounts of alcohol in the brain are followed by periods of abstinence (i.e., binge drinking; Crews et al., 2001;
Veatch and Gonzalez, 1999). Imaging studies on adolescents with alcohol use disorders have also provided evidence for brain abnormalities associated with the age at
onset of the alcohol use disorder (De Bellis et al., 2000).
It has been proposed that number of drinks in a row
differentiates binge drinkers from nonbinge drinkers
(Wechsler and Austin, 1998), and while this may be the
case it also means that binge drinkers and nonbinge drinkers will almost certainly consume different quantities of
alcohol. We have used a score (binge drinking score)
derived from items from an Alcohol Use Questionnaire
(Mehrabian and Russell, 1978) referring to drinking behavior and not to consumption and have compared it with the
measurement drinks in a row as described by Wechsler
and Austin (Wechsler and Austin, 1998). We have shown
that, unlike the measurement drinks in a row, the binge
drinking score was unrelated to weekly alcohol consumption (Townshend and Duka, 2002). Based on the proposal
that repeated withdrawal from alcohol may contribute to
the development of addiction (withdrawal sensitization
theory of addiction, Stephens, 1995) a binge score
founded on patterns of drinking rather than quantities of
317

318

alcohol consumed may be a better predictor of future

alcohol dependency problems.
A characteristic marker of binge drinking behavior is the
consumption of large amounts of alcohol within a limited
time period followed by a period of abstinence, as opposed
to regular drinking in which a person might consume similar weekly amounts of alcohol but without the extremes of
alcohol intoxication. Thus binge drinking can be considered
analogous to repeated withdrawal from alcohol, a behavior
that has been shown to affect both cognitive and emotional
responding in alcoholic inpatients (Duka et al., 2004; Duka
et al., 2002, 2003; Townshend and Duka, 2003). Such an
idea is based on extrapolation from animal studies that
have shown clearly binges of alcohol, like multiple withdrawals from alcohol, produce brain damage and cognitive
impairments (Duka et al., 2004; Obernier et al., 2002b;
Ripley et al., 2003; Stephens et al., 2001).
In alcoholics several morphological abnormalities in the
frontal lobe system have been reported (for a review, see
Moselhy et al., 2001), and we have recently found that
alcoholic patients with two or more previous experiences of
medically supervised detoxifications from alcohol were
more impaired than patients with a single, or no previous
experience of detoxification in tasks measuring frontal lobe
function. Given these results it is possible that binge drinking behavior in young healthy adults might also affect
performance on such tasks. We have therefore included a
task that measures the ability to disinhibit a prepotent
response (the Vigilance task in the Gordon Diagnostic
System). In a previous study that looked at the effects of
alcohol on frontal lobe tasks we have found in a posthoc
analysis that binge drinkers made more between search
errors and had a worse strategy in a task that measures
spatial working memory compared to nonbinge drinkers.
To replicate these findings in a prospective study we have
also added the Spatial Working Memory task from the
CANTAB battery in the present study. In addition we have
included a measure of visual search speed that can reveal
impulsivity, a behavioral trait often cited as an important
behavioral predictor of excessive alcohol consumption.
Such a measure will provide information about a cognitive
impairment that might have preceded the binge drinking
behavior. However, we are aware that unless a prospective
study is carried out with adolescents before and after they
have indulged into binge drinking behavior, a clear distinction of what cognitive impairment preceded and what followed as a result of binge drinking is not possible.
Traditionally more of a male activity, binge drinking is
now increasing in females. In a recent study, reported cases
of blackouts were as high in females as in males leading to
increasingly risky behavior in terms of personal safety
(White et al., 2002). However whether the consequences of
binge drinking behavior are different between males and
females is not yet known. Consequently, in this study, we
will be looking at gender differences in performance on
impulsivity and frontal lobe tasks.

TOWNSHEND AND DUKA

The grouping of binge drinkers in this study was based on

a database of 245 Alcohol Use Questionnaires (AUQ;
Mehrabian and Russell, 1978) completed by volunteers. A
binge drinking score was calculated for each individual
using the three questions from the AUQ evaluating drinking patterns (drinks per hour; times drunk within the last 6
months; % of being drunk when drinking) and excluding
weekly alcohol consumption. The lowest and the highest
33.3% were grouped as nonbinge drinkers and binge drinkers respectively. The maximum score of the nonbinge
drinking group and the minimum score of the bingedrinking group from the 245 social drinkers were used as
cutoff points to identify binge drinkers and nonbinge drinkers in this current study population. As the binge drinking
score is based on patterns of drinking rather than quantity
consumed, we did not find differences between the binge
drinking scores of males and females in our sample of social
drinkers. Consequently, the same cutoff points were used
for male and female volunteers.
There is evidence that greater positive alcohol expectancies are associated with binge drinking episodes (Blume et
al., 2003). Also peer influence can have a strong impact on
drinking behavior. It has previously been shown that sibling
smoking was one of the strongest predictors of smoking
behavior in adolescents (Wilkinson and Abraham, 2004).
Personality (temperament) traits like high Harm Avoidance, as measured by the Temperament and Character
Inventory (TCI; Cloninger et al., 1994) have been associated with binge drinking (Gilligan et al., 1987). On the
other hand aspects of impulsivity and an early age of starting drinking have been associated with high Novelty Seeking also measured by the TCI. We have therefore included
an Alcohol Outcome Expectancy Questionnaire and the
TCI in the present study. These latter measures therefore
will provide information about trait characteristics which
may predispose to binge drinking. In a previous study we
have also found that alcoholic patients who have experienced two or more detoxifications presented with high
ratings of feelings of anger compared with their counterparts with no previous detoxifications (Duka et al., 2002).
Thus the present study was designed to look at the relationship between patterns of drinking behavior, cognitive
performance, mood, expectancies from alcohol, and personality characteristics. The role of gender was also
examined.
MATERIALS AND METHODS
Participants
One hundred young, healthy volunteers (50 male and 50 female)
moderate to heavy social drinkers between the ages of 18 and 30 (mean
20.9, SD 2.6) answered an advertisement for social drinkers to take part in
a study looking at the relationship between performance on cognitive tasks
and drinking patterns. Volunteers with current symptoms or a history of
mental illness, neurological diseases, drug or alcohol dependence were not
included in the study. Participants had been instructed to abstain from the
use of illicit recreational drugs for at least 1 week prior to the experiment,

BINGE DRINKING, MOOD AND COGNITION

from the use of sleeping tablets or hay fever medication for at least 48 hr,
and from the use of alcohol for at least 12 hr prior to the experiment. It
was discovered at the data input stage that one female had participated
twice in the study so her second data set was discarded leaving 99 participants. Those who drank 6 units or less per week [3 glasses of wine or 2.5
pints lager (3 drinks)] were excluded, as by any definition they could not
have been binge drinkers (i.e., even if they had the drinks in a row there
would have been less than 4 drinks in a row). Two females were lost by this
exclusion leaving 50 male participants and 47 female participants in total.
All except 4 spoke English as their first language. The National Adult
Reading Test (NART) scores from these 4, and 1 dyslexic volunteer were
discarded. The study was approved by the University of Sussex Ethical
Committee and all volunteers gave their informed consent and were paid
for their time at a rate of approximately 5 per hour.
Demographics
Population characteristics were based on information obtained from
the participants and included smoking information and the quantity and
time of their most recent alcoholic drink and caffeinated product.
Questionnaires
I. Alcohol and Drug Use
Alcohol Use Questionnaire (AUQ). A quantity-frequency, beveragespecific index of alcohol consumption for the previous 6 months was
obtained using a revised version of the Alcohol Use Questionnaire (AUQ;
Mehrabian and Russell, 1978). The revised questions, by determining
brands of liquor, allow for actual alcoholic content (percentage volume) of
drinks to be assessed. Participants were asked to estimate the number of
drinking days, the usual quantity consumed and the pattern of drinking.
We have previously demonstrated that the AUQ is a reliable measure of
drinking quantity and drinking pattern (Townshend and Duka, 2000).
Binge drinking score. A binge drinking score was calculated for all
participants on the basis of the information given in items 10, 11, and 12 of the
AUQ [Speed of drinking (average drinks per hour); number of times being
drunk in the previous 6 months; percentage of times getting drunk when
drinking (average)]. The binge score is calculated in the same way as the
AUQ score is derived but without the items 1 9 that refer to quantity and
type of alcohol intake: [4 (Item 10) Item 11 0.2 (Item 12);
Mehrabian and Russell, 1978]. This score gives a picture of the drinking
patterns of the participants rather than just a measure of alcohol intake.
Participants who have a high binge score and drink frequently but irregularly may have a similar intake of alcohol to those with a lower binge score
who drink on a regular basis. The cutoff points of the binge score for
separating binge drinkers from nonbinge drinkers was binge score 16 for
non binge drinkers and binge score 24 for binge drinkers. Subjects with
scores in between were considered not classifiable.
Alcohol Expectancy Questionnaire (AEQ). Based on the Comprehensive
Effects of Alcohol Questionnaire (CEOA; Fromme et al., 1993), the AEQ
is a 38-item questionnaire, which assesses positive and negative expected
effects of alcohol consumption. There are seven expectancy factors, four
positive (sociability, tension reduction, liquid courage and sexuality), and
three negative (cognitive and behavioral impairments, risk and aggression,
and negative self perception).
Structured Interview Questionnaire revised (SIQ-R). The Structured
Interview Questionnaire has previously been used to evaluate the drinking
habits of an alcoholic population (Duka et al., 2002). A revised version was
constructed for the healthy volunteers in the current study that asked
about age of starting drinking, family history of alcoholism and sibling
alcohol / drug use. A family history score was derived by giving a score of
2 points for each first degree relative and 1 point for each second degree
relative. Participants were asked to estimate as best they could their
siblings weekly alcohol and/or drug use. For the analysis the amount of
alcohol or drug use was taken for the sibling (same or opposite sex) of
nearest age to the participant provided they were more than 16 years old.
Drug Use Questionnaire. This questionnaire asks for duration of use,
time since last use, how often used and dose per session for all the main

319

drug categories. For the purposes of this study as a rough guide to drug
use, participants were given a score in which 0 no drug use; 1
occasional use of cannabis/hash or marijuana; 2 regular use of cannabis/
hash or marijuana (at least once a week); 3 use of ecstasy and/or other
drugs.
II. Trait Measurements
The Temperament and Character Inventory (TCI) (Cloninger et al.,
1994) is a 240-item personality questionnaire designed to assess individual
differences on 4 measures of temperament and 3 measures of character.
The temperament measures, which represent hereditary traits, are novelty
seeking, harm avoidance, reward dependence, and persistence. The character measures, which represent acquired traits, are self-directedness,
cooperativeness, and self-transcendence. The TCI was always given at the
end of the testing session.
III. Current Mood Measures
Profile of Mood States (POMS; McNair et al., 1971). The POMS consists
of 72 mood related adjectives which participants are instructed to rate on
a 5-point scale ranging from not at all (0) to extremely (4). Through
the process of factor analysis 8-factors have been established: Anxiety,
Fatigue, Depression, Anger, Vigor, Confusion, Friendliness, and Elation.
In addition, two further composite factors can be derived as follows:
Arousal (Anxiety Vigor) (Fatigue Confusion), and Positive
Mood Elation Depression (de Wit and Doty, 1994). All 10 factors
were evaluated for this study.
The questionnaires and the Vigilance task for adults from the Gordon
Diagnostic System (see below) were given in random order before the
other cognitive measures.
Cognitive Measures
National Adult Reading Test (NART: Nelson, 1991). The participants
were given the NART to provide an estimate of the participants verbal IQ
performance.
Matching to Sample Visual Search task. CANTAB (Cambridge Cognition
Ltd). This sub test of the CANTAB is a speed/accuracy trade off task that
tests the subjects ability to match visual samples and measures their choice
and movement time. The sample stimulus appears in the center of the screen
and is an abstract pattern composed of 4 colored elements. After a brief delay
1, 2, 4, or 8 similar patterns appear around the edge of the screen. The
incorrect patterns are composed of juggled elements of the sample pattern
and only one of them matches the one in the center of the screen. The subject
must hold down a press pad to obtain the sample pattern and the matching
stimuli. When a choice has been made the subject releases the pad and
identifies the matching pattern by touching it. The matching to sample visual
search task resembles the Matching Familiar Figures test first developed by
Kagan (1965) who used it to measure reflection the amount of time spent
thinking about a response before making a decision, later developed further
by Cairns and Cammock (1978); it has been used to measure impulsivity
taking into account both time of response and number of errors made
(Messer and Brodzinsky, 1981). The Matching to Sample Visual Search task
gives two reaction time measures, choice time on the basis of the release of
the press pad, and movement time from the release of the pad to the touch
of the screen. Errors are also recorded. Results are given only for the 4 and
8-pattern condition (conditions 1 and 2 are very easy and performance runs
at ceiling with young adults).
Spatial Working Memory. CANTAB (Cambridge Cognition Ltd). This
subtest of CANTAB is a self ordered search task that requires participants
to search through a spatial array of boxes to collect tokens hidden inside.
At any one time there will be one single token hidden. The key instruction
is that once a blue token has been found inside a box, then that box will
never be used again to hide a token. There are trials of 3, 4, 6, and 8 boxes.
There are two types of errors in this task, within- and between-search
errors. A between-search error occurs when a participant returns to a
box in which a token has previously been found and a within search
error occurs when a participant returns to a box within the same search.
Results refer to between-search errors and are given only for the 6 and
8 boxes condition as in the 3 and 4 box conditions error rates are very low.
A further variable was the strategy score, which indicates the particular
sequence that participants follow in each session. A high score indicates

320

TOWNSHEND AND DUKA

poor strategy. The two CANTAB tasks were presented in counter balanced order.
The Vigilance Task for Adults from the Gordon Diagnostic System (Gordon et al., 1986). In this task participants are required to press a button on
a purpose-built electronic machine, which briefly displays 3 digits in fast,
random succession on a 3 column, LED display. Participants are required
to concentrate only on the digit in the middle column of the display, and
are instructed to press the blue button every time a 1 is followed by 9
(1 being the alerting stimulus and 9 being the target stimulus). The task
measures the subjects ability to inhibit responding under conditions that
make demands for sustained attention and impulse control. The main
variable in this task is errors of commission. Errors of commission are
targetrelated errors recorded when a response is made to the target
stimulus 9 or to the alerting stimulus 1 when they are not in the
sequence 1 / 9/.
Target Variables
For the purpose of this paper, the target variables are the reaction time,
movement time and number of errors made in the Matching to Sample
Visual Search task; the between search errors and strategy score in the
Spatial Working Memory task; errors of commission in the Vigilance task
for adults from the Gordon Diagnostic System; self-reported current
mood, alcohol expectancies and personality. All other measures represent
correlates.
Statistical Methods
For the cognitive tasks and the POMS composite factors arousal and
positive mood, initial analyses were performed using Univariate analysis
or mixed ANOVAs (task condition was the within factor) with group (2
levels: binge drinkers and nonbinge drinkers) and gender (2 levels) as the
between subject factors. For the Alcohol Expectancy and the TCI questionnaire ratings Multivariate analyses were performed with the factors
from the questionnaires as the dependent variables and with group (2
levels: binge drinkers and nonbinge drinkers) and gender (2 levels) as
fixed factors. Where an interaction was found between binge drinking
group and gender, further analysis was performed on males and females
separately. Where there was no interaction gender was not explored
further, as binge drinking was the behavior of interest in this study.
Independent t-tests were performed to analyze differences in demographic characteristics between nonbinge and binge drinkers and between
males and females within binge or nonbinge drinkers group. Between
group differences (units per week, age of starting to drink and drug use
score) were entered as covariates where binge drinkers performed differ-

ently on cognitive tasks. All procedures were carried out using SPSS
software version 11.5.

RESULTS

Group Demographics
Table 1 shows the demographic data for the drinking
pattern groups and for males and females within the
groups. There are an unequal number of males and females
in the binge drinking and nonbinge drinking groups, which
may reflect real world population ratios. Alcohol units and
age of starting drinking were different between the groups
with the binge drinkers drinking more alcohol units per
week [t(70) 3.5; p 0.01) and starting earlier regular
drinking [t(70) 2.84; p 0.05]. There was also a difference between bingers and nonbingers with respect to drug
use score with binge drinkers having higher drug use score
than nonbinge drinkers [t(70) 2.358; p 0.021). There
were no differences between males and females for any of
the demographic characteristics in the nonbinge drinker
group [ts(32) 1.8]. Only a marginal difference between
males and females in the binge group was found with males
consuming more units per week [t(36) 2.01; p 0.052].
SIQ
There were 22 nonbinge drinkers and 24 binge drinkers
who had siblings over the age of 16 years. There were
differences between groups [t(44) 2.1; p 0.05) in the
amount of reported alcohol use by their nearest aged siblings [(mean SD), nonbinge drinkers: 11.7 10.0; binge
drinkers: 19.5 13.9] but not in drug use or in family
history of alcoholism (data not shown). A Pearson correlation using the population with siblings (n 60) from the
total pool (n 97) found that the amount of sibling alcohol

Table 1. Demographic Data for Non-Binge and Binge Drinkers and for Males and Females
Non-binge drinkers
Group characteristics
Number
Age
Alcohol units per weeka
Binge drinking score
Estimated IQ (NART)
Age of starting drinking
Drug use score
Cigarette smokers (n)
Occasional use of cannabis (n)
Regular use of cannabis (n)
XTC and/or other drug use (n)
Data are presented as mean (SD).
a
One unit is 8 g of alcohol.
b
p 0.005 compared to binge drinkers.
c
p 0.05.

Binge drinkers

Total

Males

Females

Total

Males

Females

34
20.9
(2.5)
20.5
(11.9)b
10.6
(3.4)b
107.9
(7.9)
15.3
(1.6)c
0.94
(1.04)c
10
13
2
5

13
20.4
(1.9)
22.2
(11.7)
11.2
(2.8)
108.5
(7.2)
16.0
(1.9)
0.62
(0.87)
4
5
0
1

21
21.2
(2.8)
18.7
(12.1)
10.3
(3.8)
107.6
(8.4)
14.9
(1.3)
1.14
(1.1)
6
8
2
4

38
20.9
(2.6)
33.3
(19.0)
40.4
(16.1)
107.6
(5.7)
14.4
(1.3)
1.53
(1.06)
11
13
9
9

23
20.9
(2.9)
38.2
(21.3)
37.1
(13.8)
108.6
(5.1)
14.8
(1.3)
1.48
(1.17)
5
6
5
6

15
21.1
(2.1)
26.0
(11.9)
45.5
(18.4)
106.1
(6.4)
14.0
(1.4)
1.60
(0.91)
6
7
4
3

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BINGE DRINKING, MOOD AND COGNITION

Table 3. Profile of Mood States, Arousal and Positive Mood Composite Score
in the Non-Binge and Binge Drinkers
POMS factors

Non-binge drinkers (n 34)

Arousal
0.05 (1.53); range 2.402.69
Positive Mooda
1.00 (0.81); range 0.632.33

Binge drinkers (n 38)

0.55 (1.53); range 3.012.34
0.54 (1.17); range 2.472.33

Mean (SEM).
a
p 0.045 (univariate analysis of variance, group effect).

were found. There was no relationship between current

positive mood and time of last drink indicating that their
low current mood was not due to withdrawal from alcohol
in the binge drinkers.
Fig. 1. The relationship between binge drinking score of all participants with
nearest age siblings (over 16 years old) and estimated quantity of sibling alcohol
consumption.
Table 2. Scores on the Alcohol Expectancy Questionnaire and the TCI for
Non-Binge Drinkers and Binge Drinkers, Mean (SEM)
Non-binge drinkers
(n 34)
Alcohol expectancy factors
Sociability
Tension reduction
Liquid courage
Sexuality
Cognitive and behavioral
impairment
Risk and aggression
Negative self perception
TCI factors
Novelty seeking
Harm avoidance
Reward dependence
Persistence
Self directedness
Co-cooperativeness
Self-transcendence

26.1
7.4
12.5
9.7
23.7

(.52); range 2031

(.25); range 410
(.38); range 917
(.34); range 514
(.87); range 1436

Binge drinkers
(n 38)
26.6 (.56); range 1832
7.5 (.28); range 411
13.1 (.38); range 818
9.9 (.39); range 514
24.7 (.56); range 1731

12.0 (.50); range 719

7.2 (.43); range 415

12.8 (.43); range 618

7.9 (.40); range 415

21.5 (1.03); range 834

15.7 (1.23); range 530
16.6 (.67); range 924
5.26 (.35); range 18
26.6 (1.36); range 740
33.0 (1.16); range 941
15.5 (1.22); range 030

24.0 (1.07); range 935

14.3 (1.44); range 130
15.6 (.66); range 822
4.5 (.38); range 18
24.2 (1.47); range 540
31.0 (1.18); range 1341
13.6 (1.06); range 529

use was most closely related to the participants binge

drinking score (Fig. 1; Pearson R 0.358, p 0.01). A
Pearson correlation using only the population with siblings
among the binge drinkers and nonbinge drinkers group (n
46) found also that the amount of sibling alcohol use was
most closely related to the participants binge drinking
score (Pearson R 0.422; p 0.01).
Alcohol Expectancy Questionnaire and TCI
The 7 factor ratings from the Alcohol Expectancy Questionnaire and from the TCI are presented in table 2. Multivariate analysis on the 7 factors of each questionnaire
separately and with the fixed factors group and gender
found no significant interactions or main effects (F7,62
2.0).
Profile of Mood States
Table 3 shows means and SEM of arousal and positive mood scores in binge and nonbinge drinkers. Univariate analysis for positive mood found a significant group
effect (F1,71 4.2; p 0.045) with binge drinkers being
lower on positive mood. No other effects or interactions

Cognitive Measures
CANTAB; Matching to Sample Visual Search. Due to
technical reasons values from 3 participants in the nonbinge drinkers and 4 participants in the binge drinkers
group were missing. A mixed ANOVA on choice time (4
and 8 pattern choice) in the MTS task found no effect of
gender but a group (2 levels; binge drinkers and nonbinge
drinkers) pattern (2 levels: 4 and 8 pattern condition)
interaction (F1, 61 4.4, p 0.05). Further investigation
showed that the binge drinkers were faster in their choice
time in the 8 pattern, but not in the 4-pattern condition
(Fig. 2a). Mixed ANOVA on movement time (4 and 8
pattern condition) revealed a main effect of group (F1,61
5.3; p 0.05) with binge drinkers being overall faster in
movement time than nonbinge drinkers (Fig. 2b). There
were no differences in the number of errors made. None of
the covariates entered (units per week, age of starting to
drink and drug use score) affected the group results.
CANTAB; Spatial Working Memory. Due to technical
reasons values from 2 participants in the nonbinge drinkers
group were missing. A mixed ANOVA on between trial
errors (6 and 8 boxes condition) found a gender by binge
drinking group interaction (F1,66 10.26; p 0.005).
Consequently the population was split by gender and males
and females examined separately. A further mixed
ANOVA on errors for males and females separately, found
a group effect (F1,32 6.3; p 0.05) only in females
indicating that female binge drinkers (n 15) made more
errors than female nonbinge drinkers (n 19; Fig. 3). A
Univariate analysis on strategy scores showed no interactions or main effects. None of the covariates entered (units
per week, age of starting to drink and drug use score)
affected the group results.
Gordon Diagnostic System; Vigilance task for adults. Due
to technical reasons values from 2 participants in the nonbinge drinkers and 1 subject in the binge drinkers group
were missing. A Univariate Analysis with errors of commission as the dependent variable found a group by gender
interaction (F1, 68 5.3; p 0.05) so the population was
split by gender for further analysis. A further Univariate
Analysis on errors of commission for males and females
separately, found a group effect (F 1,33 4.6; p 0.05)
only in females indicating that female binge drinkers (n

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TOWNSHEND AND DUKA

Fig. 2. Choice time (a) and movement time (b) for the 4- and 8-pattern condition (ms; mean SEM) in the CANTAB Matching to Sample Visual Search task for binge
and nonbinge drinkers. *p 0.05 compared to nonbinge drinkers.

15) made more errors than female nonbinge drinkers (n

19; Fig. 4). When age of starting drinking was entered as a
covariate the group difference became marginal (F 1,33
4.0; p 0.06). No effect of the other covariates (units per
week and drug use score) was found.
DISCUSSION

The present study set out to examine the validity of a new

method of identifying binge drinking in young, healthy
social drinkers, and to look at differences in cognitive
performance and mood between groups with different
drinking patterns. Using a questionnaire method that asks
about drinking behavior rather then quantity of alcohol
consumed, we have been able to show differences in cog-

nitive performance between groups of young healthy adults

who are similar in aspects other than their drinking behavior. However it should be noted that there is an important
limitation to the study as the differentiation of binge drinkers and nonbinge drinkers was based on information provided by the participants themselves rather than objective
measures, although we have previously found that information about drinking behavior collected from the AUQ and
drinking behavior recorded daily in a diary were very
closely related (Townshend and Duka, 2002).
The groups were well matched for age and IQ but the
binge drinkers started drinking earlier than the nonbinge
drinkers. They also consumed more alcohol and used more
drugs than the nonbinge drinkers, and drug use and binge
drinking scores were positively related in the whole popu-

Fig. 3. Between search errors (total errors 6 and 8 boxes, mean SEM)
in the CANTAB Spatial Working Memory task, for male and female binge
and nonbinge drinkers. *p 0.05 compared to female nonbinge drinkers
and male binge drinkers.

BINGE DRINKING, MOOD AND COGNITION

323

Fig. 4. Errors of commission in the Gordon Diagnostic System Vigilance

task for male and female binge and nonbinge drinkers; *p 0.05 compared
to female nonbinge drinkers and male binge drinkers.

lation (data not shown). The concurrent use of alcohol and

drugs has been previously reported in several studies [e.g.,
(Sutherland and Willner, 1998)] and has been suggested to
be due to one of two hypotheses, either to alcohol acting as
a gateway to illicit drugs (Kandel et al., 1992), or as part of
a general behavior pattern in which alcohol use has a lower
threshold to other drugs and is easier to obtain (Jessor,
1987). The results from this current study do not distinguish
between these two hypotheses but provide further evidence
of a relationship between increased frequency of drug use
and increased frequency of drunkenness.
Although neither the units of alcohol drunk per week nor
the higher incidence of drug use found in binge drinkers
compared to nonbinge drinkers was found to relate to the
impairments seen in performance on cognitive tasks among
binge drinkers, a contribution of these factors cannot be
excluded from the present data.
Participants were asked to estimate the alcohol and drug
use of their siblings. The alcohol use of the nearest aged
sibling was strongly related to the participants binge drinking score. Peer influence would appear to have a strong
impact on drinking behavior and a similar result has previously been shown in a smoking study in which sibling
smoking was the one of the strongest predictors of smoking
behavior (Wilkinson and Abraham, 2004). However it cannot be ruled out that similarities between sibling drinking in
this current study may simply be due to biased reporting by
the participants [see Weitzman et al. (2003) for similar data
on peers] Conversely, family history of alcohol use was not
related to binge drinking behavior or to sibling alcohol use,
although only about 40% of participants had any family
members with alcohol dependency problems, the majority
of whom were second degree relatives. Although these data
suggest that binge drinking in the population of social
drinkers in the present study was less the result of a genetic
predisposition and more of a cultural influence or peer
pressure, future studies are needed to examine a possible
genetic predisposition of binge drinking by using more
robust measures of family history of alcoholism than self
reports as we used in the present study.
Current mood states in the binge drinkers group were less
positive than their nonbinge drinking counterparts and this
was not related to alcohol withdrawal as measured by time of
last drink. Increased anxiety and negative emotional sensitivity

has been reported previously in alcohol dependent participants with multiple alcohol withdrawals (Adinoff et al., 1994;
Duka et al., 2002). Although alcohol abuse is often comorbid
with low mood states, whether it is a cause or effect relationship is not clear. Increased anxiety could advance the progression to alcohol dependence particularly when coupled to a
binge drinking induced loss of executive protective inhibitory
functions.
The finding of faster reaction times on the Matching to
Sample Visual Search task in the binge drinkers group is of
interest. Such a finding suggests that binge drinkers require
less time to reflect and make their choice, although choice
time was found to be faster only in the 8, whereas movement time both in the 6 and 8 pattern condition. Such an
increase in the speed of response may suggest that binge
drinkers are more efficient in response execution with regard to a visuospatial task. As the task was quite easy and
there were very few errors made overall, we cannot suggest
that binge drinkers, as predicted, might be more impulsive;
further studies are required to address this question.
The Vigilance task from the Gordon Diagnostic System
is similar to a go / no go paradigm, in which participants
have to inhibit their responding following the alerting stimulus, until the target stimulus appears. The task measures
both sustained attention and impulse control and the female binge drinkers were particularly impaired in this task
being unable to inhibit their response to the alerting stimulus suggesting a lack of inhibitory control from the frontal
lobes. Interestingly when age of starting drinking was entered as a covariate the significant impairment found in the
females became marginal indicating the importance of
starting drinking early as a contributing factor to these
effects of binge drinking. Previous studies have also shown
impairments in cognitive function associated with heavy
drinking during early adolescence (Brown et al., 2000). We
found also group differences in females in the Spatial
Working Memory task in which the binge-drinking females
made more errors than their nonbinge-drinking counterparts. No other factor was found to contribute to this effect.
We have also previously shown that binge drinkers made
more between search errors in the Spatial Working Memory task compared to nonbinge drinkers (Weissenborn and
Duka, 2003), however, there was not gender difference
found. One reason for this discrepancy could be that the

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TOWNSHEND AND DUKA

female binge drinkers in the current study had a higher

binge score (45.5 4.7) than the female binge drinkers in
the previous study (28.0 2.6). Additionally in the previous
study participants were tested under alcohol or placebo and
the grouping of binge and nonbinge drinkers was based on
a posthoc median split. Further research on the relationship between gender and binge drinking is needed to clarify
the discrepancy between the two studies. Interestingly male
binge drinkers drank more alcohol than female binge
drinkers although their binge scores were lower. This finding might indicate that female drinkers, although they consume less, may become drunk more often when drinking,
giving them a higher binge score for the amount of alcohol
drunk compared to males. Thus it is perhaps not surprising
that female binge drinkers were more impaired than male
binge drinkers.
Previous studies examining drinking habits (Deckel et al.,
1995) or the adverse consequences of drinking (Giancola et
al., 1996) in young adult social drinkers, have shown a
relationship between impaired executive function and both
the frequency of drinking to get high and get drunk
(Deckel et al., 1995) or the severity of drinking consequences (Giancola et al., 1996). Although impairment in
certain cognitive tasks, also shown in the present study,
might be the cause of extreme drinking patterns (including
binge drinking) as the above studies indicate, data from
animals suggest that binge drinking can induce cortical
damage and lead to cognitive deficits like perseverative
responding in a spatial learning task (Obernier et al.,
2002b). It is acknowledged however that only a prospective
study looking at cognitive performance in adolescents before and after starting binge drinking would clarify these
questions.
In summary, these results suggest that a binge drinking
score can be used to show differences in cognition and
mood in nondependent healthy social drinkers. Patterns of
drinking may reveal differences that quantity of alcohol
consumed does not, and may be more analogous to the
effects of repeated detoxification seen in alcoholic patients.
In particular the results have revealed that binge drinking is
associated with impaired performance in cognitive tasks in
females more than males. The importance of the age of
starting drinking as a contributing factor to the findings
presented here has also been highlighted. These findings
furthermore indicate the possibility that low mood states
and loss of executive function due to binge drinking may
combine to contribute to the progression of dangerous
drinking levels and alcohol dependence.

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