Being able to measure the acute effects of alcohol consumption on psychomotor functions in natural settings could be useful in injury prevention interventions. This study examined the feasibility and acceptability of collecting app-based measures of information processing, working memory, and gait stability during times of typical alcohol consumption among young adults.
Methods
Ten young adults (aged 21–26) with hazardous drinking completed a baseline assessment and ecological momentary assessments (EMA) on 4 consecutive Fridays and Saturdays, every hour from 8 pm to 12 am. EMA assessed alcohol consumption and perceived intoxication, followed by a digit symbol substitution task (DSST), a visuospatial working memory task (VSWMT), and a 5-step tandem gait task (TGT). Exit interviews probed user experiences. Multilevel models explored relationships between estimated blood alcohol concentration (eBAC; mg/dL) and DSST and VSWMT performance.
Results
Participants completed 32% of EMA. Higher rates of noninitiation occurred later in the evening and over time. In multilevel models, higher eBAC was associated with lower DSST scores. Eight out of 10 individuals had at least 1 drinking occasion when they did not perceive any intoxication. Lower DSST scores would identify impairment in 45% of these occasions. Exit interviews indicated that adding real-time feedback on task performance could increase awareness of alcohol effects.
Conclusions
Collecting app-based psychomotor performance data from young adults during drinking occasions is feasible and acceptable, but strategies to reduce barriers to task initiation are needed. Mobile DSST is sensitive to eBAC levels and could identify occasions when an individual may not perceive impairments.
HingsonRW, ZhaW, WeitzmanER. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. J Stud Alcohol Drugs Suppl.2009;(16):12–20. doi: 10.15288/jsads.2009.s16.12
2.
National Center for Statistics and Analysis. (2015, December). Alcohol impaired driving: 2014 data. (Traffic Safety Facts. DOT HS 812 231). Washington, DC: National Highway Traffic Safety Administration.
3.
ChristoforouZ, KarlaftisMG, YannisG. Reaction times of young alcohol-impaired drivers. Accid Anal Prev.2013;61:54–62. doi: 10.1016/j.aap.2012.12.030
4.
SteeleCM, JosephsRA. Alcohol myopia: its prized and dangerous effects. Am Psychol.1990;45:921–933. doi: 10.1037//0003-066x.45.8.921
5.
MorrisDH, TreloarHR, NiculeteME, McCarthyDM. Perceived danger while intoxicated uniquely contributes to driving after drinking. Alcohol Clin Exp Res.2013;38:521–528. doi: 10.1111/acer.12252
6.
ShultsRA, ElderRW, SleetDA, . Reviews of evidence regarding interventions to reduce alcohol-impaired driving. Am J Prev Med.2001;21:66–88. doi: 10.1016/s0749-3797(01)00381-6
PiaseckiTM, AlleyKJ, SlutskeWS, . Low Sensitivity to alcohol: relations with hangover occurrence and susceptibility in an ecological momentary assessment investigation. J Stud Alcohol Drugs.2012;73:925–932. doi: 10.15288/jsad.2012.73.925
9.
ScholeyAB, BensonS, NealeC, OwenL, TipladyB. Neurocognitive and mood effects of alcohol in a naturalistic setting. Hum Psychopharmacol.2012;27:514–516. doi: 10.1002/hup.2245
10.
StarkeyNJ, CharltonSG. The effects of moderate alcohol concentrations on driving and cognitive performance during ascending and descending blood alcohol concentrations. Hum Psychopharmacol.2014;29:370–383. doi: 10.1002/hup.2415
11.
MarczinskiCA, FillmoreMT. Acute alcohol tolerance on subjective intoxication and simulated driving performance in binge drinkers. Psychol Addict Behav.2009;23:238–247. doi: 10.1037/a0014633
12.
TipladyB, OshinowoB, ThomsonJ, DrummondGB. Alcohol and cognitive function: assessment in everyday life and laboratory settings using mobile phones. Alcohol Clin Exp Res.2009;33:2094–2102. doi: 10.1111/j.1530-0277.2009.01049.x
13.
SliwinskiMJ, MogleJA, HyunJ, MunozE, SmythJM, LiptonRB. Reliability and validity of ambulatory cognitive assessments. Assessment.2016, E-pub ahead of print. doi: 10.1177/1073191116643164.
14.
AmlungMT, MorrisDH, McCarthyDM. Effects of acute alcohol tolerance on perceptions of danger and willingness to drive after drinking. Psychopharmacology (Berl).2014;231:4271–4279. doi: 10.1007/s00213-014-3579-1
15.
MaggsJL, WilliamsLR, LeeCM. Ups and downs of alcohol use among first-year college students: number of drinks, heavy drinking, and stumble and pass out drinking days. Addict Behav.2011;36:197–202. doi: 10.1016/j.addbeh.2010.10.005
16.
BradleyKA, DebenedettiAF, VolkRJ, WilliamsEC, FrankD, KivlahanDR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res.2007;31:1208–1217. doi: 10.1111/j.1530-0277.2007.00403
17.
HumeniukR, AliR, BaborTF, . Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Addiction.2008;103:1039–1047. doi: 10.1111/j.1360-0443.2007.02114.x
18.
RubinskyAD, DawsonDA, WilliamsEC, KivlahanDR, BradleyKA. AUDIT-C scores as a scaled marker of mean daily drinking, alcohol use disorder severity, and probability of alcohol dependence in a U.S. general population sample of drinkers. Alcohol Clin Exp Res.2013;37:1380–1390. doi: 10.1111/acer.12092
WechslerD. The Measurement and Appraisal of Adult Intelligence. Baltimore, MD: Williams & Wilkins; 1958.
21.
JongenS, VuurmanEF, RamaekersJG, VermeerenA. The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: a literature review. Accid Anal Prev.2016;89:31–48. doi: 10.1016/j.aap.2016.01.001
22.
CameronE, SinclairW, TipladyB. Validity and sensitivity of a pen computer battery of performance tests. J Psychopharmacol.2001;15:105–110. doi: 10.1177/026988110101500207
23.
IchikawaS. Verbal memory span, visual memory span, and their correlations with cognitive tasks. Jpn Psychol Res.1983;25:173–180.
24.
LuckSJ, VogelEK. Visual working memory capacity: from psychophysics and neurobiology to individual differences. Trends Cogn Sci.2013;17:391–400. doi: 10.1016/j.tics.2013.06.006
25.
WeissenbornR, DukaT. Acute alcohol effects on cognitive function in social drinkers: their relationship to drinking habits. Psychopharmacology (Berl).2003;165:306–312. doi: 10.1007/s00213-002-1281-1
26.
TapertSF, PulidoC, PaulusMP, SchuckitMA, BurkeC. Level of response to alcohol and brain response during visual working memory. J Stud Alcohol.2004;65:692–700. doi: 10.15288/jsa.2004.65.692
27.
SchusterRM, MermelsteinRJ, HedekerD. Ecological momentary assessment of working memory under conditions of simultaneous marijuana and tobacco use. Addiction.2016;111:1466–1476. doi: 10.1111/add.13342
28.
NieschalkM, OrtmannC, WestA, SchmWeF, StollW, FechnerG. Effects of alcohol on body-sway patterns in human subjects. Int J Legal Med.1999;112:253–260. doi: 10.1007/s004140050245
29.
MillsKC, BisgroveEZ. Body sway and divided attention performance under the influence of alcohol: dose-response differences between males and females. Alcohol Clin Exp Res.1983;7:393–397. doi: 10.1111/j.1530-0277.1983.tb05492.x
30.
JansenEC, ThyssenHH, BrynskovJ. Gait analysis after intake of increasing amounts of alcohol. Z Rechtsmed.1985;94:103–107. doi: 10.1007/BF00198678
31.
SuffolettoB, KristanJ, Person MeccaL, ChungT, ClarkDB. Optimizing a text message intervention to reduce heavy drinking in young adults: focus group findings. JMIR Mhealth Uhealth.2016;4:e73. doi: 10.2196/mhealth.5330
32.
MatthewsDB, MillerWR. Estimating blood alcohol concentration: two computer programs and their applications in therapy and research. Addict Behav.1979;4:55–60. doi: 10.1016/0306-4603(79)90021-2
33.
HustadJT, CareyKB. Using calculations to estimate blood alcohol concentrations for naturally occurring drinking episodes: a validity study. J Stud Alcohol.2005;66:130–138. doi: 10.15288/jsa.2005.66.130
34.
CareyKB, HensonJM, CareyMP, MaistoSA. Which heavy drinking college students benefit from a brief motivational intervention?J Consult Clin Psychol.2007;75:663–669. doi: 10.1037/0022-006X.75.4.663
35.
SullivanEV, BrumbackT, TapertSF, . Cognitive, emotion control, and motor performance of adolescents in the NCANDA study: contributions from alcohol consumption, age, sex, ethnicity, and family history of addiction. Neuropsychology.2016;30:449–473. doi: 10.1037/neu0000259
36.
AvolioBJ, WaldmanDA. Variations in cognitive, perceptual, and psychomotor abilities across the working life span: examining the effects of race, sex, experience, education, and occupational type. Psychol Aging.1994;9:430–442. doi: 10.1037/0882-7974.9.3.430
37.
GajeckiM, BermanAH, SinadinovicK, RosendahlI, AnderssonC. Mobile phone brief intervention applications for risky alcohol use among university students: a randomized controlled study. Addict Sci Clin Pract.2014;9:11. doi: 10.1186/1940-0640-9-11
38.
BartelsC, WegrzynM, WiedlA, AckermannV, EhrenreichH. Practice effects in healthy adults: a longitudinal study on frequent repetitive cognitive testing. BMC Neurosci.2010;11:118. doi: 10.1186/1471-2202-11-118
39.
WrayTB, MerrillJE, MontiPM. Using ecological momentary assessment (EMA) to assess situation-level predictors of alcohol use and alcohol-related consequences. Alcohol Res.2014;36:19–27.
40.
Karns-WrightTE, RoacheJD, Hill-KapturczakN, LiangY, MullenJ, DoughertyDM. Time delays in transdermal alcohol concentrations relative to breath alcohol concentrations. Alcohol Alcohol.2017;52:35–41. doi: 10.1093/alcalc/agw058
41.
LeffingwellTR, CooneyNJ, MurphyJG, . Continuous objective monitoring of alcohol use: twenty-first century measurement using transdermal sensors. Alcohol Clin Exp Res.2013;37:16–22. doi: 10.1111/j.1530-0277.2012.01869.x
42.
SuffolettoB, KristanJ, ChungT, . An interactive text message intervention to reduce binge drinking in young adults: a randomized controlled trial with 9-month outcomes. PLoS ONE.2015;10:e0142877. doi: 10.1371/journal.pone.0142877
