Table 3.

Description and main results of studies evaluating emotional response in binge drinking.

Authors (year)	Participants				Intervention	Comparator	Experimental design			Outcomes		Quality
	Sample (n)	Age	Gender ratio (% of males)	Inclusion criteria	Binge drinking criteria	Control group/variable	Processes measured	Task/scale	Stimuli	Main results	Limits
Balodis et al. (2011)	87 college students	Range 19–27 Mean 20.00	33.33%	No allergic reaction to alcohol or contraindication to drink alcohol, cardiovascular disease, or neurological disorder. No food before the experiment	Drinking at least once per month (mean occasions/month = 6.08, SD=4.3; mean alcohol gr/occasion = 74.2) Alcohol administration: BAC level of 0.08%, fresca soda and Vodka (alcohol), Fresca soda and flattened tonic water (placebo), Fresca soda (soft); 3 glasses, 10–15 min intervals	Contrast between stress and non-stress conditions Alcohol administration versus placebo versus soft drink	Physiological stress level Mood	Stress (public task) and No-stress (crossword puzzles) Cortisol and alpha-amylase Risk-taking task Profile of Mood States Mood evaluation	N/A	Stress condition, tension, anxiety, increase in cortisol: alcohol, placebo < soft groups Risk-taking: alcohol, placebo > soft groups Risk-taking was not related to stress	Small sample size	64.71
Connell et al. (2015)	10 BD 9 BD with depressive symptoms	Range 18–22	40%	N/A	At least one binge drinking episode (≥ 70 alcohol gr for boys or ≥ 56 for girls) in the past year	11 non-binge drinkers (no binge drinking episode in the past year) 12 controls with depressive symptoms	Electrophysiological emotional response	Passive viewing of neutral, positive, and negative emotional images Electrophysiological recording: event-related potentials (EPN, P3, LPP)	Neutral, positive, and negative images from the IAPS	LPP amplitudes, negative images: BD < non-BD EPN amplitude, negative and neutral images: BD > non-BD Reduced later processing P3 and LPP, all emotional: depressed BD < non-depressed BD	Small sample size	64.71
Hefner et al. (2013)	72 college students	Range 21–35 Mean 21.60	50%	No history of alcohol-related problem, medical or psychopathological disorder No alcohol/food use before the experiment	Alcohol use: ≥ 42 alcohol gr for boys and 28 for girls on one occasion in the last year Alcohol administration: BAC level of 0.08%, fruit juice and vodka (alcohol), fruit juice and water (placebo), fruit juice (soft); 2 glasses, 15min interval	Alcohol administration versus placebo versus soft drink	Startle response to anxiety and fear	Shock tolerance threshold assessment Experimental task (color square cues; predicted (fear elicitation) and unpredicted (anxiety elicitation) shocks Electromyographic activity	Electric shocks of intensity (maximum tolerance for each participant)	Startle response in predicted condition: BD < placebo, soft groups Alcohol stress-response dampening, specific to anxiety and persistent in time	No inclusion of attentional measures	58.82
Lindgren et al. (2018)	149 college students	Range 21–25 Mean 21.55	53.29%	No major medical problem or alcohol use disorder. No alcohol, drug, or food use before the experiment	At least one binge drinking episode (≥ 70 alcohol gr for boys or ≥ 56 for girls) in the last month	Control by contrasting emotional videos (positive, negative, and neutral)	Emotional and alcohol-related responses	Implicit alcohol-related association test (alcohol excite, alcohol approach, and drinking identity) Alcohol Self-Concept Scale Mood induction (video clips) Mood evaluation after the video Alcohol taste test	Emotional videos inducing sadness, happiness, or neutral state.	Alcohol approach or drinking identity associations: non-significant Sad mood moderated the negative relation between implicit alcohol excite associations and drinking Happy and neutral mood moderated the positive relation between implicit alcohol excite associations and drinking	No assessment of baseline mood	64.71
Loeber & Duka (2009)	36 moderate social drinkers	Mean 21.6	52.78%	Body mass index between 18 and 28, no pregnant or breastfeeding women, heavy smoker (≥ 20 cigarettes/day), dyslexia, mental or neurological disorder, drug use No illicit drugs, medication, and alcohol use before the experiment	At least 80 alcohol gr per week (≤ 320) Alcohol administration: Alcohol dose of 0.8 g/kg, 90% v/v alcohol, tonic water, and Angostura Bitter (alcohol), tonic water and Angostura Bitter (placebo); 10×50 ml, 3 min intervals	Control by contrasting emotional positive and negative words Alcohol administration versus placebo	Emotional response to aversive noise Inhibition of emotional information after the auditory aversive procedure	Abstract stimuli with eye tracking measures: occurrence of aversive (102 db, S+) or no noise (S−) after specific stimuli Instrumental training: same procedure with possibility to avoid the noise Stop Signal task Affective Go/No-Go task	Bursts of 102 db Presentation of positive or negative words during the affective Go/No-Go task	Avoidance in S+ trials: alcohol < placebo Stop-signal performance: alcohol < placebo Go/No-Go, positive versus negative words: alcohol < placebo Reaction time, negative words: alcohol > placebo	The alcohol group guessed they received alcohol (compared to the placebo group)	58.82
Poncin et al. (2017) 1	32 BD	Range 18–30 Mean 20.88	59.4%	No personal or family history of substance use disorder	Consumption > 60 alcohol gr per occasion, at least 2 times a week, with consumption speed > 20 gr per hour	23 non-BD (consumption < 20 alcohol gr per week, < 0.5 occasion per week, consumption speed < 10 gr per hour)	Emotional response to distress	Anagram solution task (soluble and insoluble anagrams) Visual analogue scale (distress) Emotion regulation (self-blame, blaming others, rumination, catastrophizing, putting into perspective, positive refocusing, positive, reappraisal, acceptance, and refocusing on planning) Self-consciousness scale	No emotional stimuli	No difference in distress rating Anagram induced distress predicted blaming others in the whole sample Acceptance: BD < non-BD Anagram induced distress was related to rumination and self-blame in BD	No assessment of emotional states before distress induction	58.82
Stephens et al. (2005) 2	9 BD	Range 19–30 Mean 21.65	33.3%	N/A	Binge drinking score ≥ 27	9 non-BD (binge drinking score ≤ 13.2) Groups were matched on age, gender, depression, anxiety, and severity of severe alcohol use disorder	Fear conditioning	Aversive auditory procedure (63-dB intensity with low, medium, and high frequencies; low and high tones as CS+ before an aversive burst of 97-dB, 40msec) Electromyographic recording and skin conductance	Bursts of different intensities and frequencies	Electromyographic and skin conductance: impaired fear conditioning in BD BD had reduced abilities to discriminate aversive conditioned stimuli (also in later blocks)	Not reported	76.47

Note. All alcohol units have been converted in grams of pure ethanol, according to the number of grams per unit in each country. BD = binge drinkers.

¹This study also evaluates emotional regulation processing

²This study describes animal and human experiments, but we focused on the human research in the current review.