BACKGROUND: A higher propensity for impulsive and risky choices has often been reported in individuals with addiction, such as alcohol use disorder (AUD). Although domains of choice impulsivity, for example, temporal discounting, have been identified to predispose the development of hazardous alcohol use, research on altered decision making as a consequence of drinking is scarce. These may be particularly pronounced during periods of progressive brain development, such as young adulthood.

METHODS: This 3-year prospective study investigated the effects of alcohol use on changes in four decision-making domains in 18-year-old men (N = 130). We assessed temporal changes in discounting of delayed rewards, risk aversion for gains, risk seeking for losses, and loss aversion. By correlating three-year cumulative alcohol consumption and total binge drinking frequency with respective change scores, we aimed to explore the influences of drinking on altered development in different impulsive choice tendencies.

RESULTS: From ages 18 to 21, choice impulsivity in our moderately drinking cohort decreased significantly with respect to temporal discounting and risk aversion for gains, while risk seeking for losses and loss aversion did not change significantly. Importantly, higher cumulative alcohol intake and more binge drinking occasions over 3 years were associated with slower increases in risk aversion for gains, that is, the general trend for lower choice impulsivity was diminished. Such relationships were not found for temporal discounting, risk seeking for losses, or loss aversion.

CONCLUSIONS: Alcohol consumption in young adulthood is linked to stunted development of risk aversion for gains. Given that risk seeking for gains was previously identified as a risk factor for increasing alcohol intake, this relationship may reinforce a spiral of escalating consumption over time. The absence of similar findings in other decision-making domains suggests that drinking behavior and modifying factors interact differently across domains, rather than universally enhancing impulsive choice behavior.