Delay Discounting as a Transdiagnostic Process in Psychiatric Disorders: A Meta-analysis

Aberrant glutamatergic systems underlying impulsive behaviors: Insights from clinical and preclinical research

Impulsivity is a broad construct that often refers to one of several distinct behaviors and can be measured with self-report questionnaires and behavioral paradigms. Several psychiatric conditions are characterized by one or more forms of impulsive behavior, most notably the impulsive/hyperactive subtype of attention-deficit/hyperactivity disorder (ADHD), mood disorders, and substance use disorders. Monoaminergic neurotransmitters are known to mediate impulsive behaviors and are implicated in various psychiatric conditions. However, growing evidence suggests that glutamate, the major excitatory neurotransmitter of the mammalian brain, regulates important functions that become dysregulated in conditions like ADHD. The purpose of the current review is to discuss clinical and preclinical evidence linking glutamate to separate aspects of impulsivity, specifically motor impulsivity, impulsive choice, and affective impulsivity. Hyperactive glutamatergic activity in the corticostriatal and the cerebro-cerebellar pathways are major determinants of motor impulsivity. Conversely, hypoactive glutamatergic activity in frontal cortical areas and hippocampus and hyperactive glutamatergic activity in anterior cingulate cortex and nucleus accumbens mediate impulsive choice. Affective impulsivity is controlled by similar glutamatergic dysfunction observed for motor impulsivity, except a hyperactive limbic system is also involved. Loss of glutamate homeostasis in prefrontal and nucleus accumbens may contribute to motor impulsivity/affective impulsivity and impulsive choice, respectively. These results are important as they can lead to novel treatments for those with a condition characterized by increased impulsivity that are resistant to conventional treatments.

Associations between PTSD and temporal discounting: The role of future thinking

BACKGROUND AND OBJECTIVES

Despite documented alterations in future thinking in posttraumatic stress disorder (PTSD), our understanding of how individuals with PTSD make future-oriented decisions is limited. We tested the hypothesis that increased discounting in association with PTSD reflects failure to spontaneously envision future rewarding situations.

METHODS

Thirty-seven trauma exposed war-zone veterans completed a standard temporal discounting task as well as a temporal discounting task accompanied by episodic future thinking cues.

RESULTS

Severity of PTSD symptoms was associated with preference for sooner, smaller rewards in the standard task. Consistent with our hypothesis, when participants engaged in future thinking, greater PTSD symptom severity was no longer associated with steeper discounting. Moreover, difficulty anticipating future events, as measured contemporaneously in a separate task (Verfaellie et al., 2024), mediated the relationship between PTSD symptom severity and degree of discounting in the standard task. Among PTSD symptom clusters, the severity of avoidance and negative alterations in cognition and mood was related to steeper discounting. Measures of depression and alcohol use were not associated with discounting.

LIMITATIONS

The sample included mostly male, predominantly White veterans who experienced primarily combat-related trauma.

CONCLUSIONS

PTSD-associated alterations in temporal discounting reflect failure to spontaneously imagine future positive events. Two common correlates of PTSD, depression and alcohol use, could not account for the observed associations between PTSD and future-oriented decisions.

Global reward processing deficits predict negative symptoms transdiagnostically and transphasically in a severe mental illness-spectrum sample

Reward processing impairments are a key factor associated with negative symptoms in those with severe mental illnesses. However, past findings are inconsistent regarding which reward processing components are impaired and most strongly linked to negative symptoms. The current study examined the hypothesis that these mixed findings may be the result of multiple reward processing pathways (i.e., equifinality) to negative symptoms that cut across diagnostic boundaries and phases of illness. Participants included healthy controls (n = 100) who served as a reference sample and a severe mental illness-spectrum sample (n = 92) that included psychotic-like experiences, clinical high-risk for psychosis, bipolar disorder, and schizophrenia participants. All participants completed tasks measuring four RDoC Positive Valence System constructs: value representation, reinforcement learning, effort-cost computation, and hedonic reactivity. A k-means cluster analysis of the severe mental illness-spectrum samples identified three clusters with differential reward processing profiles that were characterized by: (1) global reward processing deficits (22.8%), (2) selective impairments in hedonic reactivity alone (40.2%), and (3) preserved reward processing (37%). Elevated negative symptoms were only observed in the global reward processing cluster. All clusters contained participants from each clinical group, and the distribution of these groups did not significantly differ among the clusters. Findings identified one pathway contributing to negative symptoms that was transdiagnostic and transphasic. Future work further characterizing divergent pathways to negative symptoms may help to improve symptom trajectories and personalized treatments.

Episodic future thinking improves intertemporal choice and food choice in individuals with higher weight: A systematic review and meta-analysis

Episodic future thinking (EFT) strengthens self-regulation abilities by increasing the perceived value of long-term reinforcements and reducing impulsive choice in delay discounting tasks. As such, EFT interventions have the potential to improve dietary and eating-related decision-making in individuals with obesity or binge eating symptoms, conditions associated with elevated delay discounting. Here, we meta-analyzed evidence from 12 studies that assessed whether EFT interventions improve delay discounting and real-world food choice compared to control interventions. Included studies involved 951 adults with overweight or obesity (body mass index [BMI] ≥25). There were no studies involving participants with binge eating disorder. EFT intervention pooled effects were significant, improving delay discounting with a medium effect, g = 0.55, p < 0.0001, and subsequent food choice outcomes with a small effect, g = 0.31, p < 0.01. Notably, our review is the first to analyze mechanisms of effect in this population, demonstrating that improvements were greater when temporal horizons of EFT episodes were aligned with delay discounting tasks and more distant horizons predicted far-transfer to subsequent dietary and eating-related choices. Our findings thus show that EFT is an effective intervention for individuals with higher weight at risk of adverse health consequences.

Delay discounting and nucleus accumbens functional connectivity are related to weight status in adolescents from the ABCD study

BACKGROUND

Despite the growing epidemic of paediatric obesity, questions remain regarding potential neural mechanisms for individual risk. Delay discounting is a cognitive process of comparison of valuation between immediate and delayed reward, which has been inconsistently linked to weight status. Moreover, central to the brain's reward system is the nucleus accumbens, a region structurally and functionally altered in obesity.

OBJECTIVES/METHODS

This study aimed to examine the relationships between two continuous metrics of weight status, performance on a monetary delay-discounting task and nucleus accumbens functional connectivity in 10-12-year-olds from the Adolescent Brain and Cognitive Development (ABCD) Study.

RESULTS

Using multilevel longitudinal linear modelling, we found greater discounting was associated with higher BMI Z-scores (BMIz) and waist-to-height ratio Z-scores (WHtRz) (N = 3819). Moreover, we observed functional connectivity of the nucleus accumbens to the cingulo-opercular, dorsal attention, fronto-parietal, salience and ventral attention networks were predictive of BMIz (N = 1817). Nucleus accumbens functional connectivity was not found to mediate the association between delay-discounting behaviour and BMIz.

CONCLUSIONS

Delay discounting and nucleus accumbens functional connectivity are independently related to weight status in a large sample of early adolescents. A better understanding of the relationship between reward and overeating behaviours may better inform obesity interventions.

A structural MRI marker predicts individual differences in impulsivity and classifies patients with behavioral-variant frontotemporal dementia from matched controls

Impulsivity and higher preference for sooner over later rewards (i.e., delay discounting) are transdiagnostic markers of many psychiatric and neurodegenerative disorders. Yet, their neurobiological basis is still debated. Here, we aimed at 1) identifying a structural MRI signature of delay discounting in healthy adults, and 2) validating it in patients with behavioral variant frontotemporal dementia (bvFTD)-a neurodegenerative disease characterized by high impulsivity. We used a machine-learning algorithm to predict individual differences in delay discounting rates based on whole-brain grey matter density maps in healthy male adults (Study 1, N=117). This resulted in a cross-validated prediction-outcome correlation of r =0.35 ( p =0.0028). We tested the validity of this brain signature in an independent sample of 166 healthy adults (Study 2) and its clinical relevance in 24 bvFTD patients and 18 matched controls (Study 3). In Study 2, responses of the brain signature did not correlate significantly with discounting rates, but in both Studies 1 and 2, they correlated with psychometric measures of trait urgency-a measure of impulsivity. In Study 3, brain-based predictions correlated with discounting rates, separated bvFTD patients from controls with 81% accuracy, and were associated with the severity of disinhibition among patients. Our results suggest a new structural brain pattern-the Structural Impulsivity Signature (SIS)-which predicts individual differences in impulsivity from whole-brain structure, albeit with small-to-moderate effect sizes. It provides a new brain target that can be tested in future studies to assess its diagnostic value in bvFTD and other neurodegenerative and psychiatric conditions characterized by high impulsivity.

Predictors of Change in Vaccination Decisions Among the Vaccine Hesitant: Examining the Roles of Age and Intolerance of Uncertainty

BACKGROUND

Vaccine hesitancy and resistance pose significant threats to controlling pandemics and preventing infectious diseases. In a group of individuals unvaccinated against the disease caused by the SARS-CoV-2 coronavirus (COVID-19), we investigated how age, intolerance of uncertainty (IU), and their interaction affected the likelihood of having changed one's vaccination decision a year later. We hypothesized that higher IU would increase the likelihood of becoming vaccinated, particularly among individuals of younger age. We predicted that this effect would remain significant, even after controlling for delay discounting and trust in science.

PURPOSE

The goal of this research was to understand the factors influencing changes in vaccination decisions among the vaccine hesitant.

METHODS

In a larger longitudinal study, ~7,500 participants from Prolific.co completed demographic and vaccination status questions, a delay discounting task, and the Intolerance of Uncertainty Scale in June-August 2021. Approximately 3,200 participants completed a follow-up survey in July-August 2022, answering questions about vaccination status, reasons for vaccination decision, and trust in science. We analyzed data from 251 participants who initially had no intention of getting vaccinated and completed the follow-up survey; 38% reported becoming vaccinated in the intervening year.

RESULTS

Data were analyzed using multilevel logistic regression. Over and above other factors related to vaccination decisions (delay discounting, trust in science), younger participants were more likely to change their decision and become vaccinated a year later, especially if they had higher IU, confirming our predictions. Primary reasons for becoming vaccinated were necessity and seeking protection against the virus.

CONCLUSIONS

These findings highlight the complex interplay between age, uncertainty, and vaccination decisions, and inform health policies by suggesting the need for tailoring interventions to specific concerns in different age groups.

Anticipatory and Consummatory Responses Across Reward Domains in Adolescents With Anorexia Nervosa

OBJECTIVE

Anorexia nervosa (AN) is characterized by a tendency to limit intake of food, with specific restriction of foods that are generally considered highly palatable. This observation raises questions about whether reward processing is disturbed in AN. This study examined whether adolescents with AN differ from healthy control peers (HC) in anticipatory and consummatory reward processing.

METHOD

Adolescents with AN (n = 71) and HC (n = 41) completed the Temporal Experience of Pleasure Scale (TEPS). The TEPS Anticipatory Pleasure scale was divided into two further subscales (Food and Non-food). Anticipatory (Food and Non-food) and Consummatory Pleasure (Non-food) scores were compared between adolescents with AN and HC using independent t-tests.

RESULTS

TEPS scores were significantly lower among adolescents with AN than HC in Anticipatory Pleasure Food (t(110) = 7.80, p < 0.001) and Non-food (t(110) = 4.36, p < 0.001), and Consummatory Pleasure (t(110) = 2.60, p = 0.01) subscales. When controlling for BDI score, there was no significant group difference in TEPS Consummatory Pleasure scores (t(108) = 0.88, p = 0.38). Among adolescents with AN, Food Anticipatory Pleasure was significantly negatively correlated with all EDE-Q subscales and global score (r(68) = -0.38, p = 0.002) and positively correlated with food intake at a laboratory buffet meal (r(61) = 0.53, p < 0.001).

DISCUSSION

Measures of both anticipatory and consummatory reward were reduced among adolescents with AN with a short duration of illness. In this study, eating disorder symptoms were related to diminished reward responses in anticipation of food. Dampened anticipatory reward response may comprise a mechanism of illness in AN that should be subject to further study.

The impact of subclinical psychotic symptoms on delay and effort discounting: Insights from behavioral, computational, and electrophysiological methods

BACKGROUND

The ability to value rewards is crucial for adaptive behavior and is influenced by the time and effort required to obtain them. Impairments in these computations have been observed in patients with schizophrenia and may be present in individuals with subclinical psychotic symptoms (PS).

METHODS

In this study, we employed delay and effort-discounting tasks with food rewards in thirty-nine participants divided into high and low levels of PS. We investigated the underlying mechanisms of effort-discounting through computational modelling of dopamine prefrontal and subcortical circuits and the electrophysiological biomarker of both delay and effort-discounting alterations through resting-state frontal alpha asymmetry (FAA).

RESULTS

Results revealed greater delay discounting in the High PS group compared to the Low PS group but no differences in the effort discounting task. However, in this task, the same levels of estimated dopamine release were associated with a lower willingness to exert effort for high-calorie food rewards in High PS participants compared to Low PS participants. Although there were no significant differences in FAA between the High PS and Low PS groups, FAA was significantly associated with the severity of participants' negative symptoms.

CONCLUSIONS

Our study suggests that the dysfunction in temporal and effort cost computations, seen in patients with schizophrenia, may be present in individuals with subclinical PS. These findings provide valuable insight into the early vulnerability markers (behavioral, computational, and electrophysiological) for psychosis, which may aid in the development of preventive interventions. These findings are preliminary and warrant further investigation.

Clustering of behavioral economic biases in decision-making and risk for cigarette smoking and other substance use in women and men

BACKGROUND

Low loss aversion (LA) and high delay discounting (DD) are behavioral-economic decision-making biases that independently predict cigarette smoking and other risky substance use. Here we examine (1) whether low-LA and high-DD co-occur, (2) does co-occurrence increase the odds of current smoking and other substance use compared to only low-LA, high-DD, or neither; and (3) potential gender differences in these associations.

METHOD

Data are from five studies with U.S. adults who currently smoked or never-smoked cigarettes recruited using online convenience sampling matching on gender and education. Participants completed identical sociodemographic, substance use (cigarette, other drugs, alcohol), and LA (hypothetical 50-50 gambles) and DD (monetary-choice questionnaire) measures. LA and DD scores were dichotomized as low and high using Receiver-Operating-Characteristic Curve logistic regression.

RESULTS

LA and DD each independently predicted substance use and with few exceptions were not influenced by gender. Low-LA compared to high-LA predicted two-fold greater odds of co-occurring high-DD (AOR = 2.120, 95%CI:1.749-2.571, p < .0001). Similarly, high-DD compared to low DD predicted two-fold greater odds of low-LA (AOR = 2.118, 95%CI:1.747-2.568, p < .0001). Among those with co-occurring low-LA and high-DD, odds of substance use were 5-10 times greater than those exhibiting neither, and 2-3 times greater than those exhibiting only low-LA or high-DD.

CONCLUSIONS

Low-LA and high-DD cluster in women and men such that exhibiting one of these decision-making biases doubles the odds of exhibiting the other. These results demonstrate reliable clustering of low-LA and high-DD and a striking increase in risk for substance use relative to having only one or neither decision-making bias.

Associations between delay discounting and unhealthy behaviors in substance use recovery

BACKGROUND

Research on delay discounting (DD) is mixed on whether DD is a domain-specific component related to specific behaviors or a domain-general process that cuts across various behaviors. A pivotal group to test the associations between DD and unhealthy behaviors is individuals in recovery from substance use disorders (SUD), as they are moving away from a disorder toward a healthier state.

METHODS

Individuals in SUD recovery (n = 317) completed the Temptation Scale, the Health Behaviors Questionnaire, and an Adjusting Delay Discounting Task. An exhaustive model space search was performed using linear regression to examine associations between DD with temptation, engagement in unhealthy behaviors, and the total number of unhealthy behaviors participants engage in. We also tested whether remission status is associated with the total number of unhealthy behaviors participants engage in.

RESULTS

Results revealed that DD was positively associated with poor eating (p<.001), physical inactivity (p=.003), financial irresponsibility (p<.001), risky behaviors (p<.001), lack of personal development goals (p<.001), lack of household savings (p=.004), and lack of health behaviors (p=.003). DD was also positively associated with the total number of unhealthy behaviors participants engage in (p<.001). Participants who were not in remission engaged in more unhealthy behaviors compared to those who were in remission (p<.001).

CONCLUSION

In a sample of individuals in recovery from SUD, DD is not domain-specific and undergirds engagement in several maladaptive health behaviors that can negatively impact recovery. Thus, DD can be a target for interventions aiming to reduce other maladaptive behaviors in SUD recovery.

A parametric manipulation and meta-analysis of target-response punishment on resurgence

Resurgence can be defined as increases in previously reinforced and subsequently extinguished target responding when conditions for an alternative response worsen. Worsening of alternative conditions, such as extinction, has been linked to relapse of clinically relevant behavior. Preclinical researchers have evaluated whether punishing target responses while differentially reinforcing an alternative response could reduce resurgence when conditions are worsened with extinction, with mixed results. In the present investigation, we systematically replicated this line of research with human participants recruited via crowdsourcing, using response cost as punishment. During Phase 1, we reinforced target responses with 100 points per delivery, exchangeable for money. During Phase 2, we reinforced alternative responses, discontinued point reinforcement for target responses, and parametrically manipulated across groups the magnitude of point loss (1, 100, 320, or 1,000 points) contingent on target responses. During Phase 3, we tested for resurgence by extinguishing target and alternative responses. Added punishment systematically decreased target responding during Phase 2 but did not influence resurgence during Phase 3. With a meta-analysis, we compared our findings with existing research examining a range of punishers and species. The results of the meta-analysis comport with the present findings, suggesting that the inclusion of punishment reduces target responding during DRA but, overall, has no systematic effects on resurgence.

Reprint of: Clustering of behavioral economic biases in decision-making and risk for cigarette smoking and other substance use in women and men

BACKGROUND

Low loss aversion (LA) and high delay discounting (DD) are behavioral-economic decision-making biases that independently predict cigarette smoking and other risky substance use. Here we examine (1) whether low-LA and high-DD co-occur, (2) does co-occurrence increase the odds of current smoking and other substance use compared to only low-LA, high-DD, or neither; and (3) potential gender differences in these associations.

METHOD

Data are from five studies with U.S. adults who currently smoked or never-smoked cigarettes recruited using online convenience sampling matching on gender and education. Participants completed identical sociodemographic, substance use (cigarette, other drugs, alcohol), and LA (hypothetical 50-50 gambles) and DD (monetary-choice questionnaire) measures. LA and DD scores were dichotomized as low and high using Receiver-Operating-Characteristic Curve logistic regression.

RESULTS

LA and DD each independently predicted substance use and with few exceptions were not influenced by gender. Low-LA compared to high-LA predicted two-fold greater odds of co-occurring high-DD (AOR = 2.120, 95%CI:1.749-2.571, p < .0001). Similarly, high-DD compared to low DD predicted two-fold greater odds of low-LA (AOR = 2.118, 95%CI:1.747-2.568, p < .0001). Among those with co-occurring low-LA and high-DD, odds of substance use were 5-10 times greater than those exhibiting neither, and 2-3 times greater than those exhibiting only low-LA or high-DD.

CONCLUSIONS

Low-LA and high-DD cluster in women and men such that exhibiting one of these decision-making biases doubles the odds of exhibiting the other. These results demonstrate reliable clustering of low-LA and high-DD and a striking increase in risk for substance use relative to having only one or neither decision-making bias.

Comparison between Single-Dose and Two-Dose Psilocybin Administration in the Treatment of Major Depression: A Systematic Review and Meta-Analysis of Current Clinical Trials

Current pharmacological treatments for major depressive disorder (MDD) are often only partially effective, with many patients experiencing no significant benefit, leading to treatment-resistant depression (TRD). Psilocybin, a classical serotonergic psychedelic, has emerged as a notable emerging treatment for such disorders. The aim of this systematic review and meta-analysis is to summarize and discuss the most recent evidence about the therapeutic effects of single-dose and two-dose psilocybin administration on the severity of depressive symptoms, as well as compare the efficacy of these interventions among patients with a primary diagnosis of MDD or TRD. Articles were collected from EBSCOhost and PubMed following the PRISMA guidelines, yielding 425 articles with 138 duplicates. After screening 287 records, 12 studies met the eligibility criteria and were included in the review. A quantitative analysis of the studies indicates that psilocybin is highly effective in reducing depressive symptoms severity among patients with primary MDD or TRD. Both single-dose and two-dose psilocybin treatments significantly reduced depressive symptoms severity, with two-dose administration sometimes yielding more pronounced and lasting effects. However, it is unclear if this was solely due to dosage or other factors. Future research should include standardized trials comparing these dosing strategies to better inform clinical practice.

Impulsive Decision-Making, Affective Experiences, and Parental History of Self-Injurious Thoughts and Behaviors within Parent-Adolescent Dyads

Impulsive decision-making, particularly during states of affective intensity, is associated with greater risk of engagement in self-injurious thoughts and behaviors (SITBs) during adolescence. The proximal (dyadic parent-adolescent affect and impulsivity) and distal (family history of SITBs) risk factors that occur within the family system could be relevant processes at stake in the intergenerational transmission of risk. The current study tests the interdependence of parent-adolescent factors associated with risk for SITBs and probes the extent to which parent-adolescent affective states influence their own (actor-effects) and each other's (partner-effects) impulsive decision-making, and further whether these relationships are moderated by a parent's history of SITBs. Participants included 212 (106 dyads) community parents and their adolescents who completed self-report and behavioral tasks related to positive and negative affective states, impulsive decision-making, and lifetime history of SITBs. Application of the Actor-Partner Interdependence Model (APIM) revealed a partner-effect where greater parent negative affect in the past week was associated with elevated adolescent impulsive decision-making among families with a history of SITBs (Estimate = 0.66, Standard Error = 0.13, p < 0.001). In addition, a significant actor-effect was observed where greater positive affect was associated with decreased impulsive decision-making among adolescents (Estimate = -0.21, Standard Error = 0.10, p = 0.03), however, moderating effects of parent history of SITBs were not detected. Findings from the present study shed light on the interdependence of affect and impulsivity within parent-adolescent dyads, and the extent to which these interactions may be particularly salient for families with known vulnerabilities for SITBs.

Positive autobiographical memory recall does not influence temporal discounting: an internal meta-analysis of experimental studies

People tend to discount the value of future rewards as the delay to receiving them increases. This phenomenon, known as temporal discounting, may underlie many impulsive behaviors, such as drug abuse and overeating. Given the potential role of temporal discounting in maladaptive behaviors, many efforts have been made to find experimental manipulations that reduce temporal discounting. One class of manipulations that has held some promise involves recalling positive autobiographical memories prior to making intertemporal choices. Just as imagining positive future events has been shown to reduce temporal discounting, a few studies have shown that recalling positive past events reduces temporal discounting, especially if memory retrieval evokes positive affective states, such as gratitude and nostalgia. However, we failed to replicate these findings. Here we present an internal meta-analysis combining data from 14 studies (n = 758) that involved within-subjects positive memory recall-based manipulations. In each study, temporal discounting was assessed using a monetary intertemporal choice task. The average effect size was not significantly different from zero. This finding helps elucidate the neurocognitive mechanisms of temporal discounting; whereas engaging the episodic memory system to imagine future events might promote more patience, engaging the episodic memory system to imagine past events does not.

Genome-wide association study of delay discounting in Heterogeneous Stock rats

Delay discounting refers to the behavioral tendency to devalue rewards as a function of their delay in receipt. Heightened delay discounting has been associated with substance use disorders and multiple co-occurring psychopathologies. Human and animal genetic studies have established that delay discounting is heritable, but only a few associated genes have been identified. We aimed to identify novel genetic loci associated with delay discounting through a genome-wide association study (GWAS) using Heterogeneous Stock (HS) rats, a genetically diverse outbred population derived from eight inbred founder strains. We assessed delay discounting in 650 male and female HS rats using an adjusting amount procedure in which rats chose between smaller immediate sucrose rewards or a larger reward at various delays. Preference switch points were calculated and both exponential and hyperbolic functions were fitted to these indifference points. Area under the curve (AUC) and the discounting parameter k of both functions were used as delay discounting measures. GWAS for AUC, exponential k, and one indifference point identified significant loci on chromosomes 20 and 14. The gene Slc35f1, which encodes a member of the solute carrier family, was the sole gene within the chromosome 20 locus. That locus also contained an eQTL for Slc35f1, suggesting that heritable differences in the expression might be responsible for the association with behavior. Adgrl3, which encodes a latrophilin subfamily G-protein coupled receptor, was the sole gene within the chromosome 14 locus. These findings implicate novel genes in delay discounting and highlight the need for further exploration.

Environmental Support Moderates the association of Socioeconomic Distress and Delay Discounting across Adolescence

Early exposure to socioeconomic distress is hypothesized to reinforce decision making that prioritizes immediate, relative to delayed, rewards (i.e., delay discounting); yet these relations have not been examined longitudinal across the vulnerable adolescent period. This study is one of the first to utilize objective and subjective measures to evaluate the relative effects of environmental disadvantage and the potential protective effects of perceived environmental support on delay discounting. A diverse (48.4% White; 46.7% female) sample of participants (N = 246) reported on their home addresses at baseline when they were, on average, 11.96 years old (SDage = 0.88); Youth then reported perceived environmental supports at baseline and delay discounting annually from ages 13 to 18. A socioeconomic distress index was derived from census tract rates of unemployment, income, educational attainment, and lone parenthood. Greater socioeconomic distress was associated with a greater propensity to discount delayed rewards at baseline. Findings also suggest greater perceived higher environmental support was associated with decreasing rates of delay discounting across adolescence for youth from highly socioeconomically distressed areas. These results highlight potential future avenues for preventative and intervention efforts to improve positive youth outcomes.

Anorexia Nervosa Across the Lifespan: A Review of Recent Literature

In this review, the authors provide an update on the understanding of anorexia nervosa (AN) across the lifespan. Focusing on key pieces of literature from the past 5 years, this review summarizes recent updates to DSM-5 within the domain of AN, including the addition of a new AN diagnosis: atypical anorexia. Additional sections covered in this review include improvements in the epidemiological understanding of AN across the developmental spectrum, treatment approaches that have been established as gold standard as well as new directions recently explored in treatment, and recent advancements in the biopsychosocial underpinnings of AN. Altogether, although this review captures several advancements in the field's overall conceptualization of AN, several key areas of treatment and diagnostic capacity continue to require additional focus and research.

Temporal discounting in children and adolescents with and without attention-deficit/hyperactivity disorder: a comparison of four scoring methods

Temporal discounting (TD) tasks measure the preference for immediate rewards over larger delayed rewards and have been widely used to study impulsivity in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Relatively impulsive individuals tend to show high inconsistency in their choices, which makes it difficult to determine commonly used TD outcome measures (e.g., area under the curve, AUC). In this study, we leveraged two published datasets to compare four methods to compute TD outcome measures in children and adolescents (8-17 years) with (n = 107) and without ADHD (n = 128): two predetermined rules methods, a proportion method, and logistic regression. In both datasets, when using the two predetermined rules methods and the proportion method, TD outcomes were highly correlated and group differences in TD were similar. When using logistic regression, a large proportion of AUCs (95% in dataset 1; 33% in dataset 2) could not be computed due to inconsistent choice patterns. These findings indicate that predetermined rules methods (for studies with small sample sizes and experienced raters) and a proportion method (for studies with larger sample sizes or less experienced raters) are recommended over logistic regression when determining subjective reward values for participants with inconsistent choice patterns.

Effectiveness and feasibility of the self-administered and repeated episodic future thinking exercises in smoking cessation

Delay discounting (DD) is associated with smoking behavior and relapses. Episodic future thinking (EFT) is one of the leading interventions shown to reduce DD. The 1-month follow-up study with 60 participants that employed EFT as active intervention and episodic recent thinking (ERT) as control intervention was conducted in participants receiving smoking cessation treatment. In EFT group, there was significant decrease in DD rates from pre-intervention to post-intervention (p = 0.009), whereas no significant change was observed in ERT group (p = 0.497). DD rates in EFT group did not change significantly over 1 month (p = 0.059), while decrease was detected in ERT group (p = 0.011). Smoking cessation rates between groups were similar (p = 0.486). Adherence with completing follow-up evaluation forms and performing relevant exercises was higher in EFT group (p = 0.038, p = 0.006). Adding EFT to usual smoking cessation treatment did not increase smoking cessation rates, however feasibility of the self-administered exercises needs to be improved to clarify clinical effects.

Dorsal raphe neurons integrate the values of reward amount, delay, and uncertainty in multi-attribute decision-making

The dorsal raphe nucleus (DRN) is implicated in psychiatric disorders that feature impaired sensitivity to reward amount, impulsivity when facing reward delays, and risk-seeking when confronting reward uncertainty. However, it has been unclear whether and how DRN neurons signal reward amount, reward delay, and reward uncertainty during multi-attribute value-based decision-making, where subjects consider these attributes to make a choice. We recorded DRN neurons as monkeys chose between offers whose attributes, namely expected reward amount, reward delay, and reward uncertainty, varied independently. Many DRN neurons signaled offer attributes, and this population tended to integrate the attributes in a manner that reflected monkeys' preferences for amount, delay, and uncertainty. After decision-making, in response to post-decision feedback, these same neurons signaled signed reward prediction errors, suggesting a broader role in tracking value across task epochs and behavioral contexts. Our data illustrate how the DRN participates in value computations, guiding theories about the role of the DRN in decision-making and psychiatric disease.

Delay discounting is associated with addiction and mental health measures while controlling for health behaviors and health barriers in a large US sample

Background

Excessive discounting of future rewards [delay discounting (DD)] may be a transdiagnostic process and treatment target underlying behavioral health outcomes, including trauma, depression, anxiety, and problematic substance use. However, multiple health behaviors and barriers are also related to these outcomes, including social media usage, adverse childhood experiences (ACEs), sleep quality, healthcare access, housing status, and exercise. To extend research examining DD as transdiagnostic process, we recruited a large, heterogenous sample to examine the association between DD, problematic substance use, and mental health outcomes while controlling for certain health behaviors and health barriers.

Method

In a cross-sectional online survey of 3992 US residents, we administered validated measures of PTSD, depression, anxiety, and problematic alcohol, stimulant, and opioid use. Using linear or ordinal logistic models, scores for each outcome were regressed onto DD while controlling for demographics, health behaviors, and health barriers.

Results

Including only DD and demographics, DD was associated with each outcome at low effect sizes (ƒ2 = .013, OR range = 1.08-1.16). Except for opioid ASSIST scores, these relationships held when controlling for social media usage, sleep, housing status, healthcare access, ACEs, physical exercise, and demographic variables (ƒ2 = .002, OR range = 1.03-1.12), increasing confidence that DD concurrently and directly relates to four of these five clinical outcomes.

Discussion

These findings support the conceptualization of DD as a transdiagnostic process underlying certain psychopathologies and suggest targeting DD in co-occurring substance use disorder and/or mental health treatments may result in clinically significant outcomes.

Is waiting for rewards good for you? No association between impulsive choice, psychopathology, and functional outcomes in a large cohort sample

Background

A stronger preference for immediate rewards has been reported in individuals with ADHD and other disorders. However, the consistency of the associations between this preference and psychiatric conditions as well as functional outcomes have been questioned. Research on its association with longitudinal outcomes is scarce.

Methods

The current study used data on a choice delay task (CDT) from a school-based cohort of Brazilian children with those at higher risk for psychiatric disorders over-sampled (n = 1917). The sample included typically developing children (n = 1379), those with ADHD (n = 213), and other disorders. The frequency of the trials where children chose a larger later reward versus a smaller sooner reward was compared for those with ADHD and typically developing children. Cross-sectionally and longitudinally, the study also evaluated whether children's preference for larger delayed rewards at baseline predicted the presence of psychiatric disorders and functional life outcomes (academic performance, alcohol use, early pregnancy, criminal conviction, BMI).

Results

Children with ADHD and their typically developing peers performed similarly on the CDT. Their baseline task performance was not related to psychiatric conditions or life outcomes.

Conclusions

The current results raise questions regarding the use of the CDT with diverse populations and whether a preference for larger delayed rewards is predictive of positive long-term outcomes as widely assumed.

The Relationship of the Impulsivity and Decision-Making Behavior with Social Cognitive Skills in Borderline Personality Disorder

Introduction

In this study, we aimed to examine the relationship between decision-making processes and other cognitive characteristics associated with Borderline Personality Disorder (BPD) in comparison with healthy controls by using the neurocognitive tests.

Method

The sample of the study consists of the patient group diagnosed with BPD (n=27) and the voluntary participants without any psychiatric diagnosis (n=28). Borderline Personality Inventory (BPI) was used for psychiatric evaluation, and Iowa Gambling Test (IGT), Stroop Test, Benton Face Recognition Test, Reading the Mind in the Eyes Test, Dokuz Eylül Theory of Mind Scale (DEToM), WMS-R Digit Span and Logical Memory Subscales were administered for neuropsychological examination.

Results

A significant difference was found between the BPD and the control group in BPI scores (p=0.02). There were no significant differences on the duration of interference and the number of errors in the Stroop Test, but it was observed that the number of spontaneous correction responses differed significantly (p=0.02) between the groups. A significant difference was revealed (p<0.01) in the immediate recall scores of the WMS-R Logical Memory (subtest story A) between the groups. There were also differences in the Iowa Gambling Test between the groups in the response tendency to choose from deck A (p=0.028) in the first half and from deck B (p=0.03) in the second half of the test. Finally, among the total scores of DEToM there was significant difference between the two groups (p<0.01), and this difference was prominent in the second-degree false belief (p=0.024) and empathy (p=0.027) tasks.

Conclusion

As a result of our study, it was concluded that individuals with BPD have minimal difficulty in inhibiting inappropriate response, and this difficulty is related to making disadvantageous choices in decision-making behavior. While BPD group was successful in predicting mental states from external cues in terms of social cognition, however, it was observed that they had difficulty integrating cues within a social pattern and making coherent narratives.

Heuristics in risky decision-making relate to preferential representation of information

When making choices, individuals differ from one another, as well as from normativity, in how they weigh different types of information. One explanation for this relates to idiosyncratic preferences in what information individuals represent when evaluating choice options. Here, we test this explanation with a simple risky-decision making task, combined with magnetoencephalography (MEG). We examine the relationship between individual differences in behavioral markers of information weighting and neural representation of stimuli pertinent to incorporating that information. We find that the extent to which individuals (N = 19) behaviorally weight probability versus reward information is related to how preferentially they neurally represent stimuli most informative for making probability and reward comparisons. These results are further validated in an additional behavioral experiment (N = 88) that measures stimulus representation as the latency of perceptual detection following priming. Overall, the results suggest that differences in the information individuals consider during choice relate to their risk-taking tendencies.

Sexual Arousal-Delay Discounting: When Condoms Delay Arousal

Sexual arousal plays an important role in condom use decisions. However, combined effects of reduced sexual arousal and delay to achieving arousal on condom use decisions remain understudied. This study used a novel sexual arousal-delay discounting (SADD) task to measure individuals' willingness to use a condom in situations where condom use would (1) delay time to arousal and (2) reduce the level of arousal one could achieve even after the delay (e.g., 5 minutes to reach 50% arousal). In Study 1, U.S. college students (N = 115; Mage = 18.6) reported their willingness to have sex with a condom in hypothetical scenarios where the condom delayed and reduced their partner's sexual arousal. In Study 2, U.S. college students (N = 208; Mage = 19.6; 99% ≤ 24 years old) completed the same task for two partners-partner perceived as most desirable and partner perceived as least likely to have an STI. In this study, a condom would affect either participants' own or partner's arousal. Study 3 replicated Study 2 using a non-college sample in the U.S. (N = 227; Mage = 30.5; 84% ≥ 25 years old). Across studies, willingness to use a condom decreased as the delay to reduced arousal increased. This effect of SADD was stronger when condoms reduced participants' own (vs. partner's) arousal, whereas comparisons between most desirable and least likely-to-have-STI partners provided mixed findings. Men had higher discounting rates than women across conditions. Greater SADD was associated with lower condom use self-efficacy, providing initial evidence for the task's validity. The role of delayed arousal in condom use and implications are discussed.

A systematic review and meta-analysis of test-retest reliability and stability of delay and probability discounting

In this meta-analysis, we describe a benchmark value of delay and probability discounting reliability and stability that might be used to (a) evaluate the meaningfulness of clinically achieved changes in discounting and (b) support the role of discounting as a valid and enduring measure of intertemporal choice. We examined test-retest reliability, stability effect sizes (dz; Cohen, 1992), and relevant moderators across 30 publications comprising 39 independent samples and 262 measures of discounting, identified via a systematic review of PsychInfo, PubMed, and Google Scholar databases. We calculated omnibus effect-size estimates and evaluated the role of proposed moderators using a robust variance estimation meta-regression method. The meta-regression output reflected modest test-retest reliability, r = .670, p < .001, 95% CI [.618, .716]. Discounting was most reliable when measured in the context of temporal constraints, in adult respondents, when using money as a medium, and when reassessed within 1 month. Testing also suggested acceptable stability via nonsignificant and small changes in effect magnitude over time, dz = 0.048, p = .31, 95% CI [-0.051, 0.146]. Clinicians and researchers seeking to measure discounting can consider the contexts when reliability is maximized for specific cases.

Association of temporal discounting with transdiagnostic symptom dimensions

Temporal discounting (TD), the tendency to devalue future rewards as a function of delay until receipt, is aberrant in many mental disorders. Identifying symptom patterns and transdiagnostic dimensions associated with TD could elucidate mechanisms responsible for clinically impaired decision-making and facilitate identifying intervention targets. Here, we tested in a general population sample (N = 731) the extent to which TD was related to different symptom patterns and whether effects of time framing (dates/delay units) and monetary magnitude (large/small) had particularly strong effects in people scoring higher on specific symptom patterns. Analyses revealed that TD was related to symptom patterns loading on anxious-depression and inattention-impulsivity-overactivity dimensions. Moreover, TD was lower in the date than the delay version and with higher magnitudes, especially in people scoring higher on the inattention-impulsivity-overactivity dimension. Overall, this study provides evidence for TD as a transdiagnostic process across affective and impulsivity-related dimensions. Future studies should test framing interventions in clinical populations characterized by impulsivity.Preregistration: This research was preregistered at https://osf.io/fg9sc .

Dopamine transients follow a striatal gradient of reward time horizons

Animals make predictions to guide their behavior and update those predictions through experience. Transient increases in dopamine (DA) are thought to be critical signals for updating predictions. However, it is unclear how this mechanism handles a wide range of behavioral timescales-from seconds or less (for example, if singing a song) to potentially hours or more (for example, if hunting for food). Here we report that DA transients in distinct rat striatal subregions convey prediction errors based on distinct time horizons. DA dynamics systematically accelerated from ventral to dorsomedial to dorsolateral striatum, in the tempo of spontaneous fluctuations, the temporal integration of prior rewards and the discounting of future rewards. This spectrum of timescales for evaluative computations can help achieve efficient learning and adaptive motivation for a broad range of behaviors.

Differences in Discounting Behavior and Brain Responses for Food and Money Reward

Most neuroeconomic research seeks to understand how value influences decision-making. The influence of reward type is less well understood. We used functional magnetic resonance imaging (fMRI) to investigate delay discounting of primary (i.e., food) and secondary rewards (i.e., money) in 28 healthy, normal-weighted participants (mean age = 26.77; 18 females). To decipher differences in discounting behavior between reward types, we compared how well-different option-based statistical models (exponential, hyperbolic discounting) and attribute-wise heuristic choice models (intertemporal choice heuristic, dual reasoning and implicit framework theory, trade-off model) captured the reward-specific discounting behavior. Contrary to our hypothesis of different strategies for different rewards, we observed comparable discounting behavior for money and food (i.e., exponential discounting). Higher k values for food discounting suggest that individuals decide more impulsive if confronted with food. The fMRI revealed that money discounting was associated with enhanced activity in the right dorsolateral prefrontal cortex, involved in executive control; the right dorsal striatum, associated with reward processing; and the left hippocampus, involved in memory encoding/retrieval. Food discounting, instead, was associated with higher activity in the left temporoparietal junction suggesting social reinforcement of food decisions. Although our findings do not confirm our hypothesis of different discounting strategies for different reward types, they are in line with the notion that reward types have a significant influence on impulsivity with primary rewards leading to more impulsive choices.

Health factors that influence sustainable behaviour in a single-player resource management game

Encouraging sustainable use of limited natural, social, and economic resources requires understanding the variety of ways in which people think about how resources work and how they adjust their behaviour (or not) as available resources fluctuate. Previous investigations which have focused on understanding how individuals navigate erodible resources, have tended to use group-based, common pool games. However, such social games make it difficult to disentangle whether resource erosion is linked to difficulty navigating the dynamics of the resource or caused by social factors. Here, in two experiments, we recruited 781 participants to play a single-player resource management game in which individuals were invited to harvest monetary rewards from a fully depletable but stochastically replenishing resource over time. We find that the ability to sustain a resource over successive harvesting opportunities (in order to maximize the total harvested rewards) is reliably worse in individuals reporting elevated psychological distress, the often cooccurring hazardous alcohol use, and elevated rates of delay discounting. The associations between resource outcomes, harmful alcohol use, and psychological distress remained substantial even once we had controlled for elevated discounting rates (as a form of impulsivity and a strong risk factor for these health challenges). By contrast, individuals who reported higher levels of financial literacy and general well-being achieved better resource outcomes. Our observations demonstrate that the capacity to respond effectively to the dynamics of a resource are compromised in individuals at risk of psychological and alcohol-related disorders.

Imagine before you leap: Episodic future thinking combined with transcranial direct current stimulation training for impulsive choice in repetitive negative thinking

Background

Immediate reward preference in repetitive negative thinking (RNT) has a high clinical correlation with a variety of maladaptive behaviors, whereas episodic future thinking (EFT) may be conducive to dealing with non-adaptive thinking and decision-making.

Objectives

This study aimed to evaluate the efficacy of EFT training combined with transcranial direct current stimulation (tDCS) stimulation over the ventromedial PFC (vmPFC) in inhibiting impulsive choice of RNT individuals.

Method

Study 1 explored the effects of EFT on immediate reward preference of participants with high and low RNT (N = 48). Study 2 conducted a randomized controlled trial (RCT) to examine the treatment effect of the EFT-neural training on impulsive choice of high RNT individuals (N = 103).

Results

In study 1, individuals with high RNT were more likely to choose smaller and sooner (SS) rewards, however, there were no significant differences between the high-RNT group and the low-RNT group under the positive EFT condition. In study 2, a significant decrease was shown in the proportion of choosing SS rewards under the 8-week EFT-neural training, and the effect was maintained at 1 month follow-up.

Conclusion

RNT is a vulnerability factor for short-sighted behaviors, and EFT-neural training could be suitable for reducing RNT and improving immediate reward preference.

Waiting for it: Anorexia Risk, Future Orientation, and Intertemporal Discounting

Anorexia Nervosa is a severe eating disorder characterized by food restriction in service of a future goal: thinness and weight loss. Prior work suggests abnormal intertemporal decision-making in anorexia, with more farsighted decisions observed in patients with acute anorexia. Prospective future thinking in daily life, or temporal orientation, promotes more farsighted delay discounting. However, whether temporal orientation is altered in anorexia, and underlies reduced delay discounting in this population, remains unclear. Further, because changes in delay discounting could reflect cognitive effects of an acute clinical state, it is important to determine whether reduced delay discounting is observed in subclinical, at-risk samples. We measured delay discounting behavior and temporal orientation in a large sample of never-diagnosed individuals at risk of anorexia nervosa. We found that farsighted delay discounting was associated with elevated risk for anorexia nervosa. Anorexia nervosa risk was also associated with increased future-oriented cognition. Future-oriented cognition mediated the difference in delay-discounting behavior between high and low-risk groups. These results were unrelated to subjective time perception and were independent of mood and anxiety symptomatology. These findings establish future-oriented cognition as a cognitive mechanism underlying altered intertemporal decision-making in individuals at risk of developing anorexia nervosa.

Choice impulsivity after repeated social stress is associated with increased perineuronal nets in the medial prefrontal cortex

Repeated stress can predispose to substance abuse. However, behavioral and neurobiological adaptations that link stress to substance abuse remain unclear. This study investigates whether intermittent social defeat (ISD), a stress protocol that promotes drug-seeking behavior, alters intertemporal decision-making and cortical inhibitory function in the medial prefrontal cortex (mPFC). Male long evans rats were trained in a delay discounting task (DDT) where rats make a choice between a fast (1 s) small reward (1 sugar pellet) and a large reward (3 sugar pellets) that comes with a time delay (10 s or 20 s). A decreased preference for delayed rewards was used as an index of choice impulsivity. Rats were exposed to ISD and tested in the DDT 24 h after each stress episode, and one- and two-weeks after the last stress episode. Immunohistochemistry was performed in rat's brains to evaluate perineuronal nets (PNNs) and parvalbumin GABA interneurons (PV) labeling as markers of inhibitory function in mPFC. ISD significantly decreased the preference for delayed large rewards in low impulsive, but not high impulsive, animals. ISD also increased the density of PNNs in the mPFC. These results suggest that increased choice impulsivity and cortical inhibition predispose animals to seek out rewards after stress.

Associations Between Reward and Future-Related Orientations and General and Specific Mental Health Issues in Adolescence

Adolescence is characterised by a peak in sensation seeking accompanied by gradually developing self-control skills. Adolescents typically show steeper delay discounting performance than other age groups; a feature that is transdiagnostically related to a variety of mental health disorders. However, delay discounting performance is not a singular mental process but involves both risk/reward and future orientation elements, usually operationalised as probability/risk and time discounting tasks, respectively. To clarify the specific relations between the risk/reward and future orientation elements of delay discounting and different types of mental health problems, two bi-factor models and a series of structural equation models (SEMs) were fitted to multi-informant (parent and adolescent self-reported) mental health data from a large UK study. A transdiagnostic promotive role of future orientation was found using bi-factor modelling to separate general and dimension-specific mental health variation; however, this was limited to parent reports. In addition, future orientation was negatively associated with conduct problems and ADHD symptoms, but positively associated with emotional problems. Risk aversion was negatively associated with conduct problems, but positively associated with emotional and peer problems. The findings highlight that risk/reward and future orientation elements of delay discounting play partly distinct roles in different mental health problems and can serve both promotive and risk roles during adolescence. Findings also illuminate which elements of delay discounting should be intervention targets for different mental health concerns.

Goal characteristics predict the occurrence of goal-related events through belief in future occurrence

While previous studies have highlighted the role of episodic future thinking in goal pursuit, the underlying cognitive mechanisms remain unexplored. Episodic future thinking may promote goal pursuit by shaping the feeling that imagined events will (or will not) happen in the future - referred to as belief in future occurrence. We investigated whether goal self-concordance (Experiment 1) and other goal characteristics identified as influential in goal pursuit (Experiment 2) modulate belief in the future occurrence of goal-related events and predict the actual occurrence of these events. Results showed that goal self-concordance, engagement, and expectancy had an indirect effect on the actual occurrence of events, which was (partially) mediated by belief in future occurrence. The mediating role of belief supports the view that belief in future occurrence when imagining events conveys useful information, allowing us to make informed decisions and undertake adaptive actions in the process of goal pursuit.

Initial evidence of delay discounting's predictive utility for alcohol self-administration in ecologically valid contexts among young adults who drink heavily

BACKGROUND

While delay discounting is robustly associated with alcohol use disorder, whether discounting predicts real-time alcohol use behaviors is unclear. Existing support comes from laboratory studies using intravenous alcohol self-administration methods, thus limiting ecological validity and generalizability. The present study evaluated whether delay discounting predicted real-time alcohol use in naturalistic settings with and without probabilistic negative consequences for consuming larger amounts of alcohol.

METHODS

This secondary analysis utilized data from three laboratory alcohol self-administration studies with young adults who engaged in frequent heavy drinking (N=206, 45% female). Participants completed a delay discounting measure before an alcohol self-administration session in an actual or simulated bar with (n=187) or without (n=19) probabilistic negative consequences (compensation loss) tied to performance on cognitive and psychomotor tasks after alcohol self-administration. Bootstrapped (unstandardized) coefficient estimates and 95% confidence intervals were utilized due to the sample size discrepancy.

RESULTS

Multiple regressions revealed that delay discounting did not significantly predict estimated blood alcohol concentration (eBAC) or number of drinks consumed when procedures included probabilistic negative consequences. Among participants who completed procedures without probabilistic negative consequences, delay discounting was positively associated with peak eBAC.

CONCLUSION

Counter to hypotheses, steeper delay discounting did not predict real-time alcohol use in contexts with probabilistic negative consequences, whereas preliminary evidence suggests that delay discounting predicts real-time alcohol use behaviors in contexts without probabilistic negative consequences. The specific discounting task may have impacted study findings, thus future research should consider how the sign (gain vs. loss), outcome certainty, and delay relate to alcohol consumption.

Designing and Validating a Novel Method for Assessing Delay Discounting Associated With Health Behaviors: Ecological Momentary Assessment Study

BACKGROUND

Delay discounting quantifies an individual's preference for smaller, short-term rewards over larger, long-term rewards and represents a transdiagnostic factor associated with numerous adverse health outcomes. Rather than a fixed trait, delay discounting may vary over time and place, influenced by individual and contextual factors. Continuous, real-time measurement could inform adaptive interventions for various health conditions.

OBJECTIVE

The goals of this paper are 2-fold. First, we present and validate a novel, short, ecological momentary assessment (EMA)-based delay discounting scale we developed. Second, we assess this tool's ability to reproduce known associations between delay discounting and health behaviors (ie, substance use and craving) using a convenience-based sample.

METHODS

Participants (N=97) were adults (age range 18-71 years), recruited on social media. In phase 1, data were collected on participant sociodemographic characteristics, and delay discounting was evaluated via the traditional Monetary Choice Questionnaire (MCQ) and our novel method (ie, 7-item time-selection and 7-item monetary-selection scales). During phase 2 (approximately 6 months later), participants completed the MCQ, our novel delay discounting measures, and health outcomes questions. The correlations between our method and the traditional MCQ within and across phases were examined. For scale reduction, a random number of items were iteratively selected, and the correlation between the full and random scales was assessed. We then examined the association between our time- and monetary-selection scales assessed during phase 2 and the percentage of assessments that participants endorsed using or craving alcohol, tobacco, or cannabis.

RESULTS

In total, 6 of the 7 individual time-selection items were highly correlated with the full scale (r>0.89). Both time-selection (r=0.71; P<.001) and monetary-selection (r=0.66; P<.001) delay discounting rates had high test-retest reliability across phases 1 and 2. Phase 1 MCQ delay discounting function highly correlated with phase 1 (r=0.76; P<.001) and phase 2 (r=0.45; P<.001) time-selection delay discounting scales. One or more randomly chosen time-selection items were highly correlated with the full scale (r>0.94). Greater delay discounting measured via the time-selection measure (adjusted mean difference=5.89, 95% CI 1.99-9.79), but not the monetary-selection scale (adjusted mean difference=-0.62, 95% CI -3.57 to 2.32), was associated with more past-hour tobacco use endorsement in follow-up surveys.

CONCLUSIONS

This study evaluated a novel EMA-based scale's ability to validly and reliably assess delay discounting. By measuring delay discounting with fewer items and in situ via EMA in natural environments, researchers may be better able to identify individuals at risk for poor health outcomes.

The date/delay effect in intertemporal choice: A combined fMRI and eye-tracking study

Temporal discounting, the tendency to devalue future rewards as a function of delay until receipt, is influenced by time framing. Specifically, discount rates are shallower when the time at which the reward is received is presented as a date (date condition; e.g., June 8, 2023) rather than in delay units (delay condition; e.g., 30 days), which is commonly referred to as the date/delay effect. However, the cognitive and neural mechanisms of this effect are not well understood. Here, we examined the date/delay effect by analysing combined fMRI and eye-tracking data of N = 31 participants completing a temporal discounting task in both a delay and a date condition. The results confirmed the date/delay effect and revealed that the date condition led to higher fixation durations on time attributes and to higher activity in precuneus/PCC and angular gyrus, that is, areas previously associated with episodic thinking. Additionally, participants made more comparative eye movements in the date compared to the delay condition. A lower date/delay effect was associated with higher prefrontal activity in the date > delay contrast, suggesting that higher control or arithmetic operations may reduce the date/delay effect. Our findings are in line with hypotheses positing that the date condition is associated with differential time estimation and the use of more comparative as opposed to integrative choice strategies. Specifically, higher activity in memory-related brain areas suggests that the date condition leads to higher perceived proximity of delayed rewards, while higher frontal activity (middle/superior frontal gyrus, posterior medial frontal cortex, cingulate) in participants with a lower date/delay effect suggests that the effect is particularly pronounced in participants avoiding complex arithmetic operations in the date condition.

Imagining the future can shape the present: A systematic review of the impact of episodic future thinking on substance use outcomes

OBJECTIVE

The combination of the high prevalence of problematic substance use and substance use disorders (SUD) with the low rates of spontaneous remission continues to generate interest in the development of novel and efficacious interventions. Theoretically, episodic future thinking (EFT) is capable of targeting various underlying psychological and neurobiological substrates of SUD by traversing various research domain criteria systems.

METHOD

The systematic review examines EFT as a potentially efficacious intervention for problematic substance use and SUD. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We examined 46 full-text studies (from 1,238 total records obtained from APA PsycInfo and Pubmed databases and reference list search), which yielded a final sample of 16 studies.

RESULTS

The studies showed heterogeneity in their risk of bias, EFT protocols, and control conditions. Overall, EFT showed benefits in reducing self-reported or task-based substance use-related outcomes.

CONCLUSIONS

Future research directions include establishing the feasibility of EFT, examining the generalizability in decreasing real-world substance use, identifying mediators and moderators of EFT outcomes, and determining the sustainability of EFT effects over time. EFT has high potential for dissemination. Limitations and potential for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Posttraumatic stress and delay discounting: a meta-analytic review

Delay discounting-the extent to which individuals show a preference for smaller immediate rewards over larger delayed rewards-has been proposed as a transdiagnostic neurocognitive process across mental health conditions, but its examination in relation to posttraumatic stress disorder (PTSD) is comparatively recent. To assess the aggregated evidence for elevated delay discounting in relation to posttraumatic stress, we conducted a meta-analysis on existing empirical literature. Bibliographic searches identified 209 candidate articles, of which 13 articles with 14 independent effect sizes were eligible for meta-analysis, reflecting a combined sample size of N = 6897. Individual study designs included case-control (e.g. examination of differences in delay discounting between individuals with and without PTSD) and continuous association studies (e.g. relationship between posttraumatic stress symptom severity and delay discounting). In a combined analysis of all studies, the overall relationship was a small but statistically significant positive association between posttraumatic stress and delay discounting (r = .135, p < .0001). The same relationship was statistically significant for continuous association studies (r = .092, p = .027) and case-control designs (r = .179, p < .001). Evidence of publication bias was minimal. The included studies were limited in that many did not concurrently incorporate other psychiatric conditions in the analyses, leaving the specificity of the relationship to posttraumatic stress less clear. Nonetheless, these findings are broadly consistent with previous meta-analyses of delayed reward discounting in relation to other mental health conditions and provide further evidence for the transdiagnostic utility of this construct.

Developmental deviation in delay discounting as a transdiagnostic indicator of risk for child psychopathology

BACKGROUND

The tendency to prefer smaller, immediate rewards over larger, delayed rewards is known as delay discounting (DD). Developmental deviations in DD may be key in characterizing psychiatric and neurodevelopmental disorders. Recent work empirically supported DD as a transdiagnostic process in various psychiatric disorders. Yet, there is a lack of research relating developmental changes in DD from mid-childhood to adolescence to psychiatric and neurodevelopmental disorders. Additionally, examining the interplay between socioeconomic status/total household income (THI) and psychiatric symptoms is vital for a more comprehensive understanding of pediatric pathology and its complex relationship with DD.

METHODS

The current study addresses this gap in a robust psychiatric sample of 1843 children and adolescents aged 5-18 (M = 10.6, SD = 3.17; 1,219 males, 624 females). General additive models (GAMs) characterized the shape of age-related changes in monetary and food reward discounting for nine psychiatric disorders compared with neurotypical youth (NT; n = 123). Over 40% of our sample possessed a minimum of at least three psychiatric or neurodevelopmental disorders. We used bootstrap-enhanced Louvain community detection to map DD-related comorbidity patterns. We derived five subtypes based on diagnostic categories present in our sample. DD patterns were then compared across each of the subtypes. Further, we evaluated the effect of cognitive ability, emotional and behavioral problems, and THI in relation to DD across development.

RESULTS

Higher discounting was found in six of the nine disorders we examined relative to NT. DD was consistently elevated across development for most disorders, except for depressive disorders, with age-specific DD differences compared with NTs. Community detection analyses revealed that one comorbidity subtype consisting primarily of Attention-Deficit/Hyperactivity Disorder (ADHD) Combined Presentation and anxiety disorders displayed the highest overall emotional/behavioral problems and greater DD for the food reward. An additional subtype composed mainly of ADHD, predominantly Inattentive Presentation, learning, and developmental disorders, showed the greatest DD for food and monetary rewards compared with the other subtypes. This subtype had deficits in reasoning ability, evidenced by low cognitive and academic achievement performance. For this ADHD-I and developmental disorders subtype, THI was related to DD across the age span such that participants with high THI showed no differences in DD compared with NTs. In contrast, participants with low THI showed significantly worse DD trajectories than all others. Our results also support prior work showing that DD follows nonlinear developmental patterns.

CONCLUSIONS

We demonstrate preliminary evidence for DD as a transdiagnostic marker of psychiatric and neurodevelopmental disorders in children and adolescents. Comorbidity subtypes illuminate DD heterogeneity, facilitating the identification of high-risk individuals. Importantly, our findings revealed a marked link between DD and intellectual reasoning, with children from lower-income households exhibiting lower reasoning skills and heightened DD. These observations underscore the potential consequences of compromised self-regulation in economically disadvantaged individuals with these disorders, emphasizing the need for tailored interventions and further research to support improved outcomes.

Cognitive and motor impulsivity in the healthy brain, and implications for eating disorders and obesity: A coordinate-based meta-analysis and systematic review

Alterations in the impulse-control balance, and in its neural bases, have been reported in obesity and eating disorders (EDs). Neuroimaging studies suggest a role of fronto-parietal networks in impulsive behaviour, with evaluation and anticipatory processes additionally recruiting meso-limbic regions. However, whether distinct facets of cognitive and motor impulsivity involve common vs. specific neural correlates remains unclear. We addressed this issue through Activation Likelihood Estimation (ALE) meta-analyses of fMRI studies on delay discounting (DD) and go/no-go (GNG) tasks, alongside conjunction and subtraction analyses. We also performed systematic reviews of neuroimaging studies using the same tasks in individuals with obesity or EDs. ALE results showed consistent activations in the striatum, anterior/posterior cingulate cortex, medial/left superior frontal gyrus and left supramarginal gyrus for impulsive choices in DD, while GNG tasks elicited mainly right-lateralized fronto-parietal activations. Conjunction and subtraction analyses showed: i) common bilateral responses in the caudate nucleus; ii) DD-specific responses in the ventral striatum, anterior/posterior cingulate cortex, left supramarginal and medial frontal gyri; iii) GNG-specific activations in the right inferior parietal cortex. Altered fronto-lateral responses to both tasks are suggestive of dysfunctional cortico-striatal balance in obesity and EDs, but these findings are controversial due to the limited number of studies directly comparing patients and controls. Overall, we found evidence for distinctive neural correlates of the motor and cognitive facets of impulsivity: the right inferior parietal lobe underpins action inhibition, whereas fronto-striatal regions and the left supramarginal gyrus are related to impulsive decision-making. While showing that further research on clinical samples is required to better characterize the neural bases of their behavioural changes, these findings help refining neurocognitive model of impulsivity and highlight potential translational implications for EDs and obesity treatment.

Dissociation and other trauma symptomatology are linked to imbalance in the competing neurobehavioral decision systems

Objective

Dissociation is a conscious state characterized by alterations in sensation and perception and is thought to arise from traumatic life experiences. Previous research has demonstrated that individuals with high levels of dissociation show impairments in cognitive-emotional processes. Therefore, using the Competing Neurobehavioral Decisions System (CNDS) theory, we used statistical modeling to examine whether dissociative experience and trauma symptoms are independently predicted by impulsivity, risk-seeking, affective state (i.e., anxiety, depression, stress, and negative affect), and trauma history.

Method

In this cross-sectional study design, data were collected via Amazon Mechanical Turk from a total of n = 557 English-speaking participants in the United States. Using Qualtrics, participants answered a series of self-reported questionnaires and completed several neurocognitive tasks. Three independent multiple linear regression models were conducted to assess whether impulsivity, risk seeking, affective state, and trauma history predict depersonalization, trauma symptoms, and PTSD symptoms.

Results

As hypothesized, we found that depersonalization and other trauma symptoms are associated with heightened impulsivity, increased risk-seeking, impaired affective states, and a history of traumatic experiences.

Conclusion

We demonstrate that an imbalanced CNDS (i.e., hyperimpulsive/hypoexecutive), as evidenced by decreased future valuation, increased risk seeking, and impaired affective states, predicts heightened depersonalization and other trauma and PTSD symptomatology. This is the first time that dissociation has been connected to delay discounting (i.e., the tendency to place more value on rewards received immediately compared to farther in the future). Interventions that positively impact areas of the CNDS, such as episodic future thinking or mindfulness meditation, may be a target to help decrease dissociative symptoms.

Avoidant/restrictive food intake disorder differs from anorexia nervosa in delay discounting

BACKGROUND

Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are the two primary restrictive eating disorders; however, they are driven by differing motives for inadequate dietary intake. Despite overlap in restrictive eating behaviors and subsequent malnutrition, it remains unknown if ARFID and AN also share commonalities in their cognitive profiles, with cognitive alterations being a key identifier of AN. Discounting the present value of future outcomes with increasing delay to their expected receipt represents a core cognitive process guiding human decision-making. A hallmark cognitive characteristic of individuals with AN (vs. healthy controls [HC]) is reduced discounting of future outcomes, resulting in reduced impulsivity and higher likelihood of favoring delayed gratification. Whether individuals with ARFID display a similar reduction in delay discounting as those with AN (vs. an opposing bias towards increased delay discounting or no bias) is important in informing transdiagnostic versus disorder-specific cognitive characteristics and optimizing future intervention strategies.

METHOD

To address this research question, 104 participants (ARFID: n = 57, AN: n = 28, HC: n = 19) completed a computerized Delay Discounting Task. Groups were compared by their delay discounting parameter (ln)k.

RESULTS

Individuals with ARFID displayed a larger delay discounting parameter than those with AN, indicating steeper delay discounting (M ± SD = -6.10 ± 2.00 vs. -7.26 ± 1.73, p = 0.026 [age-adjusted], Hedges' g = 0.59), with no difference from HC (p = 0.514, Hedges' g = -0.35).

CONCLUSION

Our findings provide a first indication of distinct cognitive profiles among the two primary restrictive eating disorders. The present results, together with future research spanning additional cognitive domains and including larger and more diverse samples of individuals with ARFID (vs. AN), will contribute to identifying maintenance mechanisms that are unique to each disorder as well as contribute to the optimization and tailoring of treatment strategies across the spectrum of restrictive eating disorders.

Effects of reproductive experience on cost-benefit decision making in female rats

Many individuals undergo mating and/or other aspects of reproductive experience at some point in their lives, and pregnancy and childbirth in particular are associated with alterations in the prevalence of several psychiatric disorders. Research in rodents shows that maternal experience affects spatial learning and other aspects of hippocampal function. In contrast, there has been little work in animal models concerning how reproductive experience affects cost-benefit decision making, despite the relevance of this aspect of cognition for psychiatric disorders. To begin to address this issue, reproductively experienced (RE) and reproductively naïve (RN) female Long-Evans rats were tested across multiple tasks that assess different forms of cost-benefit decision making. In a risky decision-making task, in which rats chose between a small, safe food reward and a large food reward accompanied by variable probabilities of punishment, RE females chose the large risky reward significantly more frequently than RN females (greater risk taking). In an intertemporal choice task, in which rats chose between a small, immediate food reward and a large food reward delivered after a variable delay period, RE females chose the large reward less frequently than RN females. Together, these results show distinct effects of reproductive experience on different forms of cost-benefit decision making in female rats, and highlight reproductive status as a variable that could influence aspects of cognition relevant for psychiatric disorders.

Reward Functioning in General and Specific Psychopathology in Children and Adults

OBJECTIVE

Problems with reward processing have been implicated in multiple psychiatric disorders, but psychiatric comorbidities are common and their specificity to individual psychopathologies is unknown. Here, we evaluate the association between reward functioning and general or specific psychopathologies.

METHOD

1,213 adults and their1,531 children (ages 6-12) completed various measures of the Positive Valence System domain from the Research Domain Criteria (RDoC). Psychopathology was assessed using the Child Behavior Checklist for children and the Adult Self Report for parents.

RESULTS

One general factor identified via principal factors factor analysis explained most variance in psychopathology in both groups. Measures of reward were associated with the general factor and most specific psychopathologies. Certain reward constructs were associated solely with specific psychopathologies but not general psychopathology. However, some prior associations between reward and psychopathology did not hold following removal of comorbidity.

CONCLUSION

Reward dysfunction is significantly associated with both general and specific psychopathologies.

Using behavioral economics to optimize safer undergraduate late-night transportation

Many universities sponsor student-oriented transit services that could reduce alcohol-induced risks but only if services adequately anticipate and adapt to student needs. Human choice data offer an optimal foundation for planning and executing late-night transit services. In this simulated choice experiment, respondents opted to either (a) wait an escalating delay for a free university-sponsored "safe" option, (b) pay an escalating fee for an on-demand rideshare service, or (c) pick a free, immediately available "unsafe" option (e.g., ride with an alcohol-impaired driver). Behavioral-economic nonlinear models of averaged-choice data describe preference across arrangements. Best-fit metrics indicate adequate sensitivity to contextual factors (i.e., wait time, preceding late-night activity). At short delays, students preferred the free transit option. As delays extend beyond 30 min, most students preferred competing alternatives. These data depict a policy-relevant delay threshold to better safeguard undergraduate student safety.

Low household income, financial literacy, or financial health: Which is the strongest risk factor and outcome of depressive symptomatology?

BACKGROUND

Depression's relations to psychosocial processes are complex, bidirectional, and include financial functioning. The current study compared the extent to which household income, financial literacy (knowledge and skill), and financial health (saving, spending, borrowing, and planning behavior) were risk factors and outcomes of depression.

METHODS

A United States national sample of working-aged adults (N = 6565) completed self-report measures of financial functioning and depression in years 2020 and 2022. Depression scales assessed both negative (depressive symptoms) and positive (life satisfaction) affective dimensions.

RESULTS

Lower income, less financial literacy, and especially poorer financial health correlated significantly with more depressive symptoms and lower life satisfaction. Poorer financial health demonstrated the strongest prospective relations with increasing depressive symptoms and decreasing life satisfaction over the two-year retest interval. In parallel, higher depressive symptoms and lower life satisfaction each predicted subsequent decreases in financial health.

LIMITATIONS

Results from this longitudinal, observational study suggested but could not establish causal connections between depression and financial functioning. The study's novel results require replication before clinical application.

CONCLUSIONS

More so than low income or limited financial literacy, poor financial health is both a risk factor and potential outcome of depression, including more depressive symptoms and lower life satisfaction. If these findings are replicated, financial health may be an important research and clinical target for depression assessment, prevention, and treatment.