The effects of a working memory load on drinking-related decisions: The role of incentives, disincentives, and lifetime alcohol problems

•A working memory load increased risky and impulsive decisions to attend and drink at drinking related events.•A working memory load decreased inhibition to high disincentives association with attending and drinking at party events.•A working memory load increased effects of high party incentives on decisions to attend risky party events. This study extends this literature on effects of working memory (WM) load on impulsive and disadvantageous decision-making by investigating the impact of WM load on drinking-related decisions in different incentive and disincentive contexts in a large sample (n = 821, 373 women) of young adults, 558 of whom had an alcohol use disorder (AUD). Decisions to attend and drink at hypothetical party events that varied in terms of alcohol party incentives (high vs low) and next day responsibility disincentives (high vs moderate vs low) were assessed. Subjects were randomly assigned to either a WM load (n = 387) or no load condition (n = 434). Analyses revealed that the WM load reduced the degree to which a high disincentive deterred attendance decisions; attendance decisions were more likely under WM load in the high disincentive contexts. This effect was not found in the moderate or low disincentive contexts. Additionally, a WM load increased the effects of high alcohol party incentives on both decisions to attend and drink. The WM load also resulted in faster attendance decision reaction times, suggesting that subjects were more impulsive under load. These results suggest that a WM load had a general effect of disrupting the decision-making process, reducing the inhibitory effects of high disincentives, amplifying the facilitating effects of high party incentives on alcohol-related decisions, and reducing decision deliberation times (reaction times). This suggests that individuals under significant cognitive load engage in more impulsive and riskier decisions when deciding to attend and drink at party events.