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Aston ER, Merrill JE, Boyle HK, Berey BL, López G. Utility of a brief measure of cannabis demand: Day-level associations with cannabis use. Drug Alcohol Depend 2024; 262:111396. [PMID: 39094382 PMCID: PMC11338517 DOI: 10.1016/j.drugalcdep.2024.111396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 06/02/2024] [Accepted: 06/24/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Cannabis demand (i.e., relative value) is usually assessed as a trait-level risk-factor for cannabis use and consequences. This study examined within-person variability in day-level intensity (i.e., amount consumed at zero cost) and Omax (i.e., maximum cannabis expenditure) and tested hypotheses that demand would be positively associated with day-level cannabis use. METHODS Young adults (n=85) reporting past-month simultaneous alcohol and cannabis use completed two daily surveys for 30 days. Morning surveys assessed prior-day cannabis use and evening surveys assessed day-level demand (i.e., intensity, Omax). Multilevel models tested day-level effects of intensity and Omax on any cannabis use and flower use frequency and quantity (i.e., grams). RESULTS Approximately 52 % and 46 % of variability in intensity and Omax, respectively, was due to within-person change. At the day-level, higher intensity and Omax were associated with higher likelihood of any cannabis use, regardless of formulation; Omax was associated with use of flower in particular; and intensity was associated with the highest quantity of use. At the person-level, only Omax was associated with flower use likelihood, and only intensity was associated with flower quantity across days. CONCLUSIONS Cannabis demand demonstrated day-to-day variability, conceivably in response to various internal states and external factors. Intensity and Omax were related to elevated likelihood of using any cannabis, particularly flower, at the day-level. Overall, these data illustrate the validity and utility of brief cannabis demand measures, which might be used to further understand cannabis' reinforcing value at a fine-grained level.
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Affiliation(s)
- Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA.
| | - Jennifer E Merrill
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
| | - Holly K Boyle
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
| | - Benjamin L Berey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA; Providence VA Medical Center, Providence, RI 02908, USA
| | - Gabriela López
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912, USA
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2
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Copeland A, Stafford T, Field M. Value-based decision-making in regular alcohol consumers following experimental manipulation of alcohol value. Addict Behav 2024; 156:108069. [PMID: 38788454 DOI: 10.1016/j.addbeh.2024.108069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/02/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Devaluation of alcohol leads to reductions in alcohol choice and consumption; however, the cognitive mechanisms that underpin this relationship are not well-understood. In this study we applied a computational model of value-based decision-making (VBDM) to decisions made about alcohol and alcohol-unrelated cues following experimental manipulation of alcohol value. METHOD Using a pre-registered within-subject design, thirty-six regular alcohol consumers (≥14 UK units per week) completed a two-alternative forced choice task where they chose between two alcohol images (in one block) or two soft drink images (in a different block) after watching videos that emphasised the positive (alcohol value), and separately, the negative (alcohol devalue) consequences of alcohol. On each block, participants pressed a key to select the image depicting the drink they would rather consume. A drift-diffusion model (DDM) was fitted to reaction time and choice data to estimate evidence accumulation (EA) processes and response thresholds during the different blocks in each experimental condition. FINDINGS In the alcohol devalue condition, soft drink EA rates were significantly higher compared to alcohol EA rates (p = 0.04, d = 0.31), and compared to soft drink EA rates in the alcohol value condition (p = 0.01, d = 0.38). However, EA rates for alcoholic drinks and response thresholds (for either drink type) were unaffected by the experimental manipulation. CONCLUSIONS In line with behavioural economic models of addiction that emphasise the important role of alternative reinforcement, experimentally manipulating alcohol value is associated with changes in the internal cognitive processes that precede soft drink choice.
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Affiliation(s)
| | - Tom Stafford
- Department of Psychology, University of Sheffield, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, UK
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3
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Acuff SF, Strickland JC, Smith K, Field M. Heterogeneity in choice models of addiction: the role of context. Psychopharmacology (Berl) 2024; 241:1757-1769. [PMID: 38990313 DOI: 10.1007/s00213-024-06646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024]
Abstract
RATIONALE Theories of addiction guide scientific progress, funding priorities, and policy development and ultimately shape how people experiencing or recovering from addiction are perceived and treated. Choice theories of addiction are heterogenous, and different models have divergent implications. This breeds confusion among laypeople, scientists, practitioners, and policymakers and reduces the utility of robust findings that have the potential to reduce the global burden of addiction-associated harms. OBJECTIVE Here we differentiate classes of choice models and articulate a novel framing for a class of addiction models, called contextual models, which share as a first principle the influence of the environment and other contextual factors on behavior within discrete choice contexts. RESULTS These models do not assume that all choice behaviors are voluntary, but instead that both proximal and distal characteristics of the choice environment-and particularly the benefits and costs of both drug use and non-drug alternatives-can influence behavior in ways that are outside of the awareness of the individual. From this perspective, addiction is neither the individual's moral failing nor an internal uncontrollable urge but rather is the result of environmental contingencies that reinforce the behavior. CONCLUSIONS Contextual models have implications for guiding research, practice, and policy, including identification of novel target mechanisms while also improving existing interventions.
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Affiliation(s)
- Samuel F Acuff
- Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA, 02114, USA.
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Kirsten Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK
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4
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Cabral DAR, Tegge AN, Dwyer CL, Quddos F, Kaur RP, Nguyen J, Athamneh L, Bickel WK. Associations between delay discounting and unhealthy behaviors in substance use recovery. Drug Alcohol Depend 2024; 262:111395. [PMID: 39053430 DOI: 10.1016/j.drugalcdep.2024.111395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
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.
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Affiliation(s)
- Daniel A R Cabral
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Allison N Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Candice L Dwyer
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Psychology at Virginia Tech, Blacksburg, VA, USA
| | - Fatima Quddos
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Rose P Kaur
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | | | - Liqa Athamneh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA.
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5
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Bickel WK, Witkiewitz K, Athamneh LM, Kuhlemeier A. Recovery from alcohol use disorder: Reinforcer pathology theory, measurement, and methods. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024. [PMID: 39155126 DOI: 10.1111/acer.15406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 06/28/2024] [Indexed: 08/20/2024]
Abstract
Recovery from alcohol use disorder (AUD) is a dynamic process that often entails periods of drinking but has been defined primarily by abstinence. Recently, a broader interpretation of recovery was developed, including meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM) remission criteria and improved psychosocial functioning. This new understanding of recovery has facilitated the development of novel theories and methodologies. This paper reviews a new theoretical perspective of recovery, Reinforcer Pathology, and two novel methodological approaches in light of this broader view of recovery. Using this theoretical framework as a foundation, we propose an alternative perspective to explain the recovery process as it relates to environmental factors and valuation of the future; we suggest that changing the environment in which substances are available (e.g., increasing non-alcohol-related activities) and extending one's temporal window are associated with improved recovery outcomes (e.g., remission and quality of life). In this review, we discuss two novel methodological approaches. The first uses latent profile analysis to show that using a measure of Relative Reinforcement Value of Alcohol-Free Activities is associated with a greater likelihood of belonging to a high functioning/infrequent heavy drinking recovery profile. The second developed an online national sample and used an accelerated longitudinal design to study longer-term recovery of up to 12 years over a 5-year study period. Reinforcer Pathology theory, novel methods, and measures may further our understanding of recovery and begin to address critical questions for future studies. Subsequent randomized clinical trials should examine whether the suggested targets and interventions based on the theoretical model improve recovery outcomes prospectively. Measuring and promoting alcohol-free activity engagement may facilitate improved recovery outcomes, while novel methodologies permit an understanding of returning to use or remission across different recovery durations.
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Affiliation(s)
- Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, USA
| | | | - Liqa M Athamneh
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, Virginia, USA
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Coelho SG, Hendershot CS, Wardell JD. Within-person and between-person associations of access to environmental reward with alcohol and cannabis use and consequences among young adults. Drug Alcohol Depend 2024; 263:112417. [PMID: 39178536 DOI: 10.1016/j.drugalcdep.2024.112417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 08/07/2024] [Accepted: 08/11/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Recent behavioural economic models of substance use suggest that low access to environmental reward may increase risk for heavy substance use and associated harms. Most prior studies of these associations have been cross-sectional and have focused on alcohol. The current study extends this research using longitudinal data to examine the within-person and between-person associations of environmental reward access with both alcohol and cannabis outcomes. METHOD Young adults (N = 119, 64.71 % female) completed an online survey at three time points, spaced six months apart. The survey included measures of alcohol and cannabis use and consequences, and two facets of environmental reward access: reward probability (i.e., likelihood of experiencing environmental reward) and environmental suppression (i.e., diminished availability of environmental reward). RESULTS Multilevel models revealed that at the between-person level (i.e., averaged across time points), greater environmental suppression (but not reward probability) was significantly associated with more frequent cannabis use, and greater reward probability (but not environmental suppression) was significantly associated with heavier alcohol use. Higher environmental suppression (but not reward probability) was also associated with greater alcohol and cannabis consequences at the between-person level, over and above level of use. A significant within-person association also was observed, wherein participants reported relative increases in cannabis consequences during time periods when they also reported relative decreases in the availability of environmental reward. CONCLUSIONS Results highlight environmental suppression as a risk factor for more frequent cannabis use and for both alcohol and cannabis consequences, and provide novel support for a within-person association between environmental suppression and cannabis consequences over time. Findings may inform contextual interventions for young adult substance use.
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Affiliation(s)
- Sophie G Coelho
- Department of Psychology, York University, Toronto, ON, Canada
| | - Christian S Hendershot
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Jeffrey D Wardell
- Department of Psychology, York University, Toronto, ON, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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7
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Linden-Carmichael AN, Stull SW, Lanza ST. Alcohol and cannabis use in daily lives of college-attending young adults: Does co-use correspond to greater reported pleasure? Addict Behav 2024; 159:108130. [PMID: 39178638 DOI: 10.1016/j.addbeh.2024.108130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/23/2024] [Accepted: 08/12/2024] [Indexed: 08/26/2024]
Abstract
Co-use of alcohol and cannabis is prevalent and linked with heightened risk for substance-related harms. The current study investigated the role of substance-related pleasure as a reinforcing factor for co-use relative to alcohol or cannabis use. Specifically, we used data from a 21-day diary study of college students to examine day-level associations between co-use and self-reported substance-related pleasure (any, level of pleasure). Participants were 237 college students (65 % female sex at birth, ages 18-24) who reported 1+ alcohol and cannabis co-use occasion. Participants completed daily surveys across 21 consecutive days about yesterday's substance use and experiences of pleasure, yielding 2,086 daily surveys involving alcohol and/or cannabis use. Multilevel models indicated that odds of substance-related pleasure were higher on days with co-use relative to days with single-substance use, and level of pleasure was higher on co-use days relative to cannabis but not alcohol use days. Pleasure may serve as a reinforcing property of co-use that may be related to continued use despite experience of negative consequences. Intensity of pleasure related to co-use appears to be largely driven by use of alcohol. However, given mixed findings concerning level of pleasure, individuals may report co-use increases feelings of pleasure but do not actually experience more pleasure. Pleasure may serve as a viable target in future prevention and intervention programming targeting co-use.
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8
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Johansen AN, Acuff SF, Strickland JC. Human laboratory models of reward in substance use disorder. Pharmacol Biochem Behav 2024; 241:173803. [PMID: 38843997 PMCID: PMC11223959 DOI: 10.1016/j.pbb.2024.173803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/30/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024]
Abstract
Human laboratory models in substance use disorder provide a key intermediary step between highly controlled and mechanistically informative non-human preclinical methods and clinical trials conducted in human populations. Much like preclinical models, the variety of human laboratory methods provide insights into specific features of substance use disorder rather than modelling the diverse causes and consequences simultaneously in a single model. This narrative review provides a discussion of popular models of reward used in human laboratory research on substance use disorder with a focus on the specific contributions that each model has towards informing clinical outcomes (forward translation) and analogs within preclinical models (backward translation). Four core areas of human laboratory research are discussed: drug self-administration, subjective effects, behavioral economics, and cognitive and executive function. Discussion of common measures and models used, the features of substance use disorder that these methods are purported to evaluate, unique issues for measure validity and application, and translational links to preclinical models and special considerations for studies wishing to evaluate homology across species is provided.
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Affiliation(s)
| | - Samuel F Acuff
- Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA.
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9
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Mead-Morse EL, Cassidy RN, Kpormegbey DE, Moore T, Oncken C, Tidey JW, Delnevo CD, Litt M. Examining Demand and Substitutability of Usual Brand Little Cigars/Cigarillos and Cigarettes in Young Adults Who Dual Use. Nicotine Tob Res 2024; 26:1057-1065. [PMID: 38365185 DOI: 10.1093/ntr/ntae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/09/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Cigarette and little cigar/cigarillo (LCC) dual use is popular among young people and poses a substantial health risk. What remains unclear is the abuse liability of LCCs vs. cigarettes, LCCs' substitutability for cigarettes, and the influence of flavors on the abuse liability and substitutability of LCCs. METHODS Sixty-five young adults (18-34 years) who dual use completed hypothetical purchase tasks to measure consumption of usual brand cigarettes and LCCs in 24 hours at increasing prices (demand), and LCC consumption at increasing cigarette prices (substitution). Three demand indices were calculated from raw data: breakpoint (price after which consumption reaches 0), Omax (maximum daily expenditure), and Pmax (price at maximum expenditure). Two indices were estimated using nonlinear mixed-effects modeling: intensity (consumption when free) and price-sensitivity (rate of decline in consumption as price increases). Substitution, and associations of flavored use with demand and substitution, were estimated using linear mixed models. RESULTS Results indicated similar abuse liability for LCCs and cigarettes. Intensity was greater for cigarettes, but price-sensitivity was similar. Flavored LCC use was associated with lower price-sensitivity and greater intensity than unflavored. LCCs were significant substitutes for cigarettes, but the effect was small. Flavored use was not associated with substitution. CONCLUSIONS Among young adults who dual use, LCCs and cigarettes had similar abuse liability, and those who used flavored had higher demand for their LCCs. A flavored cigar ban, as well as targeted prevention and cessation services for those who smoke flavored LCCs, may be important for reducing dual use in young adults. IMPLICATIONS Cigarette and LCC dual use remains high among young adults. Using hypothetical purchase tasks with young adults who dual use, LCCs had abuse liability similar to cigarettes, but were only modest substitutes for cigarettes. Participants who used flavored LCCs reported greater abuse liability than those who used unflavored, but not greater substitution for cigarettes. Prevention and cessation services are needed to target LCCs in young people, particularly those smoking flavored products. A flavored cigar ban may help to reduce their demand.
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Affiliation(s)
- Erin L Mead-Morse
- Department of Public Health Sciences, UConn Health, Farmington, CT, USA
- Department of Medicine, UConn Health, Farmington, CT, USA
| | - Rachel N Cassidy
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Daniel E Kpormegbey
- Department of Statistics, University of Connecticut, Storrs, CT, USA
- Statistical Consulting Services, Center for Open Research Resources and Equipment, University of Connecticut, Storrs, CT, USA
| | - Timothy Moore
- Statistical Consulting Services, Center for Open Research Resources and Equipment, University of Connecticut, Storrs, CT, USA
| | - Cheryl Oncken
- Department of Medicine, UConn Health, Farmington, CT, USA
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Cristine D Delnevo
- Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, USA
| | - Mark Litt
- Division of Behavioral Sciences and Community Health, UConn Health, Farmington, CT, USA
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10
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Wardle MC, Webber HE, Yoon JH, Heads AM, Stotts AL, Lane SD, Schmitz JM. Behavioral therapies targeting reward mechanisms in substance use disorders. Pharmacol Biochem Behav 2024; 240:173787. [PMID: 38705285 DOI: 10.1016/j.pbb.2024.173787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/04/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
Behavioral therapies are considered best practices in the treatment of substance use disorders (SUD) and used as first-line approaches for SUDs without FDA-approved pharmacotherapies. Decades of research on the neuroscience of drug reward and addiction have informed the development of current leading behavioral therapies that, while differing in focus and technique, have in common the overarching goal of shifting reward responding away from drug and toward natural non-drug rewards. This review begins by describing key neurobiological processes of reward in addiction, followed by a description of how various behavioral therapies address specific reward processes. Based on this review, a conceptual 'map' is crafted to pinpoint gaps and areas of overlap, serving as a guide for selecting and integrating behavioral therapies.
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Affiliation(s)
- Margaret C Wardle
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Heather E Webber
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Jin H Yoon
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Angela M Heads
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Angela L Stotts
- Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, United States of America
| | - Scott D Lane
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Joy M Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America.
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11
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Chiu HJ, Sun CK, Wang HY, Chang HY, Kuo CH, Sue YR, Wu SH, Tung SY, Lee CY, Yeh PY. A systematic review and meta-analysis of the relationship between heavy smoking and probability discounting. Am J Addict 2024; 33:375-384. [PMID: 38290762 DOI: 10.1111/ajad.13521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/01/2024] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Probability discounting (PD), which refers to the process of adjusting the value of future probabilities when making decisions, is a method of measuring impulsive decision-making; however, the relationship between PD and nicotine remains unclear. The current study aimed at investigating the significance of PD in individuals who smoke. METHODS According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched the PubMed, Embase, PsycINFO, and Web of Science databases for articles comparing individuals who smoke and their tobacco-naïve controls using PD task as outcome measure from inception to May 2023. The main outcome was an overall difference in PD function, while subgroup analysis and meta-regression were conducted to examine the analysis methods and the moderators of PD. RESULTS Fourteen studies in total involving 384 individuals who smoke and 493 controls (mean age = 24.32 years, range = 15.1-38.05 years) were analyzed. The effect of smoking on PD was significant (g = 0.51, p = .02). The discounting parameter from the equation, compared to the area under the curve, was more sensitive to estimating PD function (p = .01). Regression analysis showed positive correlations of PD with female percentage, age, and the number of probability options (all p < .04), but not with the number of choices at each probability and maximum reward magnitude (all p > .07). There was no significant publication bias across the eligible studies (p = .09). CONCLUSION AND SCIENTIFIC SIGNIFICANCE Our findings, which are the first to demonstrate a smaller PD (i.e., prone to risk-taking) in individuals who smoke, shed light on the appropriate analysis method, gender effect, age, and probability options on the PD function.
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Affiliation(s)
- Hsien-Jane Chiu
- Taoyuan Psychiatric Center, Minster of Health and Welfare, Taoyuan, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming Chiao Tung University, Hsinchu, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Yu Wang
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Han-Yun Chang
- Department of Psychology, Asia University, Taichung, Taiwan
- Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan
| | - Chun-Hsien Kuo
- Department of Psychology, Asia University, Taichung, Taiwan
| | - Yu-Ru Sue
- Department of Psychology, Asia University, Taichung, Taiwan
| | - Shu-Hsuan Wu
- Department of Psychology, Asia University, Taichung, Taiwan
| | - Shih-Yi Tung
- Department of Psychology, Asia University, Taichung, Taiwan
| | - Chiao-Yu Lee
- Department of Psychology, Asia University, Taichung, Taiwan
| | - Pin-Yang Yeh
- Department of Psychology, Asia University, Taichung, Taiwan
- Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan
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12
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Kane L, Baucom DH, Daughters SB. Dual-substance use disorder couples: An integrative review and proposed theoretical model. Clin Psychol Rev 2024; 111:102447. [PMID: 38781717 DOI: 10.1016/j.cpr.2024.102447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/17/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
Committed romantic relationships between two individuals with Substance Use Disorder (or dual-SUD couples) are prevalent. Dual-SUD couples have poor treatment engagement and outcomes. Research has established a reciprocal link between relationship dynamics (e.g., conflict, intimacy) and substance use. Thus, the couple's relationship presents a distinct social context for both partner's substance use. Dual-SUD couples face unique challenges due to substance use being a shared behavior that may serve as a rewarding source of compatibility, closeness, and short-term relationship satisfaction despite it being at the cost of other alternative sources of substance-free reinforcement. Yet, treatment options for these couples are scarce. Dual-maladaptive health behaviors (e.g., dual-substance use) are challenging to treat; however, theory and preliminary research suggests that transformation of couple's joint motivation toward adaptive health behavior change may result in a more satisfying relationship and improved treatment outcomes for both individuals. The current paper reviews the extant literature on dual-SUD couples from theoretical, empirical, and treatment research and proposes an expanded paradigm regarding how we understand dual-SUD couples with the aim of informing basic research and treatment development.
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Affiliation(s)
- Louisa Kane
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA.
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
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Liu SX, Muelken P, Maxim ZL, Ramakrishnan A, Estill MS, LeSage MG, Smethells JR, Shen L, Tran PV, Harris AC, Gewirtz JC. Differential gene expression and chromatin accessibility in the medial prefrontal cortex associated with individual differences in rat behavioral models of opioid use disorder. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.29.582799. [PMID: 38979145 PMCID: PMC11230220 DOI: 10.1101/2024.02.29.582799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Opioid use disorder (OUD) is a neuropsychological disease that has a devastating impact on public health. Substantial individual differences in vulnerability exist, the neurobiological substrates of which remain unclear. To address this question, we investigated genome-wide gene transcription (RNA-seq) and chromatin accessibility (ATAC-seq) in the medial prefrontal cortex (mPFC) of male and female rats exhibiting differential vulnerability in behavioral paradigms modeling different phases of OUD: Withdrawal-Induced Anhedonia (WIA), Demand, and Reinstatement. Ingenuity Pathway Analysis (IPA) of RNA-seq revealed greater changes in canonical pathways in Resilient (vs. Saline) rats in comparison to Vulnerable (vs. Saline) rats across 3 paradigms, suggesting brain adaptations that might contribute to resilience to OUD across its trajectory. Analyses of gene networks and upstream regulators implicated processes involved in oligodendrocyte maturation and myelination in WIA, neuroinflammation in Demand, and metabolism in Reinstatement. Motif analysis of ATAC-seq showed changes in chromatin accessibility to a small set of transcription factor (TF) binding sites as a function either of opioid exposure (i.e., morphine versus saline) generally or of individual vulnerability specifically. Some of these were shared across the 3 paradigms and others were unique to each. In conclusion, we have identified changes in biological pathways, TFs, and their binding motifs that vary with paradigm and OUD vulnerability. These findings point to the involvement of distinct transcriptional and epigenetic mechanisms in response to opioid exposure, vulnerability to OUD, and different stages of the disorder.
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Gebru NM, James TG, Foxx R, Castro M, Yurasek AM. Measuring Cannabis Reinforcement among Young Adults: A Mixed Methods Examination. CANNABIS (ALBUQUERQUE, N.M.) 2024; 7:93-107. [PMID: 38975603 PMCID: PMC11225975 DOI: 10.26828/cannabis/2023/000185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Introduction Increasing reinforcement received from cannabis-free activities, relative to reinforcement from cannabis-related activities, is one way to reduce harmful cannabis use. Thus, accurate measurement of cannabis reinforcement is important. Using convergent mixed methods, we developed the Adolescent Reinforcement Survey Schedule-Cannabis Use Version (ARSS-CUV). ARSS-CUV, adapted from the alcohol use version, measures cannabis reinforcement by asking individuals how frequently they engaged in, and how much they enjoyed, different activities when using and not using cannabis. Method Young adults (N = 65; M age = 20.4 years [SD = 1.8]) completed measures of cannabis use, the ARSS-CUV, and provided feedback on included activities, via focus groups. Following Standards for Educational and Psychological Testing framework, this study examined evidence of measurement validity based on item content. Results Quantitative findings revealed that peer interactions were the most reinforcing activities, whereas activities related to family were least reinforcing. Qualitative findings indicated some confusion with question wording. Participants also indicated the importance of environmental context when using cannabis and noted who they use cannabis with may be more important than the activity they are doing. Changes were made to survey flow and response choices after participant feedback. Conclusions ARSS-CUV includes revisions in activities solicited and response format. The revised ARSS-CUV provides opportunities to advance measurement of an important construct (i.e., reinforcement) in the study of cannabis use. Psychometric properties of the ARSS-CUV across different populations and contexts of use (e.g., polysubstance use) should be examined.
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Affiliation(s)
- Nioud M Gebru
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Tyler G James
- Department of Family Medicine & Center for Disability Health and Wellness, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ricarda Foxx
- Department of Health Education & Behavior; Center for Behavioral Economic Health Research; University of Florida, Gainesville, FL, USA
| | - Michelle Castro
- Department of Health Education & Behavior; Center for Behavioral Economic Health Research; University of Florida, Gainesville, FL, USA
| | - Ali M Yurasek
- Department of Health Education & Behavior; Center for Behavioral Economic Health Research; University of Florida, Gainesville, FL, USA
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15
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Solinas M, Chauvet C, Lafay-Chebassier C, Vanderkam P, Barillot L, Moeller SJ, Goldstein RZ, Noël X, Jaafari N, Chatard A. Tobacco Images Choice and Its Association with Craving and Dependence in People who Smoke Cigarettes. Nicotine Tob Res 2024:ntae138. [PMID: 38850196 DOI: 10.1093/ntr/ntae138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Indexed: 06/10/2024]
Abstract
INTRODUCTION Increased salience of drug-related cues over non-drug reinforcers can drive drug use and contribute to tobacco use disorder (TUD). An important scientific and clinical goal is to effectively measure this elevated drug-seeking behavior in TUD. However, most TUD assessments rely on self-reported cravings and cigarette consumption, not providing an objective measure of the impact of drug-cues on biasing behavior towards drugs. The probabilistic image choice (PIC) task investigates the choice of viewing drug-related pictures as compared to other salient pictures (e.g., pleasant and unpleasant). This study aimed to develop and validate the PIC task for TUD and evaluate the associations between behavioral choice and tobacco craving, daily cigarette consumption, quit attempts and motivation to quit, and nicotine dependence (the Fagerström score). METHODS We recruited 468 smokers and 121 nonsmokers using the Prolific online platform. Participants performed the PIC task twice (at a one-month interval) and completed other measures relevant to TUD. RESULTS compared to nonsmokers, tobacco smokers selected to view significantly more tobacco images and less pleasant (non-drug reinforcer) images, a profile that remained stable at retest. Individual differences in choice of tobacco as compared to pleasant images on the PIC task were associated with craving but not with the other tobacco dependence measures, suggesting that the task may serve as a behavioral proxy measure of drug "wanting" rather than of cumulative nicotine exposure or physical dependence. CONCLUSIONS these results suggest that the PIC task can be a valuable tool for objectively assessing craving-associated tobacco seeking in TUD. IMPLICATIONS SECTION which should provide a brief description about what the study addsMost of the current measures of tobacco use disorder (TUD) rely on self-reports of consumption, dependence and craving and do not take into consideration the role of drug-related cues in driving tobacco seeking. This study shows that the probabilistic image choice (PIC) task provides an objective, reliable proxy measure of tobacco image seeking behavior in people who smoke cigarettes that is linked to craving (desire) for smoking but not to other measures of TUD. Therefore, the PIC task may be a useful complementary tool for the classification, diagnosis, and prognosis of TUD.
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Affiliation(s)
- Marcello Solinas
- Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM, U-1084, Poitiers, France
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers
| | - Claudia Chauvet
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers
| | - Claire Lafay-Chebassier
- Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM, U-1084, Poitiers, France
- INSERM, Centre d'Investigation Clinique CIC 1402, Université de Poitiers, CHU Poitiers, Poitiers, France
- Service de Pharmacologie Clinique, CHU Poitiers, Poitiers, France
| | - Paul Vanderkam
- Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM, U-1084, Poitiers, France
| | - Lila Barillot
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers
- Université de Poitiers, Université de Tours, CNRS 7295, CeRCA, Poitiers, France
| | - Scott J Moeller
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY 11794, USA
| | - Rita Z Goldstein
- Psychiatry & Neuroscience, Icahn School of Medicine at Mount Sinai, NY, USA
| | | | - Nematollah Jaafari
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers
- Service de Pharmacologie Clinique, CHU Poitiers, Poitiers, France
- Service Hospitalo-Universitaire de Psychiatrie et de Psychologie Médicale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Armand Chatard
- Unité de Recherche Clinique Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers
- Université de Poitiers, Université de Tours, CNRS 7295, CeRCA, Poitiers, France
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16
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Amlung M, Marsden E, Hargreaves T, Sweet LH, Murphy JG, MacKillop J. Neural correlates of increased alcohol demand following alcohol cue exposure in adult heavy drinkers. Psychiatry Res Neuroimaging 2024; 340:111809. [PMID: 38547596 DOI: 10.1016/j.pscychresns.2024.111809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/20/2024] [Accepted: 03/11/2024] [Indexed: 04/13/2024]
Abstract
Alcohol use disorder is associated with overvaluation of alcohol relative to other rewards, in part due to dynamic increases in value in response to alcohol-related cues. In a neuroeconomic framework, alcohol cues increase behavioral economic demand for alcohol, but the neural correlates these cue effects are unknown. This functional magnetic resonance imaging study combined a neuroeconomic alcohol purchase task with an alcohol cue exposure in 72 heavy drinkers with established sensitivity to alcohol cues (51 % female; mean age=33.74). Participants reported how many drinks they would consume from $0-$80/drink following exposure to neutral and alcohol images in a fixed order. Participants purchased significantly more drinks in the alcohol compared to the neutral condition, which was also evident for demand indices (i.e., intensity, breakpoint, Omax, elasticity; ps<0.001; ds=0.46-0.92). Alcohol purchase decisions were associated with activation in rostral middle and medial frontal gyri, anterior insula, posterior parietal cortex, and dorsal striatum, among other regions. Activation was lower across regions in the alcohol relative to neutral cue condition, potentially due to greater automaticity of choices in the presence of alcohol cues or attenuation of responses due to fixed cue order. These results contribute to growing literature using neuroeconomics to understand alcohol misuse and provide a foundation for future research investigating decision-making effects of environmental alcohol triggers.
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Affiliation(s)
- Michael Amlung
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA; Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA.
| | - Emma Marsden
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, ON, Canada
| | - Tegan Hargreaves
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, ON, Canada
| | - Lawrence H Sweet
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | - James G Murphy
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, ON, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Coelho SG, Hendershot CS, Aston ER, Ruocco AC, Quilty LC, Tyndale RF, Wardell JD. Executive functions and behavioral economic demand for cannabis among young adults: Indirect associations with cannabis consumption and cannabis use disorder. Exp Clin Psychopharmacol 2024; 32:305-315. [PMID: 37732960 PMCID: PMC10954585 DOI: 10.1037/pha0000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Behavioral economic demand for cannabis is robustly associated with cannabis consumption and cannabis use disorder (CUD). However, few studies have examined the processes underlying individual differences in the relative valuation of cannabis (i.e., demand). This study examined associations between executive functions and cannabis demand among young adults who use cannabis. We also examined indirect associations of executive functions with cannabis consumption and CUD symptoms through cannabis demand. Young adults (N = 113; 58.4% female; mean age 22 years) completed a Marijuana Purchase Task. Participants also completed cognitive tasks assessing executive functions (set shifting, inhibitory control, working memory) and semistructured interviews assessing past 90-day cannabis consumption (number of grams used) and number of CUD symptoms. Poorer inhibitory control was significantly associated with greater Omax (peak expenditure on cannabis) and greater intensity (cannabis consumption at zero cost). Poorer working memory was significantly associated with lower elasticity (sensitivity of consumption to escalating cost). Lower inhibitory control was indirectly associated with greater cannabis consumption and CUD symptoms through greater Omax and intensity, and poorer working memory was indirectly associated with greater cannabis consumption and CUD symptoms through reduced elasticity. This study provides novel evidence that executive functions are associated with individual differences in cannabis demand. Moreover, these results suggest that cannabis demand could be a mechanism linking poorer executive functioning with heavier cannabis use and CUD, which should be confirmed in future longitudinal studies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Christian S. Hendershot
- Bowles Center for Alcohol Studies, University of North Carolina–Chapel Hill, Chapel Hill, NC
- Department of Psychiatry, University of North Carolina–Chapel Hill, Chapel Hill, NC
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Anthony C. Ruocco
- Department of Psychological Clinical Science, University of Toronto
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
| | - Lena C. Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
| | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
- Department of Pharmacology and Toxicology, University of Toronto
| | - Jeffrey D. Wardell
- Department of Psychology, York University
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
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18
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Bird BM, Belisario K, Minhas M, Acuff SF, Ferro MA, Amlung MT, Murphy JG, MacKillop J. Longitudinal examination of alcohol demand and alcohol-related reinforcement as predictors of heavy drinking and adverse alcohol consequences in emerging adults. Addiction 2024; 119:1090-1099. [PMID: 38374803 DOI: 10.1111/add.16443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 12/20/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND AND AIMS Behavioral economic theory predicts that high alcohol demand and high proportionate alcohol-related reinforcement are important determinants of risky alcohol use in emerging adults, but the majority of research to date has been cross-sectional in nature. The present study investigated prospective and dynamic relationships between alcohol demand and proportionate alcohol-related reinforcement in relation to heavy drinking days and alcohol problems. DESIGN Longitudinal cohort with assessments every 4 months for 20 months. SETTING Ontario, Canada. PARTICIPANTS Emerging adults reporting regular heavy episodic drinking (n = 636, Mage = 21.44; 55.8% female). MEASUREMENTS Heavy drinking days (HDD; Daily Drinking Questionnaire), alcohol problems (Brief Young Adult Alcohol Consequences Questionnaire), alcohol demand (Alcohol Purchase Task) and proportionate alcohol-related reinforcement (Activity Level Questionnaire). FINDINGS Linear mixed effects models revealed that behavioral economic indicators and alcohol-related outcomes significantly decreased over the study, consistent with 'aging out' of risky alcohol use. Random intercept cross-lagged panel models revealed significant between-person relationships, such that higher alcohol demand and alcohol-related reinforcement were positively associated with HDD and alcohol problems (random intercepts = 0.187-0.534, Ps < 0.01). Moreover, alcohol demand indicators (particularly the rate of change in elasticity of the demand curve, as measured by α, and the maximum expenditure, Omax) and proportionate alcohol-related reinforcement significantly forecasted changes in HDD at all time points (|βs| = 0.063-0.103, Ps < 0.05) in cross-lagged relationships, with bidirectional associations noted for the rate of change in elasticity (βs = -0.085 to -0.104, Ps < 0.01). Proportionate alcohol-related reinforcement also significantly forecasted changes in alcohol problems at all time points (βs = 0.072-0.112, Ps < 0.01). CONCLUSIONS Multiple behavioral economic indicators (demand elasticity, maximum expenditure and reinforcement ratio) forecast changes in heavy episodic drinking and alcohol problems over the course of emerging adulthood. These results further implicate alcohol demand and proportionate alcohol-related reinforcement as etiologically and developmentally important mechanisms in alcohol use trajectories.
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Affiliation(s)
- Brian M Bird
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Meenu Minhas
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Samuel F Acuff
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Michael T Amlung
- Cofrin Logan Center for Addiction Research and Treatment, Department of Applied Behavioral Science, University of Kansas, Lawrence, Kansas, USA
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Kessler DA, Webber HE, de Dios C, Yoon JH, Schmitz JM, Lane SD, Harvin JA, Heads AM, Green CE, Kapoor S, Stotts AL, Motley KL, Suchting R. Opioid Risk Tool, in-hospital opioid exposure, and opioid demand predict pain outcomes following traumatic injury. J Health Psychol 2024; 29:680-689. [PMID: 38641873 DOI: 10.1177/13591053241242543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Abstract
Prescribed opioids are a mainstay pain treatment after traumatic injury, but a subgroup of patients may be at risk for continued opioid use. We evaluated the predictive utility of a traditional screening tool, the Opioid Risk Tool (ORT), and two other measures: average in-hospital milligram morphine equivalents (MME) per day and an assessment of opioid demand in predicting pain outcomes. Assessments of pain-related outcomes (pain intensity, interference, injury-related stress, and need for additional pain treatment) were administered at 2 weeks and 12 months post-discharge in a sample of 34 patients hospitalized for traumatic injury. Bayesian linear models were used to evaluate changes in responses over time as a function of predictors. High-risk ORT, higher MME per day, and greater opioid demand predicted less change in outcomes over time. This report provides first evidence that malleable factors of opioid and opioid demand have utility in predicting pain outcomes following traumatic injury.
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Affiliation(s)
| | | | | | - Jin H Yoon
- University of Texas Health Science Center at Houston, USA
| | - Joy M Schmitz
- University of Texas Health Science Center at Houston, USA
| | - Scott D Lane
- University of Texas Health Science Center at Houston, USA
| | - John A Harvin
- University of Texas Health Science Center at Houston, USA
| | - Angela M Heads
- University of Texas Health Science Center at Houston, USA
| | | | - Shweta Kapoor
- Mayo Clinic Alix School of Medicine, Mayo Clinic, USA
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20
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Musquez M, Rasmussen EB. Food Cue Reactivity Meets the Reinforcer Pathology Model: Behavioral Economic Measures of Cue-Induced Changes in Food Reinforcer Efficacy. Perspect Behav Sci 2024; 47:393-416. [PMID: 39099745 PMCID: PMC11294300 DOI: 10.1007/s40614-024-00409-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 08/06/2024] Open
Abstract
Food cue reactivity, or behavioral sensitivity to conditioned food cues, is an eating pattern observed in those with obesity and binge-eating disorder. The reinforcer pathology model, which characterizes overconsumption of a reinforcer such as food may be relevant to food cue reactivity, especially in those with obesity and binge-eating disorder. The reinforcer pathology model posits that steep delay discounting (DD) and demand elasticity are processes involved in the overconsumption of food. Two of our recent studies examine the extent to which reactivity to conditioned food cues may be involved in food reinforcer pathologies. First, food cues were conditioned with Oreo cookies with binge-eating prone (BEP) and binge-eating resistant (BER) rats. Delay discounting was compared before and after conditioning. Food cues induced steeper DD for rats, though BEP rats showed some evidence for greater sensitivity to this effect than BER rats, albeit this difference was not significant. Second, healthy-weight humans and humans with overweight/obese BMI underwent conditioning of visual cues paired with M&M candies. After acquisition, cues induced greater demand intensity and inelasticity for food compared to baseline. Participants with overweight/obese BMI, compared to controls, also showed some evidence for greater sensitivity to this change ininelasticity compared to healthy-weight participants, but this difference was also not significant. Food cues, then, may induce changes in DD and economic demand, supporting the relevance of reinforcer pathologies.
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Affiliation(s)
- Morgan Musquez
- Psychology Department, Idaho State University, 921 South 8th Avenue, Pocatello, ID 83209 USA
| | - Erin B. Rasmussen
- Psychology Department, Idaho State University, 921 South 8th Avenue, Pocatello, ID 83209 USA
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21
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Bayrakdarian ND, Bonar EE, Duguid I, Hellman L, Salino S, Wilkins C, Jannausch M, McKay JR, Staton M, Dollard K, Nahum-Shani I, Walton MA, Blow FC, Coughlin LN. Acceptability and feasibility of a mobile behavioral economic health intervention to reduce alcohol use in adults in rural areas. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 11:100225. [PMID: 38545408 PMCID: PMC10966148 DOI: 10.1016/j.dadr.2024.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 08/27/2024]
Abstract
Background At-risk alcohol use is associated with increased adverse health consequences, yet is undertreated in healthcare settings. People residing in rural areas need improved access to services; however, few interventions are designed to meet the needs of rural populations. Mobile interventions can provide feasible, low-cost, and scalable means for reaching this population and improving health, and behavioral economic approaches are promising. Methods We conducted a pilot randomized controlled trial focused on acceptability and feasibility of a mobile behavioral economic intervention for 75 rural-residing adults with at-risk alcohol use. We recruited participants from a large healthcare system and randomized them to one of four virtually-delivered conditions reflecting behavioral economic approaches: episodic future thinking (EFT), volitional choice (VC), both EFT and VC, or enhanced usual care control (EUC). The intervention included a telephone-delivered induction session followed by two weeks of condition-consistent ecological momentary interventions (EMIs; 2x/day) and ecological momentary assessments (EMAs; 1x/day). Participants completed assessments at baseline, post-intervention, and two-month follow-up, and provided intervention feedback. Results All participants completed the telephone-delivered session and elected to receive EMI messages. Average completion rate of EMAs across conditions was 92.9%. Among participants in active intervention conditions, 89.3% reported the induction session was helpful and 80.0% reported it influenced their future drinking. We also report initial alcohol use outcomes. Discussion The behavioral economic intervention components and trial procedures evaluated here appear to be feasible and acceptable. Next steps include determination of their efficacy to reduce alcohol use and public health harms.
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Affiliation(s)
- Natalie D. Bayrakdarian
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Erin E. Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
- Michigan Innovations in Addiction Care through Research & Education, University of Michigan, Ann Arbor, MI, United States
| | - Isabelle Duguid
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Lauren Hellman
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Sarah Salino
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Chelsea Wilkins
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Mary Jannausch
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - James R. McKay
- University of Pennsylvania, Philadelphia, PA, United States
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States
| | - Michele Staton
- Department of Behavioral Science, University of Kentucky, Lexington, KY, United States
| | | | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Maureen A. Walton
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
- Michigan Innovations in Addiction Care through Research & Education, University of Michigan, Ann Arbor, MI, United States
| | - Frederic C. Blow
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Lara N. Coughlin
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, United States
- Michigan Innovations in Addiction Care through Research & Education, University of Michigan, Ann Arbor, MI, United States
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Gebru NM, Wongsomboon V. Sexual Arousal-Delay Discounting: When Condoms Delay Arousal. JOURNAL OF SEX RESEARCH 2024; 61:727-741. [PMID: 37506314 PMCID: PMC10822021 DOI: 10.1080/00224499.2023.2239216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
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.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Center for Alcohol and Addictions Studies; Department of Behavioral and Social Sciences; Brown University School of Public Health, Providence, RI USA
| | - Val Wongsomboon
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA
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Murphy JG, Dennhardt AA, Utzelmann B, Borsari B, Ladd BO, Martens MP, White HR, Yurasek AM, Campbell KW, Witkiewitz K. A pilot trial of a brief intervention for cannabis use supplemented with a substance-free activity session or relaxation training. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:255-268. [PMID: 38271079 PMCID: PMC11065625 DOI: 10.1037/adb0000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Cannabis use is increasing among college students and commonly co-occurs with anxiety symptoms in this age group. Interventions that reduce anxiety may also reduce cannabis use. Behavioral economic theory suggests that substance use reductions are most likely when there is an increase in substance-free reinforcement. This randomized pilot trial evaluated the efficacy of a brief motivational intervention (BMI) for cannabis supplemented by either a substance-free activity session (SFAS) or a relaxation training (RT) session for reducing cannabis use, problems, craving, and anxiety symptoms. METHOD One hundred thirty-two college students (Mage = 19.9; 54% female; 67% White, 31% Black) who reported five or more past-month cannabis use days were randomized to: (a) assessment-only (AO); (b) BMI plus SFAS; or (c) BMI plus RT. Participants in the BMI conditions received two individual counselor-administered sessions plus a brief phone booster session. Outcomes were evaluated 1- and 6-months postintervention. RESULTS Relative to assessment, both BMI + SFAS and BMI + RT were associated with significant reductions in cannabis problems and craving at 1-month follow-up, and significant reductions in anxiety at 6-month follow-up. Relative to AO, BMI + RT was associated with significant reductions in cannabis use at 1-month follow-up. There were no differences between BMI conditions. CONCLUSIONS This pilot trial was not adequately powered to conclusively evaluate relative efficacy but provides preliminary support for the short-term efficacy of both two-session interventions for reducing anxiety and cannabis-related risk among nontreatment seeking emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- James G. Murphy
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Ashley A. Dennhardt
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Bettina Utzelmann
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Brian Borsari
- Mental Health Service (116B) San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121, United States
- Department of Psychiatry and Behavioral Sciences, University of California – San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, United States
| | - Benjamin O. Ladd
- Department of Psychology, Washington State University Vancouver, 14204 NE Salmon Creek Ave, Vancouver, WA 98686-9600, United States
| | - Matthew P. Martens
- College of Education, University of Missouri, 118D Hill Hall, Columbia, MO 65211, United States
| | - Helene R. White
- Center of Alcohol and Substance Studies, Rutgers, the State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854, United States
| | - Ali M. Yurasek
- Department of Health Education and Behavior, University of Florida, FLG16, Gainesville, FL 32611, United States
| | - Kevin W. Campbell
- Department of Psychology, University of Memphis, 400 Innovation Dr., Memphis, TN, 38152 United States
| | - Katie Witkiewitz
- Department of Psychology, Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale SE, Albuquerque, NM 87131, United States
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Gebru NM, James TG, Ahn S, Cheong J, Berry MS, Cook RL, Leeman RF. A Behavioral Economic Examination of Sexual Behaviors in the Era of Pre-exposure Prophylaxis via Explanatory Sequential Mixed Methods. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1541-1559. [PMID: 38472604 PMCID: PMC11124550 DOI: 10.1007/s10508-024-02822-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/28/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024]
Abstract
Pre-exposure prophylaxis (PrEP) use may be associated with condom use decisions. The current investigation examined sexual decision-making in the context of PrEP among young adult men who have sex with men (MSM) between 18 and 30 years old, using an explanatory sequential mixed methods design. For the quantitative aim, 99 MSM currently taking PrEP (i.e., PrEP-experienced) and 140 MSM not currently taking PrEP (i.e., PrEP-naive) completed an online survey, including the Sexual Delay Discounting Task (SDDT), which captures likelihood of condom use. For the qualitative aim, 15 people from each group were interviewed about their (1) conceptualizations of risky sex and (2) ways they manage their sexual risk. Participants were, on average, 25.69 years old (SD = 3.07) and 64% White. Results from the quantitative aim revealed, controlling for covariates, PrEP-experienced participants exhibited significantly lower likelihood of (1) using an immediately available condom and (2) waiting for a delayed condom (i.e., sexual delay discounting) compared to PrEP-naive participants. Qualitative themes explaining what young adult MSM consider to be risky sex included: (1) any sex as risky sex, (2) risky sex as "sex without a conversation," and (3) risky sex as sex with risk for physical harm. Themes on ways young adult MSM manage sexual risk were classified as proactive, reactive, and passive. Results suggest that PrEP use is related to condom use decisions. Taken together, quantitative differences in sexual delay discounting, but qualitatively similar conceptualizations and management of risky sex, suggest that the SDDT may be a useful tool in sex research to capture processes (i.e., delay discounting) underlying sexual decision-making that may be missed by traditional self-reports. Implications of results, including potentially providing (good quality) condoms with every PrEP prescription, and future research topics are discussed.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 S. Main St., Box G-S121-3, Providence, RI, 02912, USA.
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA.
- Southern HIV and Alcohol Research Consortium (SHARC), University of Florida, Gainesville, FL, USA.
| | - Tyler G James
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Seungjun Ahn
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - JeeWon Cheong
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Robert L Cook
- Southern HIV and Alcohol Research Consortium (SHARC), University of Florida, Gainesville, FL, USA
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Robert F Leeman
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
- Department of Health Sciences, Northeastern University, Boston, MA, USA
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Hawley WR, Morrow GD. Been There, Done That: The Impact of the Novelty of Penile Vaginal Intercourse (PVI) and Participants' Sex on Delay and Probability Discounting of PVI. JOURNAL OF SEX RESEARCH 2024:1-9. [PMID: 38517453 DOI: 10.1080/00224499.2024.2328250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Delay and probability discounting tasks are useful for understanding aspects of decision making. The current study, which employed a mixed-model design to assess discounting of penile-vaginal intercourse (PVI), was conducted online with male and female participants recruited from Prolific (N = 300; mean age = 34.1 years). Results of the novel delay and probability discounting tasks indicated that as the delay to PVI increased, or as PVI became less certain to occur, participants were instead more likely to choose to receive oral sex, the reward initially indicated as less desirable. Having previously engaged in PVI, however, enhanced this reversal of preferences on both tasks, which suggests PVI loses some of its value when no longer novel. Males and females similarly discounted PVI on the delay discounting task, which suggests biological sex may not impact the propensity to wait for a preferred sexual behavior. On the probability discounting task, however, males were more averse to a reduced probability of PVI occurring and instead opted for receiving oral sex. The sexual behavior discounting tasks developed in the current study, and ones like it, may prove useful for identifying preferences in sexual behaviors, and ultimately enhance sexual and relationship satisfaction.
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Affiliation(s)
- Wayne R Hawley
- Department of Psychology, Counseling and Art Therapy, Pennsylvania Western University- Edinboro
| | - Gregory D Morrow
- Department of Psychology, Counseling and Art Therapy, Pennsylvania Western University- Edinboro
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26
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Noyes ET, Davis JA, Schlauch RC. Establishing Motivational Profiles to Drink among College Students: Converging Patterns Using Multiple Theories of Alcohol use. JOURNAL OF DRUG EDUCATION 2024; 53:39-58. [PMID: 38454577 DOI: 10.1177/00472379241237937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Objective: While college student drinking has been studied utilizing many different theories and approaches, it is unclear how these theories may overlap in their explanation of problematic drinking. Rather than relying on one theory, examining overlap between multiple theories of alcohol use may lead to a better understanding of the motivational process underlying drinking behavior. The current study proposes that the Ambivalence Model of Craving, Behavioral Economics, and Alcohol Outcome Expectancy Theory account for the same underlying anticipatory process and sought to demonstrate this by establishing motivational profiles utilizing constructs within each theory. Methods: A total of 318 college student drinkers completed a series of surveys assessing their drinking behavior and the measures pertaining to each theory (i.e., Approach and Avoidance of Alcohol Questionnaire, Alcohol Purchase Task, Alcohol Expectancy Questionnaire). A latent profile analysis was used to establish profiles of motivational tendencies. Results: Results from the latent profile analysis indicated four profiles emerged, three of which were consistent with our hypotheses: approach, avoidance, and indifferent. The fourth motivational profile appeared to represent drinkers with an emerging approach tendency but relatively newer to drinking. The lack of ambivalent profile suggests that avoidant tendencies may develop later in response to an accumulation of experience with drinking. Lastly, these profiles demonstrated expected relationships with drinking behavior. Conclusion: This study is unique in its attempt to highlight similarities between theories. Results provide a useful integration of theories to allow for a more generalized understanding of motivational tendencies that develop in response to drinking experiences.
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Affiliation(s)
- Emily T Noyes
- University of South Florida, Department of Psychology, 4202 East Fowler Ave, Tampa, FL 33620, USA
| | - Jared A Davis
- University of South Florida, Department of Psychology, 4202 East Fowler Ave, Tampa, FL 33620, USA
| | - Robert C Schlauch
- University of South Florida, Department of Psychology, 4202 East Fowler Ave, Tampa, FL 33620, USA
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Hayashi Y. Problematic mobile phone use as impulsive choice: Development and empirical verification of a reinforcer-pathology model. J Exp Anal Behav 2024; 121:189-200. [PMID: 38148676 DOI: 10.1002/jeab.900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 11/18/2023] [Indexed: 12/28/2023]
Abstract
Problematic mobile phone use is characterized by its "impulsive" nature; users engage in it despite their negative attitude toward it. From a behavioral-economic perspective, this attitude-behavior discrepancy is generated by competing contingencies that involve smaller-sooner social reinforcers associated with mobile phone use and larger-later prosocial reinforcers potentially compromised by phone use. Based on this conceptualization, the reinforcer-pathology model of problematic mobile phone use is proposed, which posits that such phone use stems from excessive delay discounting of the social and prosocial reinforcers and/or excessive demand for the social reinforcers. A secondary data analysis of previously published studies was conducted, with the novel addition of principal component analysis and hierarchical cluster analysis of these data. The results generated evidence that supports the reinforcer-pathology model proposed in this article. Based on the theoretical analyses and accumulated empirical evidence, theory-driven prevention and intervention strategies for problematic mobile phone use are proposed. Overall, the reinforcer-pathology model of problematic mobile phone use provides a comprehensive framework for understanding and addressing this growing issue.
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28
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Negus SS. An economon model of drug addiction. Psychopharmacology (Berl) 2024; 241:417-425. [PMID: 38277005 PMCID: PMC10884072 DOI: 10.1007/s00213-024-06535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/14/2024] [Indexed: 01/27/2024]
Abstract
The term "economon" (i:'ka.nə.muhn; plural: economa) is introduced here to describe an economic unit composed of two participants engaged in mutually reinforcing operant behavior. Economa are basic building blocks of transactional behavior that aggregate in social networks called economies. In a drug-addiction economon, operant behavior by one participant (the "supplier") provides an addictive drug as a reinforcer to the second participant (a "Person with Substance Use Disorder; PwSUD"). Reciprocal operant behavior by the PwSUD usually provides money as a reinforcer to the supplier. After defining the features of the drug-addiction economon, this article discusses its implications for (1) prevalence and virulence of drug addiction, (2) opportunities for drug-addiction research in general, (3) the "brain-disease model of addiction" in particular, and (4) factors that mitigate harm or promote risk of drug addiction. The economon model is intended to provide a novel perspective on the uniquely human disorder of drug addiction.
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Affiliation(s)
- S Stevens Negus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 N. 12 St, Richmond, VA, 23298, USA.
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29
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González-Roz A, Belisario K, Secades-Villa R, Muñiz J, MacKillop J. Behavioral economic analysis of legal and illegal cannabis demand in Spanish young adults with hazardous and non-hazardous cannabis use. Addict Behav 2024; 149:107878. [PMID: 37924581 DOI: 10.1016/j.addbeh.2023.107878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND In October 2021, a legal framework that regulates cannabis for recreational purposes in Spain was proposed, but research on its potential impacts on cannabis use is currently limited. This study examined the reliability and discriminant validity of two Marijuana Purchase Tasks (MPTs) for measuring hypothetical legal and illegal cannabis demand, and to examine differences in demand of both commodities in young adults at hazardous vs. non-hazardous cannabis use risk levels. METHODS A total of 171 Spanish young adults [Mage = 19.82 (SD = 1.81)] with past-month cannabis use participated in a cross-sectional study from September to November 2021. Two 27-item MPTs were used to estimate hypothetical demand for legal and illegal cannabis independently. The Cannabis Use Disorder Identification Test (CUDIT-R) was used to assess hazardous cannabis use and test for discriminant validity of the MPTs. Reliability analyses were conducted using Classical Test Theory (Cronbach's alpha) and Item Response Theory (Item Information Functions). RESULTS The MPT was reliable for measuring legal (α = 0.94) and illegal (α = 0.90) cannabis demand. Breakpoint (price at which demand ceases), and Pmax (price associated with maximum expenditure) were the most sensitive indicators to discriminate participants with different levels of the cannabis reinforcing trait. No significant differences between legal and illegal cannabis demand in the whole sample were observed, but hazardous vs. non-hazardous users showed higher legal and illegal demand, and decreased Breakpoint and Pmax if cannabis were legal vs illegal. CONCLUSION The MPT exhibits robust psychometric validity and may be useful to inform on cannabis regulatory science in Spain.
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Affiliation(s)
- Alba González-Roz
- Addictive Behaviors Research Group (GCA), Department of Psychology, University of Oviedo, Oviedo 33003, Spain.
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario L9C 0E3, Canada
| | - Roberto Secades-Villa
- Addictive Behaviors Research Group (GCA), Department of Psychology, University of Oviedo, Oviedo 33003, Spain
| | - José Muñiz
- Faculty of Psychology, University of Nebrija, Madrid 28015, Spain
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario L9C 0E3, Canada
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Novak MD, Holtyn AF, Toegel F, Rodewald AM, Leoutsakos JM, Fingerhood M, Silverman K. Long-Term Effects of Incentives for HIV Viral Suppression: A Randomized Clinical Trial. AIDS Behav 2024; 28:625-635. [PMID: 38117449 DOI: 10.1007/s10461-023-04249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
Achieving viral suppression in people living with HIV improves their quality of life and can help end the HIV/AIDS epidemic. However, few interventions have successfully promoted HIV viral suppression. The purpose of this study was to evaluate the long-term effectiveness of financial incentives for viral suppression in people living with HIV. People living with a detectable HIV viral load (≥ 200 copies/mL) were randomly assigned to Usual Care (n = 50) or Incentive (n = 52) groups. Incentive participants earned up to $10 per day for providing blood samples with an undetectable or reduced viral load. During the 2-year intervention period, the percentage of blood samples with a suppressed viral load was significantly higher among Incentive participants (70%) than Usual Care participants (43%) (OR = 7.1, 95% CI 2.7 to 18.8, p < .001). This effect did not maintain after incentives were discontinued. These findings suggest that frequent delivery of large-magnitude financial incentives for viral suppression can produce large and long-lasting improvements in viral load in people living with HIV. ClinicalTrials.gov Identifier: NCT02363387.
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Affiliation(s)
- Matthew D Novak
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA
| | - August F Holtyn
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA
| | - Forrest Toegel
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA
| | - Andrew M Rodewald
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA
| | - Jeannie-Marie Leoutsakos
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA
| | - Michael Fingerhood
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kenneth Silverman
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA.
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Basso JC, Satyal MK, McKee KL, Lynn S, Gyamfi D, Bickel WK. Dissociation and other trauma symptomatology are linked to imbalance in the competing neurobehavioral decision systems. Front Psychol 2024; 14:1317088. [PMID: 38356995 PMCID: PMC10864435 DOI: 10.3389/fpsyg.2023.1317088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/19/2023] [Indexed: 02/16/2024] Open
Abstract
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.
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Affiliation(s)
- Julia C. Basso
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
- School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
| | - Medha K. Satyal
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Kevin L. McKee
- Center for Biostatistics and Health Data Science, Virginia Tech, Blacksburg, VA, United States
| | - Sarah Lynn
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Daphne Gyamfi
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
| | - Warren K. Bickel
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, United States
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA, United States
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32
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Bouton ME. Habit and persistence. J Exp Anal Behav 2024; 121:88-96. [PMID: 38149526 PMCID: PMC10842266 DOI: 10.1002/jeab.894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/26/2023] [Indexed: 12/28/2023]
Abstract
Voluntary behaviors (operants) can come in two varieties: Goal-directed actions, which are emitted based on the remembered value of the reinforcer, and habits, which are evoked by antecedent cues and performed without the reinforcer's value in active memory. The two are perhaps most clearly distinguished with the reinforcer-devaluation test: Goal-directed actions are suppressed when the reinforcer is separately devalued and responding is tested in extinction, and habitual behaviors are not. But what is the function of habit learning? Habits are often thought to be strong and unusually persistent. The present selective review examines this idea by asking whether habits identified by the reinforcer-devaluation test are more resistant to extinction, resistant to the effects of other contingency change, vulnerable to relapse, resistant to the weakening effects of context change, or permanently in place once they are learned. Surprisingly little evidence supports the idea that habits are permanent or more persistent. Habits are more context-specific than goal-directed actions are. Methods that make behavior persistent do not necessarily work by encouraging habit. The function of habit learning may not be to make a behavior strong or more persistent but to make it automatic and efficient in a particular context.
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Miller BP, Aston ER, Davis W, Berey BL, Dowd AN, Amlung M. Examining the effect of cannabis cues on cannabis demand in sleep, driving, and typical drug-use contexts. Drug Alcohol Depend 2024; 254:111057. [PMID: 38101283 DOI: 10.1016/j.drugalcdep.2023.111057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/10/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Given the expanding legal cannabis market in the U.S., it is vital to understand how context impacts cannabis use. Therefore, we explored the effect of cannabis cues and cannabis-use context on cannabis demand in 79 adults who reported smoking cannabis at least weekly. METHODS Participants completed a single laboratory session consisting of four hypothetical marijuana purchase tasks (MPTs) involving either a typical use situation or a driving or sleep context. The MPTs were alternated with exposure to cannabis or neutral picture cues based on block randomization by gender. RESULTS Cannabis cues increased self-reported craving for cannabis (p =.044) but did not significantly alter demand (ps =0.093-0.845). In the driving context, participants demonstrated a significant reduction in cannabis demand, indicated by lower intensity (p <0.001), Omax (p <0.001), and Pmax (p <0.001), breakpoint (p =.003), and higher α (p <0.001). The sleep context was associated with significantly greater α (p <0.006) but nonsignificant effects for other indices (ps =0.123-0.707). Finally, cannabis cues increased Omax (p =.013) and breakpoint (p =.035) in the sleep context but not in the typical-use context. CONCLUSIONS These findings suggest that cannabis-use behavior is sensitive to contingencies surrounding driving after cannabis use and may also be sensitive to sleep contexts in the presence of cannabis cues. Since this is the first study to examine driving and sleep contexts, we caution against drawing broad conclusions until future research is conducted to replicate these findings.
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Affiliation(s)
- Brandon P Miller
- Department of Applied Behavioral Science, University of Kansas, USA.
| | - Elizabeth R Aston
- Department of Behavioral and Social Sciences, Brown University, USA; Center for Alcohol and Addiction Studies, Brown University, USA
| | - William Davis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Benjamin L Berey
- Department of Behavioral and Social Sciences, Brown University, USA; Center for Alcohol and Addiction Studies, Brown University, USA; Providence VA Medical Center, USA
| | - Ashley N Dowd
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Michael Amlung
- Department of Applied Behavioral Science, University of Kansas, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, USA
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Olson EA, Ahmad S, Granger SJ, Ashraf A, Pizzagalli DA, Rosso IM. Anhedonia and Delay Discounting: Differing Patterns of Brain-Behavior Relationships in Healthy Control Participants Versus Individuals With Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:80-90. [PMID: 37536568 PMCID: PMC10830883 DOI: 10.1016/j.bpsc.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Anhedonia may contribute to individual differences in delay discounting (DD). In prior work, we found that higher anhedonia was associated with shallower DD in healthy control (HC) participants but steeper DD in individuals with posttraumatic stress disorder (PTSD). In this study, we aimed to directly compare the relationship between anhedonia and DD across groups and to identify functional brain correlates of this interaction. METHODS Participants (HC group: n = 23, DSM-5 PTSD group: n = 23) completed a questionnaire assessing anhedonia (Snaith-Hamilton Pleasure Scale [SHAPS]), task-based functional magnetic resonance imaging of decision making including DD, and resting-state functional magnetic resonance imaging. Task-based activity and resting-state functional connectivity were evaluated in reward-related regions that have also been implicated in PTSD (nucleus accumbens [NAcc], right anterior insula). RESULTS Higher SHAPS scores were associated with steeper DD in PTSD, but there was no relationship between DD and SHAPS in the HC group. There was a significant group-by-SHAPS interaction for NAcc activity, t31 = 2.92, p = .007: Greater NAcc activity when immediate rewards were chosen was associated with higher SHAPS in the PTSD group but lower SHAPS in the HC group. In resting-state functional connectivity, there was a group-by-SHAPS interaction between the NAcc seed and right parietal and frontal pole clusters. CONCLUSIONS These results extend prior findings that anhedonia is associated with steeper DD in PTSD and demonstrate that this behavioral finding occurs in the context of NAcc hyperactivity to immediate rewards and hyperconnectivity in anhedonic individuals with PTSD.
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Affiliation(s)
- Elizabeth A Olson
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
| | - Subul Ahmad
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - Steven J Granger
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Aseelah Ashraf
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
| | - Isabelle M Rosso
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Dwyer CL, Tegge AN, Craft WH, Tomlinson DC, Athamneh LN, Bickel WK. The Phenotype of Recovery X: Associations between delay discounting, regulatory flexibility, and remission from substance use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 155:209122. [PMID: 37451516 PMCID: PMC10787043 DOI: 10.1016/j.josat.2023.209122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/09/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Delay discounting (DD) and self-regulation are important predictors of substance use disorder (SUD) outcomes. Further, regulatory flexibility (RF; i.e., selecting, monitoring, and adapting coping techniques based on contextual demands) is related to psychological resilience. However, studies have yet to examine associations among DD, RF, and remission from SUDs among individuals in recovery. METHODS Individuals (N = 148) in SUD recovery completed the Context Sensitivity Index (CSI), the Flexible Regulation of Emotional Expression (FREE) Scale, and the Perceived Ability to Cope with Trauma (PACT) Scale to assess RF and, an $1000 hypothetical reward Adjusting Amount Delay Discounting Task. The study considered individuals to be in remission from SUD if they did not endorse any SUD DSM-5 symptom other than craving (except tobacco use disorder) in the past three months. The study team used t-tests to examine differences in RF and DD by remission status. Univariate linear regressions were used to examine the relationship between RF and DD. Finally, mediation models examined the dynamic relationship among DD, RF, and remission status. RESULTS Remitted individuals (n = 82) had significantly lower DD (i.e., greater preference for larger, later rewards) rates (p < .001) and higher context sensitivity (p < .001) and coping flexibility (p < .001). The study found significant negative associations between DD and context sensitivity (p = .008), coping flexibility (p = .002), and emotion regulation flexibility (p < .001). Finally, context sensitivity (p = .023) and coping flexibility (p = .009) mediated the relationship between DD and SUD remission. CONCLUSIONS Results suggest that individuals in recovery with broader temporal windows can better identify contextual demands and flexibly cope, contributing to improved SUD recovery outcomes.
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Affiliation(s)
- Candice L Dwyer
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Allison N Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - William H Craft
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, USA
| | - Devin C Tomlinson
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, USA
| | - Liqa N Athamneh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA.
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Smith TR, Southern R, Kirkpatrick K. Mechanisms of impulsive choice: Experiments to explore and models to map the empirical terrain. Learn Behav 2023; 51:355-391. [PMID: 36913144 PMCID: PMC10497727 DOI: 10.3758/s13420-023-00577-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 03/14/2023]
Abstract
Impulsive choice is preference for a smaller-sooner (SS) outcome over a larger-later (LL) outcome when LL choices result in greater reinforcement maximization. Delay discounting is a model of impulsive choice that describes the decaying value of a reinforcer over time, with impulsive choice evident when the empirical choice-delay function is steep. Steep discounting is correlated with multiple diseases and disorders. Thus, understanding the processes underlying impulsive choice is a popular topic for investigation. Experimental research has explored the conditions that moderate impulsive choice, and quantitative models of impulsive choice have been developed that elegantly represent the underlying processes. This review spotlights experimental research in impulsive choice covering human and nonhuman animals across the domains of learning, motivation, and cognition. Contemporary models of delay discounting designed to explain the underlying mechanisms of impulsive choice are discussed. These models focus on potential candidate mechanisms, which include perception, delay and/or reinforcer sensitivity, reinforcement maximization, motivation, and cognitive systems. Although the models collectively explain multiple mechanistic phenomena, there are several cognitive processes, such as attention and working memory, that are overlooked. Future research and model development should focus on bridging the gap between quantitative models and empirical phenomena.
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Tolbert PT, Ramirez MP, Strickland JC, Lile JA, Stoops WW, Stamper BJ, Sumner CB, Wesley MJ. Exponentiated model of drug demand is preferred over exponential models in people with daily/near daily cannabis use. Exp Clin Psychopharmacol 2023; 31:1010-1016. [PMID: 37126035 PMCID: PMC10618410 DOI: 10.1037/pha0000652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Cannabis use is a growing health concern emphasizing the need to better understand the complexities of drug choice in people with daily/near daily cannabis use. Hypothetical purchasing tasks provide a means to collect data on drug consumption behavior without requiring drug administration and have been used to isolate behavioral economic factors of choice, including facets of drug demand in substance using populations. Various models are used for analyzing hypothetical purchasing task data, but challenges exist in modeling data sets with consumption values of zero. Additionally, a single model or approach may not be best for all commodities and drug classes. This study compared two common demand models (exponential vs. exponentiated) applied to identical hypothetical purchasing task data from 21 (n = 21) individuals with daily/near daily cannabis use. The exponential model was fit using three common levels of replacement values for zero consumption (.1, .01, .001) and compared to the exponentiated model without replacement values. We found that the exponentiated model produced significantly better model fits for individual data, compared to all exponential models. Additionally, significant differences for model derived values of demand elasticity and intensity were found between the exponentiated model and different levels of the exponential model. We conclude that the exponentiated model is preferred over the exponential model for performing demand analysis on hypothetical purchasing task data from individuals with daily/near daily cannabis use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Preston T. Tolbert
- Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room
140, Lexington, KY 40536-0086, USA
| | - Miranda P. Ramirez
- Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room
140, Lexington, KY 40536-0086, USA
- Department of Psychology, University of Kentucky College
of Arts and Sciences, 110 Kastle Hall Lexington, KY 40506-0044, USA
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences Johns
Hopkins University School of Medicine, 5510 Nathan Shock Dr., Baltimore, MD 21224,
USA
| | - Joshua A. Lile
- Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room
140, Lexington, KY 40536-0086, USA
- Department of Psychology, University of Kentucky College
of Arts and Sciences, 110 Kastle Hall Lexington, KY 40506-0044, USA
- Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Parkway, Lexington, KY 40509-1810, USA
| | - William W. Stoops
- Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room
140, Lexington, KY 40536-0086, USA
- Department of Psychology, University of Kentucky College
of Arts and Sciences, 110 Kastle Hall Lexington, KY 40506-0044, USA
- Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Parkway, Lexington, KY 40509-1810, USA
| | - Brady J. Stamper
- Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room
140, Lexington, KY 40536-0086, USA
| | - Caroline B. Sumner
- Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room
140, Lexington, KY 40536-0086, USA
| | - Michael J. Wesley
- Department of Behavioral Science, University of Kentucky
College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building Room
140, Lexington, KY 40536-0086, USA
- Department of Psychology, University of Kentucky College
of Arts and Sciences, 110 Kastle Hall Lexington, KY 40506-0044, USA
- Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Parkway, Lexington, KY 40509-1810, USA
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Aston ER, Meshesha LZ, Stevens AK, Borsari B, Metrik J. Cannabis demand and use among veterans: A prospective examination. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:985-995. [PMID: 37079805 PMCID: PMC10587363 DOI: 10.1037/adb0000916] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
OBJECTIVE Cannabis demand (i.e., relative value), assessed cross-sectionally via a hypothetical marijuana purchase task (MPT), has been associated with use, problems, and dependence symptoms, among others. However, limited work exists on the prospective stability of the MPT. Furthermore, cannabis demand among veterans endorsing cannabis use, and the prospective cyclical relationship between demand and use over time, have yet to be investigated. METHOD Two waves of data from a veteran sample (N = 133) reporting current (past 6-month) cannabis use were analyzed to assess stability in cannabis demand over 6 months. Autoregressive cross-lagged panel models (CLPMs) assessed the longitudinal associations between demand indices (i.e., intensity, Omax, Pmax, breakpoint) and cannabis use. RESULTS Baseline cannabis use predicted greater intensity (β = .32, p < .001), Omax (β = .37, p < .001), breakpoint (β = .28, p < .001), and Pmax (β = .21, p = .017) at 6 months. Conversely, baseline intensity (β = .14, p = .028), breakpoint (β = .12, p = .038), and Pmax (β = .12, p = .043), but not Omax, predicted greater use at 6 months. Only intensity demonstrated acceptable prospective reliability. CONCLUSIONS Cannabis demand demonstrated stability over 6 months in CLPM models, varying along with natural changes in cannabis use. Importantly, intensity, Pmax, and breakpoint displayed bidirectional predictive associations with cannabis use, and the prospective pathway from use to demand was consistently stronger. Test-retest reliability ranged from good to poor across indices. Findings highlight the value of assessing cannabis demand longitudinally, particularly among clinical samples, to determine how demand fluctuates in response to experimental manipulation, intervention, and treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912
- Department of Behavioral and Social Sciences, Brown University School of Public Heath, Providence, RI, 02912
| | - Lidia Z. Meshesha
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912
- Department of Psychology, University of Central Florida, Orlando, FL, 32816
| | - Angela K. Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912
| | - Brian Borsari
- San Francisco Veterans Affairs Health Care System
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912
- Department of Behavioral and Social Sciences, Brown University School of Public Heath, Providence, RI, 02912
- Providence Veterans Affairs Medical Center, Providence, RI, 02908
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Marsden E, Murphy JG, MacKillop J, Amlung M. Alcohol cues increase behavioral economic demand and craving for alcohol in nontreatment-seeking and treatment-seeking heavy drinkers. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2149-2160. [PMID: 38226748 DOI: 10.1111/acer.15190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/29/2023] [Accepted: 08/31/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Behavioral economic research has revealed significant increases in alcohol demand following exposure to alcohol-related cues. Prior research has focused exclusively on nontreatment-seeking heavy drinkers, included only male participants, or used heterogeneous methods. The current studies sought to replicate and extend existing findings in treatment-seeking and nontreatment-seeking heavy drinkers while also examining sex effects and moderation by alcohol use disorder (AUD) severity. METHODS Study 1 included 117 nontreatment-seeking heavy drinkers (51.5% women; M age 34.69; 56.4% AUD+), and Study 2 included 89 treatment-seeking heavy drinkers with AUD (40.4% women; M age = 41.35). In both studies, alcohol demand was measured using a hypothetical alcohol purchase task (APT), and subjective alcohol craving was measured using visual analog scales. Measures were collected following exposure to neutral (water) cues in a standard room and alcohol cues in a bar lab. RESULTS Alcohol demand (intensity, Omax , breakpoint, and elasticity) and craving were significantly increased following alcohol cues compared to neutral cues (ps < 0.005) with effect sizes ranging from small to large (ηp 2 = 0.074-0.480). Participants with AUD (Study 1) or with higher AUD severity (Study 2) reported higher craving and higher demand for most indices (i.e., main effects; ps < 0.032, ηp 2 = 0.043-0.239). A larger alcohol cue increase in Omax was found for AUD+ participants in Study 1 compared to non-AUD participants (p = 0.028, ηp 2 = 0.041) but not for any other indices in Study 1 or Study 2. There were no significant sex effects. CONCLUSIONS These findings replicate and extend prior research by offering additional insight into alcohol cue effects on the reinforcing value of alcohol and subjective motivation to drink. The results also suggest that sex and AUD severity do not meaningfully impact cue effects across most indices of demand.
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Affiliation(s)
- Emma Marsden
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, Tennessee, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Michael Amlung
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
- Department of Applied Behavioral Science, University of Kansas, Lawrence, Kansas, USA
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Regnier SD, Rzeszutek MJ, Strickland JC, Shellenberg TP, Stoops WW. The endowment effect and temporal discounting of drug and non-drug commodities. Pharmacol Biochem Behav 2023; 232:173638. [PMID: 37717822 PMCID: PMC10947334 DOI: 10.1016/j.pbb.2023.173638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES Despite a rich history of behavioral economic research on substance use there remains a need for further exploration of behavioral mechanisms that may underlie the etiology or persistence of substance use disorder. The purpose of this study was to measure the association between delay discounting and the endowment effect in people who smoke cigarettes, use cocaine, and controls, using online crowdsourcing. METHODS Participants were categorized to a cocaine group (n = 36), cigarette group (n = 48), or control group (n = 47) based on recent reported drug use. Based on group, participants completed up to three delay discounting tasks (i.e., money, cigarettes and cocaine), an endowment effect task for multiple commodities, and other questionnaires. RESULTS Participants in the cocaine and cigarette group demonstrated an increased rate in discounting for money compared to controls. Participants in the cocaine group had a less pronounced endowment effect for beer, compared to controls, as suggested by willingness to accept less to sell beer. A significant negative association was found between endowment ratios for non-drug commodities and delay discounting for cigarettes, but not monetary or cocaine delay discounting, indicating an inconsistent relationship between the two measures. CONCLUSIONS These results support prior research demonstrating a relationship between cocaine and cigarette use and delay discounting and extend that work by measuring the association between delay discounting and the endowment effect. Future research should include both loss aversion and endowment effect tasks and compare their relationship with delay discounting among people that use drugs.
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Affiliation(s)
- Sean D Regnier
- Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building, Lexington, KY 40536-0086, USA
| | - Mark J Rzeszutek
- Department of Family & Community Medicine, University of Kentucky College of Medicine, 2195 Harrodsburg Road, Lexington, KY 40504, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr, Baltimore, MD 21224, USA
| | - Thomas P Shellenberg
- Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building, Lexington, KY 40536-0086, USA
| | - William W Stoops
- Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Drive, Medical Behavioral Science Building, Lexington, KY 40536-0086, USA; Department of Psychiatry, University of Kentucky College of Medicine, 245 Fountain Court, Lexington, KY 40509-1810, USA; Department of Psychology, University of Kentucky College of Arts and Sciences, 171 Funkhouser Drive, Lexington, KY 40506-0044, USA; Center on Drug and Alcohol Research, University of Kentucky College of Medicine, 845 Angliana Ave, Lexington, KY 40508, USA.
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Freitas-Lemos R, Tomlinson DC, Yeh YH, Dwyer CL, Dai HD, Leventhal A, Tegge AN, Bickel WK. Can delay discounting predict vaccine hesitancy 4-years later? A study among US young adults. Prev Med Rep 2023; 35:102280. [PMID: 37576839 PMCID: PMC10413160 DOI: 10.1016/j.pmedr.2023.102280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/15/2023] [Accepted: 06/07/2023] [Indexed: 08/15/2023] Open
Abstract
Despite being a major threat to health, vaccine hesitancy (i.e., refusal or reluctance to vaccinate despite vaccine availability) is on the rise. Using a longitudinal cohort of young adults (N = 1260) from Los Angeles County, California we investigated the neurobehavioral mechanisms underlying COVID-19 vaccine hesitancy. Data were collected at two time points: during adolescence (12th grade; fall 2016; average age = 16.96 (±0.42)) and during young adulthood (spring 2021; average age = 21.33 (±0.49)). Main outcomes and measures were delay discounting (DD; fall 2016) and tendency to act rashly when experiencing positive and negative emotions (UPPS-P; fall 2016); self-reported vaccine hesitancy and vaccine beliefs/knowledge (spring 2021). A principal components analysis determined four COVID-19 vaccine beliefs/knowledge themes: Collective Responsibility, Confidence and Risk Calculation, Complacency, and Convenience. Significant relationships were found between themes, COVID-19 vaccine hesitancy, and DD. Collective Responsibility (β = -1.158[-1.213,-1.102]) and Convenience (β = -0.132[-0.185,-0.078]) scores were negatively associated, while Confidence and Risk Calculation (β = 0.283[0.230,0.337]) and Complacency (β = 0.412[0.358,0.466]) scores were positively associated with COVID-19 vaccine hesitancy. Additionally, Collective Responsibility (β = -0.060[-0.101,-0.018]) was negatively associated, and Complacency (β = -0.063[0.021,0.105]) was positively associated with DD from fall 2016. Mediation analysis revealed immediacy bias during adolescence, measured by DD, predicted vaccine hesitancy 4 years later while being mediated by two types of vaccine beliefs/knowledge: Collective Responsibility (β = 0.069[0.022,0.116]) and Complacency (β = 0.026[0.008,0.044]). These findings provide a further understanding of individual vaccine-related decision-making among young adults and inform public health messaging to increase vaccination acceptance.
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Affiliation(s)
| | - Devin C. Tomlinson
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA
| | - Yu-Hua Yeh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Candice L. Dwyer
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Adam Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Allison N. Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - Warren K. Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
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Bellitti JS, Fazzino TL. Discounting of Hyper-Palatable Food and Money: Associations with Food Addiction Symptoms. Nutrients 2023; 15:4008. [PMID: 37764791 PMCID: PMC10536694 DOI: 10.3390/nu15184008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Delay discounting (DD), the tendency to prefer small, immediate rewards over larger, delayed rewards, is associated with health-risk behaviors. The study examined associations between DD for money and hyper-palatable foods (HPF) with food addiction (FA) symptoms among a general population sample. METHODS Participants (N = 296) completed an adjusting DD task that consisted of a single-commodity condition with HPF as the reward (HPF now vs. HPF later) and cross-commodity conditions comparing money and HPF (money now vs. HPF later; HPF now vs. money later). The Yale Food Addiction Scale 2.0 was used to assess FA symptoms. Zero-inflated negative binomial regression models tested whether discounting of HPF and money was associated with FA symptoms. RESULTS Findings indicated there were no significant associations between DD and FA symptoms in the single-commodity HPF condition (logit: OR = 1.02, p-value = 0.650; count: IRR = 1.04, p-value = 0.515). There were no significant associations among cross-commodity conditions comparing money now vs. HPF later (logit: OR = 0.96, p-value = 0.330; count: IRR = 1.02, p-value = 0.729) or conditions comparing HPF now vs. money later (logit: OR = 1.02, p-value = 0.682; count: IRR = 0.92, p-value = 0.128) and FA symptoms. CONCLUSIONS Discounting HPF may not be a key behavioral feature among individuals who endorse FA symptoms.
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Affiliation(s)
- Joseph S. Bellitti
- Department of Psychology, The University of Kansas, Fraser Hall, 1415 Jayhawk Blvd., Lawrence, KS 66045, USA;
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045, USA
| | - Tera L. Fazzino
- Department of Psychology, The University of Kansas, Fraser Hall, 1415 Jayhawk Blvd., Lawrence, KS 66045, USA;
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045, USA
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Sutton CA, Grandfield E, Yi R, Fazzino TL. Engagement in types of activities and frequency of alcohol use in a national sample of United States adolescents. PLoS One 2023; 18:e0291257. [PMID: 37682954 PMCID: PMC10490845 DOI: 10.1371/journal.pone.0291257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE Adolescents with fewer sources of environmental reinforcement may be at risk for alcohol use. Behavioral economic theories posit that engagement in some activities may facilitate alcohol use, whereas other activities may be incompatible with use and reduce likelihood of alcohol use. It is unclear which types of activities may facilitate or may be incompatible with alcohol use in adolescence. Using a national sample of adolescents, the current study examined differences in engagement with types of activities that may be incompatible with alcohol use, compared among adolescents who endorsed alcohol use, and adolescents who did not. METHOD Data from the 2019 Monitoring the Future (MTF) study (N = 4626) were analyzed. Potentially incompatible and facilitating activities, and alcohol-involved activities were identified from pre-existing survey measures. Confirmatory factor analysis, measurement invariance, and structural equation modeling were used to examine patterns in activity engagement among those who endorsed alcohol use and those who did not. RESULTS Participants who did not endorse alcohol use reported higher engagement in activities that may be incompatible with alcohol use, including enjoyment from school and going to the mall (p < .001). Participants who endorsed alcohol use reported higher engagement in activities that may facilitate alcohol use (p < .001), such as spending time with friends and attending parties. Facilitating activities (β = 0.15, p < .001) and alcohol-involved activities (β = 0.70, p < .001) were positively associated with alcohol use frequency. Observed effect sizes were small in magnitude for all findings. CONCLUSIONS The findings support the premise of behavioral economic theory, suggesting some activities may serve as protective factors against alcohol use frequency while other activities may facilitate alcohol use among adolescents. National surveys may consider adding specific measure of activity engagement to identify activities that may be incompatible with alcohol use among adolescents.
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Affiliation(s)
- Cassandra A. Sutton
- Department of Psychology, University of Kansas, Lawrence, Kansas, United States of America
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, United States of America
| | - Elizabeth Grandfield
- Department of Methodology and Statistics, Utrecht University, Utrecht, Netherlands
| | - Richard Yi
- Department of Psychology, University of Kansas, Lawrence, Kansas, United States of America
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, United States of America
| | - Tera L. Fazzino
- Department of Psychology, University of Kansas, Lawrence, Kansas, United States of America
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, United States of America
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Strickland JC, Acuff SF. Role of social context in addiction etiology and recovery. Pharmacol Biochem Behav 2023; 229:173603. [PMID: 37487953 PMCID: PMC10528354 DOI: 10.1016/j.pbb.2023.173603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/07/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Abstract
While social context has long been considered central to substance use disorder prevention and treatment and many drug-taking events occur in social settings, experimental research on social context has historically been limited. Recent years have seen an emergence of concerted preclinical and human laboratory research documenting the direct impact of social context on substance use, delineating behavioral and neurobiological mechanisms underlying social influence's role. We review this emerging preclinical and human laboratory literature from a theoretical lens that considers distinct stages of the addiction process including drug initiation/acquisition, escalation, and recovery. A key conclusion of existing research is that the impact of the social environment is critically moderated by the drug-taking behavior and drug use history of a social peer. Specifically, while drug-free social contexts can reduce the likelihood of drug use initiation and act as a competitive non-drug alternative preventing escalation, drug-using peers can equally facilitate initiation and escalation through peer modeling as a contingent reward of use. Likewise, social context may facilitate recovery or serve as a barrier that increases the chances of a return to regular use. We conclude by discussing evidence-based treatments and recovery support services that explicitly target social mechanisms or that have identified social context as a mechanism of change within treatment. Ultimately, new areas for research including the expansion of drug classes studied and novel human laboratory designs are needed to further translate emerging findings into clinical practice.
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Affiliation(s)
- Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA.
| | - Samuel F Acuff
- Department of Psychology, The University of Memphis, 202 Psychology Building, Memphis, TN 38152, USA; Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 152 Merrimac St, Boston MA, 02135 USA
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Marcus MM, Banks ML. Effects of environmental and pharmacological manipulations on cocaine-vs-negative reinforcer choice in male and female rats. Psychopharmacology (Berl) 2023; 240:1677-1689. [PMID: 37340053 PMCID: PMC11162248 DOI: 10.1007/s00213-023-06404-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023]
Abstract
RATIONALE The adverse consequences of human addictive drug use could be the result of either addictive drug consumption resulting in punishment (e.g., incarceration) or failure to engage in negative-reinforced behaviors that might compete with drug-maintained behaviors (e.g., contingency management strategies that reset payment amounts for drug free urines). OBJECTIVE The goal of the present study was to establish a discrete-trial cocaine-vs-negative reinforcer (SNR) choice procedure where rats were presented with a simplified model of this conflict: choose negative reinforcement (i.e., escape or avoid foot shock) or choose an intravenous (IV) cocaine infusion followed by an inescapable shock. METHODS Responding was maintained in male and female rats by IV cocaine infusions (0.32-1.8 mg/kg/inf) and a SNR (0.1-0.7 mA shock) under a discrete-trial concurrent "choice" schedule during daily sessions. Following parametric reinforcer magnitude and response requirement experiments, the effects of 12 h extended access cocaine self-administration and acute diazepam (0.32-10 mg/kg, IP) pretreatment were determined on cocaine-vs-SNR choice. RESULTS Negative reinforcement was chosen over all cocaine doses. Lowering shock magnitude or increasing SNR response requirement failed to promote behavioral reallocation towards cocaine. Extended access cocaine self-administration sessions resulted in high daily cocaine intakes but failed to significantly increase cocaine choice in all (19) but one rat. Acute diazepam pretreatment also did not alter choice behavior up to doses that produced behavioral depression. CONCLUSIONS These results suggest that SNRs may be a source of reinforcement that effectively compete with and mitigate maladaptive addictive drug-maintained behaviors in the general population.
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Affiliation(s)
- Madison M Marcus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
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Strickland JC, Hatton KW, Hays LR, Rayapati AO, Lile JA, Rush CR, Stoops WW. Use of drug purchase tasks in medications development research: orexin system regulation of cocaine and drug demand. Behav Pharmacol 2023; 34:275-286. [PMID: 37403694 PMCID: PMC10328554 DOI: 10.1097/fbp.0000000000000731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Commodity purchase tasks provide a useful method for evaluating behavioral economic demand in the human laboratory. Recent research has shown how responding to purchase tasks for blinded drug administration can be used to study abuse liability. This analysis uses data from a human laboratory study to highlight how similar procedures may be particularly useful for understanding momentary changes in drug valuation when screening novel interventions. Eight nontreatment-seeking participants with cocaine use disorder (one with partial data) were enrolled in a cross-over, double-blind, randomized inpatient study. Participants were maintained on the Food and Drug Administration-approved insomnia medication suvorexant (oral; 0, 5, 10, 20 mg/day) in randomized order with experimental sessions completed after at least 3 days of maintenance on each suvorexant dose. Experimental sessions included administration of a sample dose of 0, 10 and 30 mg/70 kg intravenous cocaine. Analyses focused on purchase tasks for the blinded sample dose as well as alcohol, cigarettes and chocolate completed 15 min after the sample dose. As expected based on abuse liability, near zero demand was observed for placebo with dose-related increases in cocaine demand. Suvorexant maintenance increased cocaine demand in a dose-related manner with the greatest increase observed for the 10 mg/kg cocaine dose. Increased demand under suvorexant maintenance was also observed for alcohol. No effect of cocaine administration was observed for alcohol, cigarette, or chocolate demand. These data support the validity of demand procedures for measuring blinded drug demand. Findings also parallel self-administration data from this study by showing increases in cocaine use motivation under suvorexant maintenance.
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Affiliation(s)
- Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kevin W Hatton
- Department of Anesthesiology, University of Kentucky College of Medicine
| | - Lon R Hays
- Department of Psychiatry, University of Kentucky College of Medicine
| | - Abner O Rayapati
- Department of Psychiatry, University of Kentucky College of Medicine
| | - Joshua A Lile
- Department of Psychiatry, University of Kentucky College of Medicine
- Department of Behavioral Science, University of Kentucky College of Medicine
- Department of Psychology, University of Kentucky College of Arts and Sciences
| | - Craig R Rush
- Department of Psychiatry, University of Kentucky College of Medicine
- Department of Behavioral Science, University of Kentucky College of Medicine
- Department of Psychology, University of Kentucky College of Arts and Sciences
| | - William W Stoops
- Department of Psychiatry, University of Kentucky College of Medicine
- Department of Behavioral Science, University of Kentucky College of Medicine
- Department of Psychology, University of Kentucky College of Arts and Sciences
- Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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47
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Sistad RE, Livingston NA, Crowe ML, Newberger N, Spitzer E, Brief D, Litwack S, Helmuth E, Roy M, Solhan M, Rosenbloom D, Keane TM. Network analysis of reasons for and against changing alcohol use among veterans engaged in a web-based intervention for hazardous drinking and PTSD symptoms. Addict Behav 2023; 143:107689. [PMID: 36924646 PMCID: PMC10485876 DOI: 10.1016/j.addbeh.2023.107689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/28/2022] [Accepted: 03/06/2023] [Indexed: 03/12/2023]
Abstract
Better understanding of reasons for and against change may be an effective strategy for supporting drinking reduction or abstinence among Iraq and Afghanistan veterans. The current study explored connections between reasons for and against changing hazardous alcohol use, as well as the relative importance of a given reason. Data from 366 veterans (86% male, 77% White) between the ages of 21 and 56 (M = 31.8, SD = 7.3) were obtained from a nationwide web-based alcohol and posttraumatic stress disorder randomized clinical trial. Participant-generated reasons for and against change were used to estimate two separate network models. The network of motives for changing alcohol use was generally well connected with predominately positive associations. Veterans reporting motivation to change alcohol use to improve functioning, enhance self-worth, and decrease alcohol-related consequences tended to have higher than average motivation to reduce or abstain from alcohol use. Alternatively, the network structure of motives against changing alcohol use demonstrated a nearly equal number of positive and negative associations. Whereas reasons to cope and sleep may imply higher than average motivation to continue drinking the same, veterans reporting reasons to reduce anxiety and have fun tended to have lower than average motivation to continue drinking. The current study may inform content modifications to self-help tools to more quickly and effectively target users' motivations from the beginning. Capitalizing on intervention users' motivations early may promote sustained engagement or improve therapeutic impact among those who only use the intervention for a short period of time.
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Affiliation(s)
- Rebecca E Sistad
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; U.S. Department of Veteran Affairs, Minneapolis VA Health Care System, Minneapolis, MN, United States; Department of Psychiatry, Boston University, School of Medicine, United States.
| | - Nicholas A Livingston
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States; National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States.
| | - Michael L Crowe
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States
| | - Noam Newberger
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States
| | - Elizabeth Spitzer
- Center for Healthcare Organization and Implementation Research, Boston, MA, United States; Harvard Medical School, Harvard University, Boston, MA, United States
| | - Deborah Brief
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States
| | - Scott Litwack
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States
| | - Eric Helmuth
- Educational Development Center, Waltham, MA, United States
| | - Monica Roy
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States
| | - Marika Solhan
- Department of Psychiatry, Boston University, School of Medicine, United States; U.S. Department of Veterans Affairs, Boston Vet Center, Boston, MA, United States
| | - David Rosenbloom
- Boston University School of Public Health, Boston, MA, United States
| | - Terence M Keane
- U.S. Department of Veteran Affairs, VA Boston Health Care System, Boston, MA, United States; Department of Psychiatry, Boston University, School of Medicine, United States; National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, United States
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Gabriel DB, Liley AE, Franks H, Minnes GL, Tutaj M, Dwinell MR, de Jong T, Williams RW, Mulligan MK, Chen H, Simon NW. Divergent risky decision-making and impulsivity behaviors in Lewis rat substrains with low genetic difference. Behav Neurosci 2023; 137:254-267. [PMID: 37104777 PMCID: PMC10524952 DOI: 10.1037/bne0000557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Substance use disorder (SUD) is associated with a cluster of cognitive disturbances that engender vulnerability to ongoing drug seeking and relapse. Two of these endophenotypes-risky decision-making and impulsivity-are amplified in individuals with SUD and are augmented by repeated exposure to illicit drugs. Identifying genetic factors underlying variability in these behavioral patterns is critical for early identification, prevention, and treatment of SUD-vulnerable individuals. Here, we compared risky decision-making and different facets of impulsivity between two fully inbred substrains of Lewis rats-LEW/NCrl and LEW/NHsd. We performed whole genome sequencing of both substrains to identify almost all relevant variants. We observed substantial differences in risky decision-making and impulsive behaviors. Relative to LEW/NHsd, the LEW/NCrl substrain accepts higher risk options in a decision-making task and higher rates of premature responses in the differential reinforcement of low rates of responding task. These phenotypic differences were more pronounced in females than males. We defined a total of ∼9,000 polymorphisms between these substrains at 40× whole genome short-read coverage. Roughly half of variants are located within a single 1.5 Mb region of Chromosome 8, but none impact protein-coding regions. In contrast, other variants are widely distributed, and of these, 38 are predicted to cause protein-coding variants. In conclusion, Lewis rat substrains differ significantly in risk-taking and impulsivity and only a small number of easily mapped variants are likely to be causal. Sequencing combined with a reduced complexity cross should enable identification of one or more variants underlying multiple complex addiction-relevant behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Anna E. Liley
- Department of Psychology, University of Memphis, Memphis TN 38152
| | - Hunter Franks
- Department of Developmental Neurobiology, St. Jude Children’s Research Hospital, Memphis TN 38105
| | - Grace L. Minnes
- Department of Psychology, University of Memphis, Memphis TN 38152
| | - Monika Tutaj
- Department of Physiology, Medical College of Wisconsin, Milwaukee WI 53226
| | - Melinda R. Dwinell
- Department of Physiology, Medical College of Wisconsin, Milwaukee WI 53226
| | - Tristan de Jong
- Department of Pharmacology, Addiction and Toxicology, University of Tennessee Health Science Center, Memphis TN 38163
| | - Robert W. Williams
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis TN 38163
| | - Megan K. Mulligan
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis TN 38163
| | - Hao Chen
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis TN 38163
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Reach G. How is Patient Adherence Possible? A Novel Mechanistic Model of Adherence Based on Humanities. Patient Prefer Adherence 2023; 17:1705-1720. [PMID: 37484740 PMCID: PMC10362896 DOI: 10.2147/ppa.s419277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Patient non-adherence is a major contemporary medical issue because of its consequences in terms of frequency, morbidity and mortality, and health care costs. This article aims to propose a mechanistic model of adherence based on the tenet that non-adherence is the default option, as long-term adherence in chronic diseases requires sustained effort. The real question becomes, how is patient adherence possible? By focusing on adherent patients, the paper explains the mental mechanisms of adherence using concepts largely drawn from humanities, philosophy of mind, and behavioral economics and presents the findings of empirical studies supporting these hypotheses. The analysis first demonstrates the relationship between patient adherence and temporality and the influence of character traits. Further, it points out the importance of habit, which allows adherence to become non-intentional, thereby sparing patients' cognitive efforts. Finally, it points out the importance of the quality of the interaction between the person with a chronic disease and the health professional. These features explain why adherence is a syndrome (the healthy adherer phenotype), separating people into those who are safe and those who are at risk of non-adherence, non-control of diabetes, and complications. The concepts presented in this article summarize 20 years of personal clinical and philosophical reflection on patient adherence. They are mainly illustrated by examples from diabetes care but can be applied to all chronic diseases. This novel model of adherence has major practical and ethical implications, explaining the importance of patient education and shared medical decision-making in chronic disease management.
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Affiliation(s)
- Gérard Reach
- Education and Health Promotion Laboratory, Sorbonne Paris Nord University, Bobigny, Île-de-France, 93000, France
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50
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Yip SW, Barch DM, Chase HW, Flagel S, Huys QJ, Konova AB, Montague R, Paulus M. From Computation to Clinic. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:319-328. [PMID: 37519475 PMCID: PMC10382698 DOI: 10.1016/j.bpsgos.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/25/2022] [Accepted: 03/22/2022] [Indexed: 12/12/2022] Open
Abstract
Theory-driven and data-driven computational approaches to psychiatry have enormous potential for elucidating mechanism of disease and providing translational linkages between basic science findings and the clinic. These approaches have already demonstrated utility in providing clinically relevant understanding, primarily via back translation from clinic to computation, revealing how specific disorders or symptoms map onto specific computational processes. Nonetheless, forward translation, from computation to clinic, remains rare. In addition, consensus regarding specific barriers to forward translation-and on the best strategies to overcome these barriers-is limited. This perspective review brings together expert basic and computationally trained researchers and clinicians to 1) identify challenges specific to preclinical model systems and clinical translation of computational models of cognition and affect, and 2) discuss practical approaches to overcoming these challenges. In doing so, we highlight recent evidence for the ability of computational approaches to predict treatment responses in psychiatric disorders and discuss considerations for maximizing the clinical relevance of such models (e.g., via longitudinal testing) and the likelihood of stakeholder adoption (e.g., via cost-effectiveness analyses).
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Affiliation(s)
- Sarah W. Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Deanna M. Barch
- Departments of Psychological & Brain Sciences, Psychiatry, and Radiology, Washington University, St. Louis, Missouri
| | - Henry W. Chase
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Shelly Flagel
- Department of Psychiatry and Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan
| | - Quentin J.M. Huys
- Division of Psychiatry and Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Institute of Neurology, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Anna B. Konova
- Department of Psychiatry and Brain Health Institute, Rutgers University, Piscataway, New Jersey
| | - Read Montague
- Fralin Biomedical Research Institute and Department of Physics, Virginia Tech, Blacksburg, Virginia
| | - Martin Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma
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