Individual differences in delay discounting under acute stress: the role of trait perceived stress

No effects of acute stress on monetary delay discounting: A systematic literature review and meta-analysis

Many everyday decisions, including those concerning our health, finances and the environment, involve choosing between a smaller but imminent reward (e.g., €20 now) and a later but larger reward (e.g., €40 in a month). The extent to which an individual prefers smaller imminent rewards over larger delayed rewards can be measured using delay discounting tasks. Acute stress induces a cascade of biological and psychological responses with potential consequences for how individuals think about the future, process rewards, and make decisions, all of which can impact delay discounting. Several studies have shown that individuals focus more on imminent rewards under stress. These findings have been used to explain why individuals make detrimental choices under acute stress. Yet, the evidence linking acute stress to delay discounting is equivocal. To address this uncertainty, we conducted a meta-analysis of 11 studies (14 effects) to systematically quantify the effects of acute stress on monetary delay discounting. Overall, we find no effect of acute stress on delay discounting, compared to control conditions (SMD = -0.18, 95% CI [-0.57, 0.20], p = 0.32). We also find that neither the gender/sex of the participants, the type of stressor (e.g., physical vs. psychosocial) nor whether monetary decisions were hypothetical or incentivized (i.e. monetary decisions were actually paid out) moderated the impact of acute stress on monetary delay discounting. We argue that establishing the effects of acute stress on the separate processes involved in delay discounting, such as reward valuation and prospection, will help to resolve the inconsistencies in the field.

Decision-making under stress: A psychological and neurobiological integrative model

Understanding the impact of stress on cognitive processes, particularly decision-making, is crucial as it underpins behaviors essential for survival. However, research in this domain has yielded disparate results, with inconsistencies evident across stress-induction paradigms and drug administration protocols designed to investigate specific stress pathways or neuromodulators. Building upon empirical studies, this research identifies a multifaceted matrix of variables contributing to the divergent findings. This matrix encompasses factors such as the temporal proximity between stressors and decision tasks, the nature of stressors and decision contexts, individual characteristics including psychobiological profiles and affective states at the time of decision-making and even cultural influences. In response to these complexities, we propose a comprehensive model that integrates these relevant factors and their intricate interplay to elucidate the mechanisms governing decision-making during stressful events. By synthesizing these insights, our model not only refines existing paradigms but also provides a framework for future study designs, offering avenues for theoretical advancements and translational developments in the field of stress's impact on cognitive functions. This research contributes to a deeper understanding of the nuanced relationship between stress and decision-making, ultimately advancing our knowledge of cognitive processes under challenging conditions.

Gender differences in the effects of emotion induction on intertemporal decision-making

'Good things come to those who wait' is a popular saying, which goes along with numerous daily life decisions requiring trade-offs between immediate-small and later-larger rewards; however, some individuals have a tendency to prefer sooner rewards while discounting the value of delayed rewards, known as delay discounting. The extant literature indicates that emotions and gender can modulate intertemporal choices, but their interplay remains hitherto poorly investigated. Here, 308 participants were randomized to different conditions, inducing distinct emotions-fear, joy, a neutral state-through standardized movie clips, and then completed a computerized delay discounting task for hypothetical money rewards. Following the induction of fear, women discount the future steeper than men, thus preferring immediate-smaller rewards rather than larger-delayed ones. Also, women were more prone to choose immediate rewards when in a fearful condition than when in a positive state of joy/happiness. By contrast, men were unaffected by their emotional state when deciding on monetary rewards. Our findings provide evidence that fear can trigger different intertemporal choices according to gender, possibly reflecting the adoption of different evolutionary strategies.

The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.

COVID-19-related financial scarcity is associated with greater delay discounting but not probability discounting

Prior studies suggest that scarcity increases delay discounting (devaluation of delayed outcomes) and disturbs other decision-making processes. Evidence on the effect of COVID-19 on delay discounting is mixed. Also, no study has examined the effect of COVID-19-related scarcity on probability discounting (devaluation of probabilistic outcomes). The goal of the study was to examine cross-sectional associations between financial impact during the COVID-19 pandemic, delay discounting, and probability discounting. During April 2020, 1012 participants with low income were recruited on Amazon Mechanical Turk and completed measures of delay and probability discounting, perceived COVID-19-related financial impacts, and food security. Regression analyses indicate that compared to those with no COVID-19-related financial impacts, those with severe COVID-19-related financial impacts had greater delay discounting of money and greater delay discounting of a grocery gift card. Also, greater food insecurity in the past month was associated with greater delay discounting of a grocery gift card but not delay discounting of money. Perceived COVID-19 related financial impact was not associated with probability discounting. Combined with laboratory experiments, this study provides additional support for the idea that feelings of scarcity may increase delay discounting. However, as this study was observational, no assumptions of causality should be made about the specific effect of COVID-19 on delay discounting.

The Insidious Influence of Stress: An Integrated Model of Stress, Executive Control, and Psychopathology

Although exposure to acute stress undoubtedly contributes to psychopathology, most individuals do not develop psychopathology following stress exposure. To explain this, biological, emotional, and cognitive responses to stress have been implicated, but individual differences in executive control (i.e., top-down control of cognition and behavior) measured in response to stress has only recently emerged as a potential factor contributing to psychopathology. In this review, we introduce a model-the integrated model of stress, executive control, and psychopathology-positing how the impairing effects of acute stress on executive control can contribute to psychopathology. We link to research on biological, emotional, and cognitive processes, all of which can be impacted by executive control, to propose a framework for how poorer executive control under conditions of acute stress can contribute to psychopathology. This integrated model is intended to further our understanding of who is more susceptible to the negative consequences of stress.

Pharmacological Modulation of Temporal Discounting: A Systematic Review

Temporal discounting is a phenomenon where a reward loses its value as a function of time (e.g., a reward is more valuable immediately than when it delays in time). This is a type of intertemporal decision-making that has an association with impulsivity and self-control. Many pathologies exhibit higher discounting rates, meaning they discount more the values of rewards, such as addictive behaviors, bipolar disorder, attention-deficit/hyperactivity disorders, social anxiety disorders, and major depressive disorder, among others; thus, many studies look for the mechanism and neuromodulators of these decisions. This systematic review aims to investigate the association between pharmacological administration and changes in temporal discounting. A search was conducted in PubMed, Scopus, Web of Science, Science Direct and Cochrane. We used the PICO strategy: healthy humans (P-Participants) that received a pharmacological administration (I-Intervention) and the absence of a pharmacological administration or placebo (C-Comparison) to analyze the relationship between the pharmacological administration and the temporal discounting (O-outcome). Nineteen studies fulfilled the inclusion criteria. The most important findings were the involvement of dopamine modulation in a U-shape for choosing the delayed outcome (metoclopradime, haloperidol, and amisulpride). Furthermore, administration of tolcapone and high doses of d-amphetamine produced a preference for the delayed option. There was a time-dependent hydrocortisone effect in the preference for the immediate reward. Thus, it can be concluded that dopamine is a crucial modulator for temporal discounting, especially the D2 receptor, and cortisol also has an important time-dependent role in this type of decision. One of the limitations of this systematic review is the heterogeneity of the drugs used to assess the effect of temporal discounting.

The Role of Time Perspectives and Impulsivity Dimensions in Coping Styles

Both time perspectives and impulsivity dimensions are groups of traits that are connected to self-control abilities and might be important for coping styles. However, to date, no study has systematically investigated their utility in predicting coping styles with regard to their multidimensional nature. The current study was correlational and exploratory, aiming to discover what amount of variance in each of the three coping styles, problem-oriented, active emotion-oriented, and avoidant, is accounted for by two groups of predictors: time perspectives and impulsivity dimensions. N = 397 young adults aged 18-35 from the general population took part in the study. Results of a multiple linear regression testing both groups of predictors separately and of hierarchical regression analysis introducing the two predictor groups in subsequent steps suggested that time perspectives accounted for more variance in adaptive coping styles: problem-oriented and active emotion-oriented coping. For avoidant coping, both time perspectives and impulsivity dimensions accounted for a similar amount of variance. The results provide evidence that time perspectives should be investigated in domains related to coping (e.g., mental health issues, substance abuse, and risk-taking behaviors), for which impulsivity has been considered an important predictor. Moreover, impulsivity ought to be tested with regard to its multidimensionality.

Imagining emotional events benefits future-oriented decisions

How does imagining future events-whether positive or negative-influence our choices in the present? Prior work has shown the simulation of hypothetical future events, dubbed episodic future thinking, can alter the propensity to engage in delay discounting (the tendency to devalue future rewards) and does so in a valence-specific manner. Some research shows that positive episodic future thinking reduces delay discounting, whereas negative future thinking augments it. However, more recent research indicates that both positive and negative episodic future thinking reduce delay discounting, suggesting an effect of episodic future thinking that is independent of valence. In this study, we sought to replicate and extend these latter findings. Here, participants (N = 604; N = 572 after exclusions) completed an online study. In the baseline task, participants completed a delay discounting task. In the experimental task, they engaged in episodic future thinking before completing a second delay discounting task. Participants were randomly assigned to engage in either positive, neutral, or negative episodic future thinking. In accordance with Bulley et al., we found that episodic future thinking, regardless of valence, reduced delay discounting. Although episodic future thinking shifted decision-making in all conditions, the effect was stronger when participants engaged in positive episodic future thinking, even after accounting for personal relevance and vividness of imagined events. These findings suggest that episodic future thinking may promote future-oriented choices by contextualising the future, and this effect is further strengthened when the future is tied to positive emotion.

Effects of psychological stress and cortisol on decision making and modulating factors: a systematic review

Evidence suggests that psychological stress has effects on decision making, but the results are inconsistent, and the influence of cortisol and other modulating factors remains unclear. Based on the PRISMA criteria, 18 studies carried out between 2015 and 2020 that examined the effects of psychological stress on decision making and measured cortisol levels were selected. Eight studies employed uncertainty-based economic tasks, five studies used decision-making tasks in hypothetical situations that can be encountered in real life or in a specific setting, and five studies employed prosocial decision tasks. Seventeen studies assessed acute stress, and two assessed chronic stress; eight evaluated the influence of sex. Most of the studies that explored the association between stress and decision making using uncertainty-based economic tasks found statistically significant differences as a function of stress exposure and the cortisol response to stress, whereas most of the studies that employed non-economic decision-making tasks in hypothetical situations did not find statistically significant differences. When prosocial decision making was evaluated, more altruistic decisions were found after acute stress, and these decisions were positively associated with cortisol. Half of the studies that assessed the role of sex observed a greater impact on decision making after stress in women. Results suggest that it is important to consider modulating factors - the type of decision-making task, the cortisol response to stress, the characteristics of the psychological stressor, or the subject's sex - when trying to understand psychosocial stress phenomena.

The effect of acute and chronic scarcity on acute stress: A dyadic developmental examination

BACKGROUND

Food insecurity, obesity, and psychological stress are interrelated constructs which are thought to be connected through increased energy intake, but the underlying mechanisms for these relationships remain unclear. The current study used experimental methods to investigate how financial losses may influence acute stress in the context of food insecurity for both parents and offspring. This study also sought to examine the effect of acute stress related to financial losses on the reinforcing value of food (RRV_food) and delay discounting (DD).

METHODS

One hundred and six families stratified by both offspring age (53 children aged 7-10, 53 adolescents aged 15-17) and household financial resources, visited our laboratory for three separate appointments. Each appointment included the experimental manipulation of financial gains and losses, saliva samples for cortisol assay, continuous heart rate monitoring, self-rated tension, and computer-based DD and RRV_food tasks. Participants also completed surveys to report perceived life stress level and food insecurity status.

RESULTS

Among all participants, financial losses were related to decreased heart rates and increased self-rated tension. Among parents reporting food insecurity, acute financial losses resulted in an increase in cortisol levels. Changes in cortisol, heart rate, and tension were not related to RRV_food or DD.

CONCLUSION

Food insecure parents are sensitive to financial losses and respond with an increase in cortisol. However, we found no evidence for a relationship between cortisol and RRV_food or DD. This sensitivity to financial losses did not extend to children or adolescents.

OUP accepted manuscript

The Coronavirus disease of 2019 (COVID-19) and measures to curb it created population-level changes in male-dominant impulsive and risky behaviors such as violent crimes and gambling. One possible explanation for this is that the pandemic has been stressful, and males, more so than females, tend to respond to stress by altering their focus on immediate versus delayed rewards, as reflected in their delay discounting rates. Delay discounting rates from healthy undergraduate students were collected twice during the pandemic. Discounting rates of males (n=190) but not of females (n=493) increased during the pandemic. Using machine learning, we show that prepandemic functional connectome predict increased discounting rates in males (n=88). Moreover, considering that delay discounting is associated with multiple psychiatric disorders, we found the same neural pattern that predicted increased discounting rates in this study, in secondary datasets of patients with major depression and schizophrenia. The findings point to sex-based differences in maladaptive delay discounting under real-world stress events, and to connectome-based neuromarkers of such effects. They can explain why there was a population-level increase in several impulsive and risky behaviors during the pandemic and point to intriguing questions about the shared underlying mechanisms of stress responses, psychiatric disorders and delay discounting.

Impulsivity and compulsivity in binge eating disorder: A systematic review of behavioral studies

BACKGROUND

Binge eating disorder (BED) often includes impulsive and compulsive behaviors related to eating behavior and food. Impulsivity and compulsivity generally may contribute to the etiology and maintenance of multiple psychiatric disorders including BED. This review aimed to identify and synthesize available behavioral studies of impulsivity and compulsivity among individuals with BED.

METHOD

A systematic search was performed focusing on BED and specific facets of impulsivity (rapid response and choice) and compulsivity (set-shifting, cognitive flexibility, and/or habit learning). All case-control studies comparing adults with either full-threshold or subthreshold BED to individuals with normal weight, overweight/obesity, or other eating disorders (e.g., bulimia nervosa) were included.

RESULTS

Thirty-two studies representing 29 unique samples met inclusion criteria. Increased choice impulsivity was observed among individuals with BED relative to individuals with normal weight. There were mixed findings and/or a lack of available evidence regarding rapid response impulsivity and compulsivity. The presence of between-group differences was not dependent on sample characteristics (e.g., full or sub threshold BED diagnosis, or treatment-seeking status). Heterogeneity relating to covariates, task methodologies, and power limited conclusions.

CONCLUSIONS

Literature supports a postive association between choice impulsivity and BED. More research is needed to determine if individuals with BED demonstrate elevated levels of either rapid response impulsivity or types of compulsivity. Careful selection of covariates and consideration of task methodologies and power would aid future research.

Now or Later? Stress-Induced Increase and Decrease in Choice Impulsivity Are Both Associated with Elevated Affective and Endocrine Responses

Exposure to acute stress elicit physiological and psychological responses that can impact decision-making, often expressed as an increased tendency to act in an impulsive manner following stress. Delay discounting (DD) task has emerged as a reliable measure of impulsive behavior in the form of choice impulsivity (CI). Interestingly, studies that examined the effect of acute stress on DD performance reported mixed results. To address this, we conducted a within-subject examination of the impact of acute stress on CI, focusing on individual differences in response patterns. One hundred and fifty healthy female participants completed the DD task twice, before and after undergoing an acute laboratory stress induction procedure. Saliva samples and self-report mood and affect measures were collected at four time points throughout the session. Fifty-nine matched healthy control participants completed only the DD task twice, with no stress in between. Results indicate that the acute stress procedure elicited the expected effects of increased cortisol release and increased negative mood and affect, at the group level. With respect to DD, stress indeed increased CI at the group level, yet participants differed in the magnitude and direction of this effect. Interestingly, regression analysis revealed quadratic relations between stress-induced changes in CI and cortisol release. Indeed, dividing the sample into three sub-groups based on the impact of stress on CI revealed that, compared to participants that exhibited no substantial change in their CI following stress, participants that exhibited either stress-induced increase or decrease in their CI also exhibited more stress-induced cortisol release, as well as more negative affect. Taken together, these findings suggest that elevated physiological and psychological responses to stress are associated with either increased or decreased choice impulsivity, thus depicting quadratic relations between stress and impulsivity.

A story to tell: the role of narratives in reducing delay discounting for people who strongly discount the future

Delay Discounting (DD) or devaluing a future, larger reward in favour of a smaller, more immediate reward, has been linked to negative health behaviours. One intervention that reduces DD is Episodic Future Thinking (EFT). EFT has participants generate cues representing positive future events that correspond to temporal windows during the DD task. The current study examined if incorporating EFT cues into narratives would strengthen effects on DD. One hundred and sixty adults were recruited from Amazon Mechanical Turk and were randomised to traditional or narrative EFT. Results showed that participants in narrative EFT discounted the future less (p = 0.034) than participants who engaged in traditional EFT. This novel approach to EFT is well grounded in research and theory on the power of narratives to influence behaviour and can open a new window into ways to reduce DD to strengthen engagement in positive choices.

Reduced adaptation of glutamatergic stress response is associated with pessimistic expectations in depression

Stress is a significant risk factor for the development of major depressive disorder (MDD), yet the underlying mechanisms remain unclear. Preclinically, adaptive and maladaptive stress-induced changes in glutamatergic function have been observed in the medial prefrontal cortex (mPFC). Here, we examine stress-induced changes in human mPFC glutamate using magnetic resonance spectroscopy (MRS) in two healthy control samples and a third sample of unmedicated participants with MDD who completed the Maastricht acute stress task, and one sample of healthy control participants who completed a no-stress control manipulation. In healthy controls, we find that the magnitude of mPFC glutamate response to the acute stressor decreases as individual levels of perceived stress increase. This adaptative glutamate response is absent in individuals with MDD and is associated with pessimistic expectations during a 1-month follow-up period. Together, this work shows evidence for glutamatergic adaptation to stress that is significantly disrupted in MDD.

Temporal discounting when outcomes are experienced in the moment: Validation of a novel paradigm and comparison with a classic hypothetical intertemporal choice task

When faced with intertemporal choices, people typically devalue rewards available in the future compared to rewards more immediately available, a phenomenon known as temporal discounting. Decisions involving intertemporal choices arise daily, with critical impact on health and financial wellbeing. Although many such decisions are "experiential" in that they involve delays and rewards that are experienced in real-time and can inform subsequent choices, most studies have focused on intertemporal choices with hypothetical outcomes (or outcomes delivered after all decisions are made). The present study focused on experiential intertemporal choices. First, a novel intertemporal choice task was developed and validated, using delays experienced in real time and artistic photographs as consumable perceptual rewards. Second, performance on the experiential task was compared to performance on a classic intertemporal choice task with hypothetical outcomes. Involvement of distinct processes across tasks was probed by examining differential relations to state and trait anxiety. A two-parameter logistic function framework was proposed to fit indifference point data. This approach accounts for individual variability not only in the delay at which an individual switches from choosing the delayed to more immediate option, but also in the slope of that switch. Fit results indicated that the experiential task elicited temporal discounting, with effective trade-off between delay and perceptual reward. Comparison with the hypothetical intertemporal choice task suggested distinct mechanisms: first, temporal discounting across the two tasks was not correlated; and second, state and trait anxiety both were associated with choice behavior in the experiential task, albeit in distinct ways, whereas neither was significantly associated with choice behavior in the hypothetical task. The engagement of different processes in the experiential compared to hypothetical task may align with neural evidence for the recruitment of the hippocampus in animal but not in classic human intertemporal choice studies.

Impact of bifrontal transcranial Direct Current Stimulation on decision-making and stress reactivity. A pilot study

Stress is an adaptive response with repercussions on the human health. The dorsolateral prefrontal cortex (DLPFC) is thought to be involved in stress regulation by contributing to limit its biological and behavioral pejorative consequences. Here, to investigate the contribution of the DLPFC in stress response, we applied transcranial Direct Current Stimulation (tDCS) over the DLPFC during acute stress exposure in healthy participants. We hypothesized that active tDCS compared to sham would impact top-down control of the DLPFC on goal-directed behavior and hypothalamo-pituitary-adrenal (HPA) axis activity. In a double-blind sham-controlled study, 30 healthy subjects were randomly allocated to receive either active (2 mA, n = 15) or sham tDCS (n = 15) with the anode over the left DLPFC and the cathode over the right DLFPC. During the 30-min stimulation period, participants faced an experimental acute stress paradigm. Changes in goal-directed behavior were measured with a decision-making task. HPA axis reactivity was assessed by repeated measures of salivary cortisol. Acute stress decreased appetite for immediate reward in the sham group (mean - 4.40%; p = 0.017) whereas no significant effect of stress was observed in the active group. During stress exposure, we observed a significant larger elevation of salivary cortisol (p = 0.045; Cohen's d = 0.431) in the sham tDCS group (+179.8%; Standard error of the mean (SEM) = 20.6) than in the active group (+138.5%; SEM = 14.2). Stimulating the DLPFC using bifrontal tDCS may prevent stress-induced acute effects on both biological and behavioral outcomes.

Acute stress enhances tolerance of uncertainty during decision-making

Acute stress has been shown to influence reward sensitivity, feedback learning, and risk-taking during decision-making, primarily through activation of the hypothalamic pituitary axis (HPA). However, it is unclear how acute stress affects decision-making among choices that vary in their degree of uncertainty. To address this question, we conducted two experiments in which participants repeatedly chose between two options-a high-uncertainty option that offered highly variable rewards but was advantageous in the long-term, and a low-uncertainty option that offered smaller yet more consistent rewards. The Socially Evaluated Cold Pressor Task (SECPT) was utilized to induce acute stress. Participants in Experiment 1 (N = 114) were exposed to either the SECPT or a warm-water control condition and then completed the decision-making under uncertainty task. Compared to the control condition, those exposed to the acute stress manipulation chose the high-uncertainty option that provided highly variable but larger rewards over the option that provided stable, smaller rewards. Experiment 2 (N = 95) incorporated a salivary cortisol measure. Results replicated the behavioral findings in Experiment 1 and demonstrated that the acute stress manipulation increased salivary cortisol. This work suggests that moderate acute stress is associated with tolerance of outcome variability in contexts that depend on learning to maximize rewards.

A brief review of choice bundling: A strategy to reduce delay discounting and bolster self-control

Choice bundling is a behavioral economic strategy designed to reduce excessive delay discounting and bolster self-control. Choice bundling entails aggregating a series of individual, identical intertemporal decisions (e.g., should I smoke today?) into a single choice (e.g., should I smoke this month?). In this brief review, we succinctly summarize delay discounting and how it has been linked to lapses in self-control, using substance use as an exemplar. Next, we describe how choice bundling may theoretically work to counter excess discounting rates. Finally, we review the extant empirical research on choice bundling and offer recommendations for future research.

Vagal signaling and the somatic marker hypothesis: The effect of transcutaneous vagal nerve stimulation on delay discounting is modulated by positive mood

Controlling impulsivity and delaying gratifications are key features of effective self-control. Delay Discounting (DD) indexes the ability to delay rewards and previous research has shown that discounting is influenced by affective states such as mood. According to the Somatic Marker Hypothesis (SMH), afferent somatic signals, such as mood, are carried by the vagus and can influence decision making. In the current study, we employed transcutaneous vagus nerve stimulation (tVNS), a novel non-invasive brain stimulation technique that stimulates the auricular branch of the afferent vagus nerve (located in the outer ear), to assess its effects on decision impulsivity, while taking into account individuals' mood and resting-state HRV as a possible confounding factor. Employing a within-subjects cross-over design, 94 participants received active or sham tVNS while performing delay discounting in two separate sessions. As compared to sham, active tVNS increased discounting, but only for individuals reporting lower positive mood, regardless of the level of negative mood reported. We evidence that the effect of tVNS on reward discounting depends on the level of positive mood. This result suggests that positive mood state might be a proxy of task-relevant arousal, likely influencing the effectiveness of afferent vagal stimulation on self-control processes, as temporal discounting.

Moderation of relation between psychological risk factors and alcohol use by sex

Alcohol consumption is a significant public health concern among young adults, with most recent research suggesting that the sex gap in alcohol consumption among young adults is closing. Thus, the present study tested sex as a moderator for known risk factors for alcohol use (impulsivity, sensation seeking, mindfulness). We examined sex differences by surveying young adults (n = 1,437) from across Washington state between 2011 and 2013 on alcohol risk factors (impulsivity, sensation seeking, mindfulness), alcohol consumption (quantity and frequency), and alcohol related negative consequences. Zero inflated Poisson and Zero inflated Negative Binomial models revealed that sex moderated the relationship between Peak Blood Alcohol Content (BAC) and impulsivity such that higher impulsivity was more strongly related to higher Peak BAC for women than for men. Overall, these results suggest that very few sex differences exist in alcohol consumption and alcohol-related negative consequences. Future research should look beyond the risk factors studied here to identify other important mechanisms that vary by sex that may be important targets for clinical or prevention efforts related to alcohol consumption.

Acute stress improves long-term reward maximization in decision-making under uncertainty

Acute stress influences reward-seeking tendencies and risky decision-making. However, it is unclear how acute stress influences decision-making in situations in which individuals must learn to either maximize long-term or immediate rewards from experience. Consequently, this study sought to investigate whether acute stress enhances salience of small, immediate or large, delayed rewards on decision-making under uncertainty. The Socially Evaluated Cold Pressor Task (SECPT) was used to induce acute stress. Participants in Experiment 1 (N = 50) were exposed to either the SECPT or a warm-water control condition and then completed a decision-making task in which participants needed to learn to forego immediate rewards in favor of larger delayed rewards. The results demonstrated that acute stress enhanced decisions that maximized long-term, large rewards over immediate, small rewards. Experiment 2 (N = 50) included an assessment of salivary cortisol. Results replicated the behavioral findings in Experiment 1 and demonstrated that the acute stress manipulation increased salivary cortisol, thus providing a potential physiological mechanism for these results. This work suggests that moderate acute stress can improve decision-making under uncertainty that depends on learning to maximize long-term rewards from experience.

Cuing both positive and negative episodic foresight reduces delay discounting but does not affect risk-taking

Humans frequently create mental models of the future, allowing outcomes to be inferred in advance of their occurrence. Recent evidence suggests that imagining positive future events reduces delay discounting (the devaluation of reward with time until its receipt), while imagining negative future events may increase it. Here, using a sample of 297 participants, we experimentally assess the effects of cued episodic simulation of positive and negative future scenarios on decision-making in the context of both delay discounting (monetary choice questionnaire) and risk-taking (balloon-analogue risk task). Participants discounted the future less when cued to imagine positive and negative future scenarios than they did when cued to engage in control neutral imagery. There were no effects of experimental condition on risk-taking. Thus, although these results replicate previous findings suggesting episodic future simulation can reduce delay discounting, they indicate that this effect is not dependent on the valence of the thoughts, and does not generalise to all other forms of “impulsive” decision-making. We discuss various interpretations of these results, and suggest avenues for further research on the role of prospection in decision-making.

The treasure of now and an uncertain future: Delay discounting and health behaviors among cancer survivors

BACKGROUND

The identification of new therapeutic targets to improve health behaviors among cancer survivors (CS) is likely to improve cancer treatment outcomes. Delay discounting (DD) rate is the degree to which one devalues rewards as a function of time to receipt. Lower DD rates (ie, prioritizing long-term over immediate rewards) are associated with healthier behaviors. CS often experience distress and thoughts of early mortality that can potentially shift priorities to the present and negatively impact DD rates, especially when newly diagnosed. Understanding relations between DD and health behaviors among CS will contribute to the examination of DD as a therapeutic target for improving health behaviors for CS.

METHOD

CS (n = 1001) were recruited from a web panel and administered a web-based questionnaire. Multivariate models examined relations among DD rate, years since diagnosis, and 10 health behavior indicators. We hypothesized that 1) higher DD rates would be associated with fewer years since diagnosis, and 2) lower DD rates would be associated with healthier behaviors, moderated by years since diagnosis.

RESULTS

In general, higher DD rates were associated with fewer years since diagnosis. Higher DD rates were associated with more alcohol consumption, cigarette smoking, other tobacco use, tanning booth use, and conversely, greater adherence to annual primary care visits. A significant interaction between DD rate and years since diagnosis was not found.

CONCLUSION

Lower DD rates are associated with several important healthy lifestyle behaviors. DD rate is a promising therapeutic target for new interventions to improve multiple health behaviors among CS.

Testosterone, Cortisol and Financial Risk-Taking

Both testosterone and cortisol have major actions on financial decision-making closely related to their primary biological functions, reproductive success and response to stress, respectively. Financial risk-taking represents a particular example of strategic decisions made in the context of choice under conditions of uncertainty. Such decisions have multiple components, and this article considers how much we know of how either hormone affects risk-appetite, reward value, information processing and estimation of the costs and benefits of potential success or failure, both personal and social. It also considers how far we can map these actions on neural mechanisms underlying risk appetite and decision-making, with particular reference to areas of the brain concerned in either cognitive or emotional functions.

The effects of acute stress on the calibration of persistence

People frequently fail to wait for delayed rewards after choosing them. These preference reversals are sometimes thought to reflect self-control failure. Other times, however, continuing to wait for a delayed reward may be counterproductive (e.g., when reward timing uncertainty is high). Research has demonstrated that people can calibrate how long to wait for rewards in a given environment. Thus, the role of self-control might be to integrate information about the environment to flexibly adapt behavior, not merely to promote waiting. Here we tested effects of acute stress, which has been shown to tax control processes, on persistence, and the calibration of persistence, in young adult human participants. Half the participants (n = 60) performed a task in which persistence was optimal, and the other half (n = 60) performed a task in which it was optimal to quit waiting for reward soon after each trial began. Each participant completed the task either after cold pressor stress or no stress. Stress did not influence persistence or optimal calibration of persistence. Nevertheless, an exploratory analysis revealed an "inverted-U" relationship between cortisol increase and performance in the stress groups, suggesting that choosing the adaptive waiting policy may be facilitated with some stress and impaired with severe stress.

The role of emotions and physiological arousal in modulating impulsive behaviour

Impulsivity received considerable attention in the context of drug misuse and certain neuropsychiatric conditions. Because of its great health and well-being importance, it is crucial to understand factors which modulate impulsive behaviour. As a growing body of literature indicates the role of emotional and physiological states in guiding our actions and decisions, we argue that current affective state and physiological arousal exert a significant influence on behavioural impulsivity. As 'impulsivity' is a heterogeneous concept, in this paper, we review key theories of the topic and summarise information about distinct impulsivity subtypes and their methods of assessment, pointing out to the differences between the various components of the construct. Moreover, we review existing literature on the relationship between emotional states, arousal and impulsive behaviour and suggest directions for future research.

Positive Arousal Increases Individuals' Preferences for Risk

Much is known about the effect of negative arousal on decision making, but little is known about the effect of positive arousal. In this study, we manipulated positive arousal and measured individual choices under risk using an incentivized task. Participants were randomly assigned to either a low arousal or a high arousal condition and asked to choose between pairs of two-outcome monetary lotteries with the same expected value but different risk in terms of outcome variance. The probability was set at 50% for each lottery. Participants in the high arousal group selected the riskier lottery more often and took more time to make choices than participants in the low arousal group. This finding shows that introducing a pleasant arousing cue as part of the decision context shifts an individual’s preferences toward the risky economic option and away from the safer one.

Impulsivity influences betting under stress in laboratory gambling

Although recent research suggests that acute stress influences subsequent decision-making under ambiguity, less is known about the role of personality variables in this relationship. This study tested whether impulsivity traits and acute stress differentially influence the way in which a prior feedback is incorporated into further decisions involving ambiguity. Sixty college students (50% male; aged 18-25 years) were randomly assigned to a stress versus a non-stress condition before completing a laboratory gambling task. The results revealed that independently of the stress condition, subjects behaved as if the odds of winning increase after a single loss. Additionally, stress effects varied as a function of impulsivity traits. Individuals who lacked perseverance (i.e., had difficulty focusing on a difficult or boring task) gambled more after experiencing a loss in the stress condition than did those in the control condition. The present study supports that impulsivity traits can explain the differential effect of stress on the relationship between prior feedback and choices made under ambiguity.

Stress and Decision Making: Effects on Valuation, Learning, and Risk-taking

A wide range of stressful experiences can influence human decision making in complex ways beyond the simple predictions of a fight-or-flight model. Recent advances may provide insight into this complicated interaction, potentially in directions that could result in translational applications. Early research suggests that stress exposure influences basic neural circuits involved in reward processing and learning, while also biasing decisions towards habit and modulating our propensity to engage in risk-taking. That said, a substantial array of theoretical and methodological considerations in research on the topic challenge strong cross study comparisons necessary for the field to move forward. In this review we examine the multifaceted stress construct in the context of human decision making, emphasizing stress' effect on valuation, learning, and risk-taking.

A working memory task reveals different patterns of impulsivity in male and female college students

Impulsivity is an important personality trait that affects people's lives every day. Because of the complicated structures and various measurements of impulsivity, the conclusion that whether there were gender differences on impulsivity remained controversial. In our study, we used delay discounting and probability discounting to measure impulsive choice and employed stop signal reaction time task (SSRT) to measure impulsive action within the same subjects. No inherent gender differences were found, either on impulsive choice or on impulsive action. However, after adding a working memory (WM) task, we found an interaction between gender and WM: males made more impulsive choices in the delay discounting task, but females remained no change, and this only occurred when the reward amount was large; in the SSRT, the males showed better inhibitory control under the WM load condition, but females did not. These results demonstrate that gender difference does not exist on impulsivity biologically, but the increased working memory load could affect the gender's sense of delay gratification and the ability of inhibitory control differently. These findings can contribute to the studies of gender differences on impulsivity and draw attention to the need for further research that gender factors should be considered more carefully when exploring the effects of working memory.

Prolonged Effects of Acute Stress on Decision-Making under Risk: A Human Psychophysiological Study

This study investigates the prolonged effects of physiological responses induced by acute stress on risk-taking in decision-making. Participants were divided into a Stress group (N = 14) and a Control group (N = 12). The Trier Social Stress Test was administered as an acute stressor, and reading was administered as a control task; thereafter, participants performed a decision-making task in which they needed to choose a sure option or a gamble option in Gain and Loss frame trials 2 h after (non-) exposure to the stressor. Increased cortisol, adrenaline, heart rate (HR), and subjective stress levels validated acute stress manipulation. Stressed participants made fewer risky choices only in the Gain domain, whereas no effect of stress was shown in the Loss domain. Deceleration of HR reflecting attention was greater for Gains compared with Losses only in the Stress group. Risk avoidance was determined by increased levels of cortisol caused by acute stress. These results suggest that processes regarding glucocorticoid might be involved in the prolonged effects of acute stress on the evaluation of risks and the monitoring of outcomes in decision-making.

Acute stress alters individual risk taking in a time-dependent manner and leads to anti-social risk

Decision‐making processes can be modulated by stress, and the time elapsed from stress induction seems to be a crucial factor in determining the direction of the effects. Although current approaches consider the first post‐stress hour a uniform period, the dynamic pattern of activation of the physiological stress systems (i.e., the sympathetic nervous system and hypothalamic‐pituitary‐adrenal axis) suggests that its neurobehavioural impact might be heterogeneous. Here, we evaluate economic risk preferences on the gain domain (i.e., risk aversion) at three time points following exposure to psychosocial stress (immediately after, and 20 and 45 min from onset). Using lottery games, we examine decisions at both the individual and social levels. We find that risk aversion shows a time‐dependent change across the first post‐stress hour, evolving from less risk aversion shortly after stress to more risk averse behaviour at the last testing time. When risk implied an antisocial outcome to a third party, stressed individuals showed less regard for this person in their decisions. Participants’ cortisol levels explained their behaviour in the risk, but not the antisocial, game. Our findings reveal differential stress effects in self‐ and other‐regarding decision‐making and highlight the multidimensional nature of the immediate aftermath of stress for cognition.

Prospection and the Present Moment: The Role of Episodic Foresight in Intertemporal Choices between Immediate and Delayed Rewards

Humans are capable of imagining future rewards and the contexts in which they may be obtained. Functionally, intertemporal choices between smaller but immediate and larger but delayed rewards may be made without such episodic foresight. However, we propose that explicit simulations of this sort enable more flexible and adaptive intertemporal decision-making. Emotions triggered through the simulation of future situations can motivate people to forego immediate pleasures in the pursuit of long-term rewards. However, we stress that the most adaptive option need not always be a larger later reward. When the future is anticipated to be uncertain, for instance, it may make sense for preferences to shift toward more immediate rewards, instead. Imagining potential future scenarios and assessment of their likelihood and affective consequences allows humans to determine when it is more adaptive to delay gratification in pursuit of a larger later reward, and when the better strategy is to indulge in a present temptation. We discuss clinical studies that highlight when and how the effect of episodic foresight on intertemporal decision-making can be altered, and consider the relevance of this perspective to understanding the nature of self-control.

Stress potentiates decision biases: A stress induced deliberation-to-intuition (SIDI) model

Humans often make decisions in stressful situations, for example when the stakes are high and the potential consequences severe, or when the clock is ticking and the task demand is overwhelming. In response, a whole train of biological responses to stress has evolved to allow organisms to make a fight-or-flight response. When under stress, fast and effortless heuristics may dominate over slow and demanding deliberation in making decisions under uncertainty. Here, I review evidence from behavioral studies and neuroimaging research on decision making under stress and propose that stress elicits a switch from an analytic reasoning system to intuitive processes, and predict that this switch is associated with diminished activity in the prefrontal executive control regions and exaggerated activity in subcortical reactive emotion brain areas. Previous studies have shown that when stressed, individuals tend to make more habitual responses than goal-directed choices, be less likely to adjust their initial judgment, and rely more on gut feelings in social situations. It is possible that stress influences the arbitration between the emotion responses in subcortical regions and deliberative processes in the prefrontal cortex, so that final decisions are based on unexamined innate responses. Future research may further test this 'stress induced deliberation-to-intuition' (SIDI) model and examine its underlying neural mechanisms.

Increased Risk Taking in Relation to Chronic Stress in Adults

Chronic stress is a public health problem that affects a significant part of the population. While the physiological damage it causes is under ongoing scrutiny, its behavioral effects have been overlooked. This is one of the first studies to examine the relation between chronic stress and decision-making, using a standard lottery paradigm. We measured risk taking in the gain domain through binary choices between financially incentivized lotteries. We then measured self-reported chronic stress with the Trier Inventory for the Assessment of Chronic Stress (TICS). We additionally collected hair samples in a subsample of volunteers, in order to quantify accumulation of the stress hormone cortisol. We discovered a significant positive, though modest, correlation between self-reported chronic stress and risk taking that is stronger for women than for men. This confirms part of the findings in acute stress research that show a connection between higher stress and increased risk taking. However, unlike the biologically-based results from acute stress research, we did not identify a significant relation between hair cortisol and behavior. In line with previous literature, we found a clear gender difference in risk taking and self-reports: women generally take less risk and report slightly higher stress levels than men. We conclude that perceived chronic stress can impact behavior in risky situations.

A Computational Analysis of Aberrant Delay Discounting in Psychiatric Disorders

Impatience for reward is a facet of many psychiatric disorders. We draw attention to a growing literature finding greater discounting of delayed reward, an important aspect of impatience, across a range of psychiatric disorders. We propose these findings are best understood by considering the goals and motivation for discounting future reward. We characterize these as arising from either the opportunity costs of waiting or the uncertainty associated with delayed reward. We link specific instances of higher discounting in psychiatric disorder to heightened subjective estimates of either of these factors. We propose these costs are learned and represented based either on a flexible cognitive model of the world, an accumulation of previous experience, or through evolutionary specification. Any of these can be considered suboptimal for the individual if the resulting behavior results in impairments in personal and social functioning and/or in distress. By considering the neurochemical and neuroanatomical implementation of these processes, we illustrate how this approach can in principle unite social, psychological and biological conceptions of impulsive choice.

Differential effects of the pharmacological stressor yohimbine on impulsive decision making and response inhibition

RATIONALE

High levels of impulsivity have been associated with psychiatric disorders such as attention-deficit/hyperactivity disorder (ADHD) and substance abuse. In addition, acute stress is known to exacerbate many psychiatric symptoms in impulse control disorders.

OBJECTIVES

The purpose of the current study was to investigate the acute effects of the pharmacological stressor yohimbine on response inhibition and impulsive choice.

METHODS

A group of male rats (n = 12) was trained in the delayed reward task (DRT) to assess impulsive choice. A separate group (n = 10) was trained in the stop-signal task (SST) to measure response inhibition. Upon stable responding, the effects of yohimbine (0, 1.25, 2.5, and 5 mg/kg i.p.) were tested in a Latin square design.

RESULTS

Acute yohimbine significantly increased the preference for the large and delayed reinforcer in the DRT, indicating a decrease in impulsive choice. On the contrary, the effect size of 1.25 mg/kg yohimbine on stop-signal reaction times correlated negatively with baseline performance, suggesting a baseline-dependent effect on response inhibition as measured in the SST.

CONCLUSIONS

The current data suggest that the effects of the pharmacological stressor yohimbine on impulse control strongly depend on the type of impulsive behavior. Pharmacological stress decreased impulsive decision making, an observation that is in line with previously published rodent studies. By contrast, the lowest dose of yohimbine revealed a baseline-dependent effect on response inhibition. As such, the effects of yohimbine are largely comparable to the effects of psychostimulants on impulsivity and may support the notion of cross sensitization of stress and psychostimulants.

The Malleability of Intertemporal Choice

Intertemporal choices are ubiquitous: people often have to choose between outcomes realized at different times. Although it is generally believed that people have stable tendencies toward being impulsive or patient, an emerging body of evidence indicates that intertemporal choice is malleable and can be profoundly influenced by context. How the choice is framed, or the state of the decision-maker at the time of choice, can induce a shift in preference. Framing effects are underpinned by allocation of attention to choice attributes, reference dependence, and time construal. Incidental affective states and prospection also influence intertemporal choice. We advocate that intertemporal choice models account for these context effects, and encourage the use of this knowledge to nudge people toward making more advantageous choices.

The impact of threat of shock on the framing effect and temporal discounting: executive functions unperturbed by acute stress?

Anxiety and stress-related disorders constitute a large global health burden, but are still poorly understood. Prior work has demonstrated clear impacts of stress upon basic cognitive function: biasing attention toward unexpected and potentially threatening information and instantiating a negative affective bias. However, the impact that these changes have on higher-order, executive, decision-making processes is unclear. In this study, we examined the impact of a translational within-subjects stress induction (threat of unpredictable shock) on two well-established executive decision-making biases: the framing effect (N = 83), and temporal discounting (N = 36). In both studies, we demonstrate (a) clear subjective effects of stress, and (b) clear executive decision-making biases but (c) no impact of stress on these decision-making biases. Indeed, Bayes factor analyses confirmed substantial preference for decision-making models that did not include stress. We posit that while stress may induce subjective mood change and alter low-level perceptual and action processes (Robinson et al., 2013c), some higher-level executive processes remain unperturbed by these impacts. As such, although stress can induce a transient affective biases and altered mood, these need not result in poor financial decision-making.

Choice impulsivity: Definitions, measurement issues, and clinical implications

Impulsivity critically relates to many psychiatric disorders. Given the multifaceted construct that impulsivity represents, defining core aspects of impulsivity is vital for the assessment and understanding of clinical conditions. Choice impulsivity (CI), involving the preferential selection of smaller sooner rewards over larger later rewards, represents one important type of impulsivity. The International Society for Research on Impulsivity (InSRI) convened to discuss the definition and assessment of CI and provide recommendations regarding measurement across species. Commonly used preclinical and clinical CI behavioral tasks are described, and considerations for each task are provided to guide CI task selection. Differences in assessment of CI (self-report, behavioral) and calculating CI indices (e.g., area-under-the-curve, indifference point, and steepness of discounting curve) are discussed along with properties of specific behavioral tasks used in preclinical and clinical settings. The InSRI group recommends inclusion of measures of CI in human studies examining impulsivity. Animal studies examining impulsivity should also include assessments of CI and these measures should be harmonized in accordance with human studies of the disorders being modeled in the preclinical investigations. The choice of specific CI measures to be included should be based on the goals of the study and existing preclinical and clinical literature using established CI measures.