Social Decision Making in Binge Drinking: An Exploration Through Moral Dilemmas

Objective: The continuum hypothesis proposes that binge drinking and severe alcohol use disorder (SAUD) share qualitatively similar cognitive and emotional impairments. In SAUD, these deficits have a demonstrated impact on social decision making, resulting in a utilitarian bias. Namely, when confronted with moral dilemmas, patients with SAUD tend to focus on the consequences of their actions rather than on social norms. However, social decision-making abilities remain unexplored in binge drinking. We offered the first insights on the generalization of the continuum hypothesis to social decision making, through a multinomial processing tree model applied to moral dilemmas, the "CNI model" of moral decision making. Method: We compared 35 binge drinkers (20 females) and 36 light drinkers (21 females) on a battery of 48 moral dilemmas involving interpersonal relations from the CNI model, through multinomial modeling analyses. In each dilemma, participants were asked if they would perform the described action, generating individual scores for sensitivity to consequences, sensitivity to norms, and inaction tendency. Results: The statistical model related to the CNI approach fits the data well. Binge drinkers and controls did not differ regarding their sensitivity to consequences nor their sensitivity to moral norms, and both groups displayed an equal inaction tendency in response to moral dilemmas. Conclusions: We provided insights to better understand the specific (socio)cognitive domains impaired in subclinical populations with alcohol use disorder. We showed preserved social decision making in binge drinking, which suggests that the continuum hypothesis documented for classical neurocognitive functions does not extend to complex social abilities.