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Gelino BW, Graham ME, Strickland JC, Glatter HW, Hursh SR, Reed DD. Using behavioral economics to optimize safer undergraduate late-night transportation. J Appl Behav Anal 2024; 57:117-130. [PMID: 37932923 DOI: 10.1002/jaba.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 09/17/2023] [Indexed: 11/08/2023]
Abstract
Many universities sponsor student-oriented transit services that could reduce alcohol-induced risks but only if services adequately anticipate and adapt to student needs. Human choice data offer an optimal foundation for planning and executing late-night transit services. In this simulated choice experiment, respondents opted to either (a) wait an escalating delay for a free university-sponsored "safe" option, (b) pay an escalating fee for an on-demand rideshare service, or (c) pick a free, immediately available "unsafe" option (e.g., ride with an alcohol-impaired driver). Behavioral-economic nonlinear models of averaged-choice data describe preference across arrangements. Best-fit metrics indicate adequate sensitivity to contextual factors (i.e., wait time, preceding late-night activity). At short delays, students preferred the free transit option. As delays extend beyond 30 min, most students preferred competing alternatives. These data depict a policy-relevant delay threshold to better safeguard undergraduate student safety.
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Affiliation(s)
- Brett W Gelino
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
| | - Madison E Graham
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hannah W Glatter
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
| | - Steven R Hursh
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Institutes for Behavior Resources, Inc., Baltimore, MD, USA
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin-Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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3
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Stone BM. A positive psychology framework for why people use substances: Implications for treatment. Front Psychol 2022; 13:1017186. [PMID: 36248491 PMCID: PMC9557359 DOI: 10.3389/fpsyg.2022.1017186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/13/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Bryant M. Stone
- Department of Psychological and Behavioral Sciences, Institute of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
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Huynh A, Wisk LE. Application of behavioral economics for understanding health behaviors among adolescents and young adults. Curr Opin Pediatr 2022; 34:326-33. [PMID: 35793607 DOI: 10.1097/MOP.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Behavioral economics (BE) concepts have become well studied tools in addressing patient issues, such as weight loss, smoking cessation, and medication adherence. Although predominantly studied in adult populations, emerging literature has shown BE's utility for adolescent/young adult (AYA) populations, offering a practical framework to safeguard AYA health and influence healthy decision making. RECENT FINDINGS We identified substantive areas in which BE concepts have been applied in AYA populations (e.g., substance use) and outline how these concepts have been used as a tool to identify individuals at risk for poor outcomes and to leverage behavioral insights to improve health behaviors. SUMMARY BE research holds significant promise as a tool for clinicians and researchers to encourage healthy decision making in AYA populations. Yet, there are opportunities for BE research to expand further into current trends impacting adolescent health, such as electronic nicotine delivery systems, social media apps, and coronavirus disease 2019 vaccinations. Furthermore, the full degree of BE utility remains to be explored, as few studies demonstrate the translation of associative findings into direct interventions. Additional work is needed to formalize BE techniques into best practices that clinicians can implement in their daily practice.
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Abstract
Behavioral economic research demonstrates that alcohol and drug consumption is (a) an inverse function of constraints on access to the substance and (b) a direct function of constraints on access to alternative rewards. Physical distancing interventions and economic consequences of the COVID-19 pandemic have resulted in unprecedented reductions in many of the constraints on substance use and in critical evolutionarily salient sources of alternative reward, such as social interaction, physical activity, leisure activities and hobbies, and academic and occupational pursuits. Thus, behavioral economics suggests that the pandemic and necessary public health response have created a "perfect storm" for exacerbation of individual-level and population-level substance use problems and also points to multilevel intervention strategies. We summarize this perspective and research by highlighting 3 critical behavioral processes that will influence drug and alcohol consumption. First, the sudden absence of many effective constraints on substance use (work, school, community, or service obligations) will reduce the actual and perceived cost of use. Second, physical distancing measures will reduce the availability, and increase the cost, of many rewarding substance-free activities and commodities. Third, increased uncertainty around current and future events increases discounting of delayed rewards. These effects will be especially pernicious among populations with existing health disparities. Next, we outline interventions suggested by behavioral economics to mitigate the impact of COVID-19 on substance use that are aimed at increasing perceived costs of use; increasing access to substance-free activities, including treatment; and lengthening the timeframe for behavioral allocation and altering environmental contexts to promote healthy choices. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Naudé GP, Johnson MW, Strickland JC, Berry MS, Reed DD. At-Risk Drinking, Operant Demand, and Cross-Commodity Discounting as Predictors of Drunk Driving in Underage College Women. Behav Processes 2021; 195:104548. [PMID: 34801655 DOI: 10.1016/j.beproc.2021.104548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/03/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022]
Abstract
Behavioral economics offers unique tools for assessing value and motivation associated with college drinking. Tasks that model changes in consumption as a function of price (operant demand) or the decline in an outcome's subjective value as a function of time-to-occurrence (delay discounting) provide valuable information that may efficiently supplement clinical screening instruments when characterizing alcohol use severity. The first aim of this investigation was to examine the extent to which at-risk drinking, operant demand for alcohol, and single- and cross-commodity discounting of money and alcohol predict adverse consequences of past-month drinking in underage college women (N = 72). The second aim was to determine whether these clinical and behavioral economic measures could significantly predict the odds of past-month drunk driving, a serious public health concern due to the increasing prevalence of heavy episodic drinking among women in their first 1 - 2 years of college. Results showed that higher scores on the consumption factor of the Alcohol Use Disorder Identification Test (AUDIT-C), greater Persistence (consumption amidst constraint) and Amplitude (maximum consumption) of demand, as well as lower rates of discounting for choices between receiving alcohol now or double the amount after a delay (choosing the larger amount of alcohol even when it is delayed) significantly predicted adverse consequences of past-month drinking. Moreover, scores on the AUDIT-C, Amplitude of demand, and higher rates of discounting for choices between receiving alcohol now and money later (choosing immediately available alcohol at the expense of double the equivalent in delayed money) significantly predicted past-month drunk driving. We contend that operant demand along with single- and cross-commodity discounting can be viewed as intersecting measures of reinforcer value with clinical relevance to college women.
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Affiliation(s)
- Gideon P Naudé
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA.
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, University of Florida; Department of Psychology, University of Florida
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
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Acuff SF, Murphy JG. Commentary on Martínez-Loredo et al.: Where do we go from here? Increasing the clinical utility of alcohol purchase tasks by expanding our definition of constraint. Addiction 2021; 116:2651-2652. [PMID: 33763918 DOI: 10.1111/add.15481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Samuel F Acuff
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - James G Murphy
- Department of Psychology, The University of Memphis, Memphis, TN, USA
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Ferguson E, Bush N, Yurasek A, Boissoneault J. The effect of next day responsibilities and an adaptive purchase task on cannabis demand. Drug Alcohol Depend 2021; 227:108919. [PMID: 34340160 DOI: 10.1016/j.drugalcdep.2021.108919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The marijuana purchase task (MPT) is a commonly used behavioral economic measure of relative cannabis value (i.e. demand) that presents specific methodological concerns due to non-standardized measurement, variability in modality of use, and evolving legalization policies. Refinement of the task is critical to improve task ecological validity and accurate measurement of cannabis demand. The present study examined the construct validity of an adaptive MPT that allowed for participant selection of their preferred cannabis-based product and unit of measurement and the effect of next-day responsibilities on demand. METHODS Participants reporting at least monthly cannabis use (N = 186, 40.3 % women, Mage = 33.59) were recruited via Amazon Mechanical Turk and completed the original MPT and our adaptive form with 2 next-day responsibilities scenarios (no responsibilities vs. morning job interview) for each MPT. Cannabis use motives, problems, and risk for cannabis use disorder were also assessed. RESULTS Cannabis demand was sensitive to next-day responsibility, with higher hypothetical consumption observed in the no responsibilities condition. Responsibility-related decreases in Omax (F(1,185) = 4.83, p = .029, η2p = .03) were significantly greater on the adaptive MPT than the original MPT. Demand indices derived from the adaptive MPT were significantly correlated with cannabis problems (rbreakpoint = .19, rPmax = 0.18, relasticity=-0.18) and motives (rrange=-.32-.25), and demand metrics from the original MPT. CONCLUSIONS Results provide preliminary support for the construct validity of an adaptive MPT and suggest that early-morning work responsibilities may reduce cannabis demand. Continued research is needed to further refine this task and determine implications for cannabis use disorder intervention and prevention approaches.
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Affiliation(s)
- Erin Ferguson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
| | - Nicholas Bush
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
| | - Ali Yurasek
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA.
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Martínez-Loredo V, González-Roz A, Secades-Villa R, Fernández-Hermida JR, MacKillop J. Concurrent validity of the Alcohol Purchase Task for measuring the reinforcing efficacy of alcohol: an updated systematic review and meta-analysis. Addiction 2021; 116:2635-2650. [PMID: 33338263 PMCID: PMC9186155 DOI: 10.1111/add.15379] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/09/2020] [Accepted: 12/09/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS An early meta-analysis testing the concurrent validity of the Alcohol Purchase Task (APT), a measure of alcohol's relative reinforcing value, reported mixed associations, but predated a large number of studies. This systematic review and meta-analysis sought to: (1) estimate the relationships between trait-based alcohol demand indices from the APT and multiple alcohol indicators, (2) test several moderators and (3) analyze small study effects. METHODS A meta-analysis of 50 cross-sectional studies in four databases (n = 18 466, females = 43.32%). Sex, year of publication, number of APT prices and index transformations (logarithmic, square root or none) were considered as moderators. Small study effects were examined by using the Begg-Mazumdar, Egger's and Duval & Tweedie's trim-and-fill tests. Alcohol indicators were quantity of alcohol use, number of heavy drinking episodes, alcohol-related problems and hazardous drinking. APT indices were intensity (i.e. consumption at zero cost), elasticity (i.e. sensitivity to increases in costs), Omax (i.e. maximum expenditure), Pmax (i.e. price associated to Omax ) and breakpoint (i.e. price at which consumption ceases). RESULTS All alcohol demand indices were significantly associated with all alcohol-related outcomes (r = 0.132-0.494), except Pmax , which was significantly associated with alcohol-related problems only (r = 0.064). The greatest associations were evinced between intensity in relation to alcohol use, hazardous drinking and heavy drinking and between Omax and alcohol use. All the tested moderators emerged as significant moderators. Evidence of small-study effects was limited. CONCLUSIONS The Alcohol Purchase Task appears to have concurrent validity in alcohol research. Intensity and Omax are the most relevant indices to account for alcohol involvement.
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Affiliation(s)
- Victor Martínez-Loredo
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain,Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology, University of the Balearic Islands, Research Institute on Health Sciences, Palma de Mallorca, Spain,Department of Psychology, University of Oviedo, Oviedo, Spain
| | | | | | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph’s Healthcare Hamilton/McMaster University, Hamilton, ON, Canada
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Campbell KW, Voss AT, Acuff SF, Pebley K, Berlin KS, Martens MP, Borsari B, Dennhardt AA, Murphy JG. Statistically derived patterns of behavioral economic risk among heavy-drinking college students: A latent profile analysis. Exp Clin Psychopharmacol 2021; 29:191-202. [PMID: 32730058 PMCID: PMC8409244 DOI: 10.1037/pha0000420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
High levels of 3 behavioral economic indices (delay discounting, alcohol demand, and proportionate substance-related reinforcement) are consistently associated with greater alcohol misuse and alcohol-related problems. However, it is unclear whether and how these variables jointly increase the risk for alcohol-related outcomes among college students who engage in heavy episodic drinking (HED; 4/5+ drinks for women/men, respectively). The current study used a person-centered approach to identify similar patterns of behavioral economic domains among heavy-drinking college students and investigate the relationship between these empirically derived classes and alcohol-related outcomes. A sample of 393 college students (60.8% female, 78.9% White/Caucasian) reporting at least 2 heavy drinking episodes in the previous month completed measures of alcohol use and problems, demographics, delay discounting, and alcohol reward value (alcohol demand and proportionate substance-related reinforcement). Latent profile analyses revealed that a 3-class solution provided the best fit to the data: a low reward value, high discounting (LRHD) class (n = 53), a moderate reward value, low discounting (MRLD) class (n = 214), and a high reward value, high discounting (HRHD) class (n = 126). Members of the HRHD class reported significantly greater alcohol consumption, past-month HED episodes, alcohol-related problems, and symptoms of alcohol use disorder than those in the MRLD and LRHD classes. The results suggest that there are 3 constellations of behavioral economic processes and that, consistent with the reinforcer pathology model, students who overvalue alcohol-related reward and discount the future more steeply are at the greatest risk for alcohol misuse and alcohol-related problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | - Brian Borsari
- Mental Health Service San Francisco VA Health Care System
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Hardy L, Bakou AE, Shuai R, Acuff SF, MacKillop J, Murphy CM, Murphy JG, Hogarth L. Associations between the Brief Assessment of Alcohol Demand (BAAD) questionnaire and alcohol use disorder severity in UK samples of student and community drinkers. Addict Behav 2021; 113:106724. [PMID: 33203596 DOI: 10.1016/j.addbeh.2020.106724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022]
Abstract
Value based choice and compulsion theories of addiction offer distinct explanations for the persistence of alcohol use despite harms. Choice theory argues that problematic drinkers ascribe such high value to alcohol that costs are outweighed, whereas compulsion theory argues that problematic drinkers discount costs in decision making. The current study evaluated these predictions by testing whether alcohol use disorder (AUD) symptom severity (indexed by the AUDIT) was more strongly associated with the intensity item (maximum alcohol consumption if free, indexing alcohol value) compared to the breakpoint item (maximum expenditure on a single drink, indexing sensitivity to monetary costs) of the Brief Assessment of Alcohol Demand (BAAD) questionnaire, in student (n = 579) and community (n = 120) drinkers. The community sample showed greater AUD than the student sample (p = .004). In both samples, AUD severity correlated with intensity (students, r = 0.63; community, r = 0.47), but not with breakpoint (students, r = -0.01; community, r = 0.12). Similarly, multiple regression analyses indicated that AUD severity was independently associated with intensity (student, ΔR2 < 0.20, p < .001; community, ΔR2 = 0.09, p = .001) but not breakpoint (student, ΔR2 = 0.003, p = .118; community ΔR2 = 0.01, p = .294). There was no difference between samples in the strength of these associations. The value ascribed to alcohol may play a more important role in AUD severity than discounting of alcohol-associated costs (compulsivity), and there is no apparent difference between student and community drinkers in the contribution of these two mechanisms.
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Reed DD, Naudé GP, Salzer AR, Peper M, Monroe-Gulick AL, Gelino BW, Harsin JD, Foster RNS, Nighbor TD, Kaplan BA, Koffarnus MN, Higgins ST. Behavioral economic measurement of cigarette demand: A descriptive review of published approaches to the cigarette purchase task. Exp Clin Psychopharmacol 2020; 28:688-705. [PMID: 31961164 PMCID: PMC8428680 DOI: 10.1037/pha0000347] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The cigarette purchase task (CPT) is a behavioral economic method for assessing demand for cigarettes. Growing interest in behavioral correlates of tobacco use in clinical and general populations as well as empirical efforts to inform policy has seen an increase in published articles employing the CPT. Accordingly, an examination of the published methods and procedures for obtaining these behavioral economic metrics is timely. The purpose of this investigation was to provide a review of published approaches to using the CPT. We searched specific Boolean operators (["behavioral economic" AND "purchase task"] OR ["demand" AND "cigarette"]) and identified 49 empirical articles published through the year 2018 that reported administering a CPT. Articles were coded for participant characteristics (e.g., sample size, population type, age), CPT task structure (e.g., price framing, number and sequence of prices; vignettes, contextual factors), and data analytic approach (e.g., method of generating indices of cigarette demand). Results of this review indicate no standard approach to administering the CPT and underscore the need for replicability of these behavioral economic measures for the purpose of guiding clinical and policy decisions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Derek D. Reed
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Gideon P. Naudé
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Allyson R. Salzer
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | | | | | - Brett W. Gelino
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Joshua D. Harsin
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Rachel N. S. Foster
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, Kansas
| | - Tyler D. Nighbor
- Vermont Center on Behavior and Health, Burlington, Vermont, and University of Vermont
| | | | | | - Stephen T. Higgins
- Vermont Center on Behavior and Health, Burlington, Vermont, and University of Vermont
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Stancato SS, Schneider TD, Reed DD, Lemley SM, Carrillo A, Jarmolowicz DP. Reinforcer pathology II: Reward magnitude, reward delay, and demand for alcohol collectively relate to college students' alcohol related problems. J Exp Anal Behav 2020; 114:354-367. [PMID: 33184869 DOI: 10.1002/jeab.635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 01/08/2023]
Abstract
The reinforcer pathologies model of addiction posits that two characteristic patterns of operant behavior characterize addiction. Specifically, individuals suffering from addiction have elevated levels of behavioral economic demand for their substances of abuse and have an elevated tendency to devalue delayed rewards (reflected in high delay discounting rates). Prior research has demonstrated that these behavioral economic markers are significant predictors of many of college students' alcohol-related problems. Delay discounting, however, is a complex behavioral performance likely undergirded by multiple behavioral processes. Emerging analytical approaches have isolated the role of participants' sensitivity to changes in reinforcer magnitude and changes in reinforcer delay. The current study uses these analytic approaches to compare participants' discounting of money versus alcohol, and to build regression models that leverage these new insights to predict a wider range of college students' alcohol related problems. Using these techniques, we were able to 1) demonstrate that individuals differed in their sensitivity to magnitudes of alcohol versus money, but not sensitivity to delays to those commodities and 2) that we could use our behavioral economic measures to predict a range of students' alcohol related problems.
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Affiliation(s)
| | | | - Derek D Reed
- University of Kansas.,Cofrin Logan Center for Addiction Research and Treatment
| | | | | | - David P Jarmolowicz
- University of Kansas.,Cofrin Logan Center for Addiction Research and Treatment
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Meshesha LZ, Aston ER, Teeters JB, Blevins CE, Battle CL, Marsh E, Feltus S, Stein MD, Abrantes AM. Evaluating alcohol demand, craving, and depressive symptoms among women in alcohol treatment. Addict Behav 2020; 109:106475. [PMID: 32480282 DOI: 10.1016/j.addbeh.2020.106475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression and alcohol craving predict drinking and relapse rates among alcohol treatment seekers. Alcohol demand, or one's valuation of alcohol may be another determinant of drinking. There is little known about alcohol demand and its association with depression, craving, and drinking among treatment-seeking adults. METHOD Participants were 71 women with elevated depressive symptoms seeking outpatient treatment for alcohol use disorder (AUD). At baseline, participants self-reported daily drinking amount, alcohol craving, depressive symptoms, and alcohol demand assessed with the alcohol purchase task (APT; a task requesting participants to make hypothetical purchases of drinks at escalating prices). Baseline associations among alcohol demand, depressive symptoms, alcohol craving, and drinking severity were assessed. RESULTS Participants averaged 40.68 (SD = 11.78) years of age, consumed 8.84 (SD = 5.14) drinks per drinking day and reported 15.45 (SD = 7.51) heavy drinking days in the past 30 days, and had an average PHQ-9 depression score of 13.00 (SD = 4.28). Results suggest that the alcohol demand metrics of intensity (consumption level when drinks are free) and Omax (maximum expenditure on alcohol) were associated with drinks per drinking day, whereas craving and depressive symptoms were not significantly associated with drinking. The number of heavy drinking days were not significantly associated with demand, craving, or depressive symptoms. CONCLUSIONS These results suggest that demand may reflect unique risk for drinking relative to craving or depressive symptoms. These findings provide support for the utility of the APT within a clinical setting to assess individualized valuation of alcohol.
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Hogarth L, Field M. Relative expected value of drugs versus competing rewards underpins vulnerability to and recovery from addiction. Behav Brain Res 2020; 394:112815. [PMID: 32707138 PMCID: PMC7495042 DOI: 10.1016/j.bbr.2020.112815] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/13/2022]
Abstract
Behavioural economic theories of addiction contend that greater expected value of drug relative to alternative non-drug rewards is the core mechanism underpinning vulnerability to and recovery from addiction. To evaluate this claim, we exhaustively review studies with human drug users that have measured concurrent choice between drugs vs. alternative rewards, and explored individual differences. These studies show that drug choice can be modulated by drug cues, drug devaluation, imposition of costs/punishment and negative mood induction. Regarding individual differences, dependence severity was reliably associated with overall drug preference, and self-reported drug use to cope with negative affect was reliably associated with greater sensitivity to mood induced increases in drug choice. By contrast, there were no reliable individual differences in sensitivity to the effect of drug cues, drug devaluation or punishment on drug choice. These findings provide insight into the mechanisms that underpin vulnerability to dependence: vulnerability is conferred by greater relative value ascribed to drugs, and relative drug value is further augmented by negative affective states in those who report drug use coping motives. However, dependence does not appear to be characterised by abnormal cue-reactivity, habit learning or compulsion. We then briefly review emerging literature which demonstrates that therapeutic interventions and recovery from addiction might be attributed to changes in the expected relative value of drug versus alternative rewards. Finally, we outline a speculative computational account of the distortions in decision-making that precede action selection in addiction, and we explain how this account provides a blueprint for future research on the determinants of drug choice, and mechanisms of treatment and recovery from addiction. We conclude that a unified economic decision-making account of addiction has great promise in reconciling diverse addiction theories, and neuropsychological evaluation of the underlying decision mechanisms is a fruitful area for future research and treatment.
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Affiliation(s)
- Lee Hogarth
- Lee Hogarth, School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, UK.
| | - Matt Field
- Department of Psychology, University of Sheffield
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16
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Acuff SF, Amlung M, Dennhardt AA, MacKillop J, Murphy JG. Experimental manipulations of behavioral economic demand for addictive commodities: a meta-analysis. Addiction 2020; 115:817-831. [PMID: 31656048 PMCID: PMC7156308 DOI: 10.1111/add.14865] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/19/2019] [Accepted: 10/14/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Reinforcing value, an index of motivation for a drug, is commonly measured using behavioral economic purchase tasks. State-oriented purchase tasks are sensitive to phasic manipulations, but with heterogeneous methods and findings. The aim of this meta-analysis was to characterize the literature examining manipulations of reinforcing value, as measured by purchase tasks and multiple-choice procedures, to inform etiological models and treatment approaches METHODS: A random-effects meta-analysis of published findings in peer-reviewed articles. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol, studies were gathered through searches in PsycINFO and PubMed/MEDLINE (published 22 May 2018). Searches returned 34 unique studies (aggregate sample n = 2402; average sample size = 68.94) yielding 126 effect sizes. Measurements included change (i.e. Cohen's d) in six behavioral economic indices (intensity, breakpoint, Omax , Pmax , elasticity, cross-over point) in relation to six experimental manipulations (cue exposure, stress/negative affect, reinforcer magnitude, pharmacotherapy, behavioral interventions, opportunity cost). RESULTS Cue exposure (d range = 0.25-0.44, all Ps < 0.05) and reinforcer magnitude [d = 0.60; 95% confidence interval (CI) = 0.18, 1.01; P < 0.005] manipulations resulted in significant increases in behavioral economic demand across studies. Stress/negative affect manipulations also resulted in a small, significant increase in Omax (d = 0.18; 95% CI = 0.01, 0.34; P = 0.03); all other effect sizes for negative affect/stress were non-significant, albeit similar in size (d range = 0.14-0.18). In contrast, pharmacotherapy (d range = -0.37 to -0.49; Ps < 0.04), behavioral intervention (d = -0.36 to -1.13) and external contingency (d = -1.42; CI = -2.30, -0.54; P = 0.002) manipulations resulted in a significant decrease in intensity. Moderators (substance type) explained some of the heterogeneity in findings across meta-analyses. CONCLUSIONS In behavioral economic studies, purchase tasks and multiple-choice procedures appear to provide indices that are sensitive to manipulations found to influence motivation to consume addictive substances in field experiments.
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Affiliation(s)
- Samuel F. Acuff
- Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University/St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | | | - James MacKillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University/St Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - James G. Murphy
- Department of Psychology, The University of Memphis, Memphis, TN, USA
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17
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Abstract
The marijuana purchase task (MPT) is a behavioral economic measure of individualized cannabis value (i.e., demand). The MPT follows purchase tasks for other substances (e.g., alcohol, tobacco), though presents with unique caveats due to its mixed illicit status, non-uniform units of purchase and use, and substantial within substance variability in strain, potency, and quality. As the regulatory climate surrounding purchase and use of cannabis continues to evolve in the USA and globally, rigorous assessment of cannabis use and value are of the utmost importance. This study represents the first comprehensive review of investigations utilizing the MPT. Searches through PubMed and Web of Science databases by two independent coders identified 15 empirical articles referencing the use of an MPT and were published through the year 2019. Articles were coded for demographic and procedural characteristics, structural characteristics of the MPT itself, data analytic characteristics, and relationships with cannabis-related outcomes. Rigorous assessment of demand for cannabis is essential with respect to the broad public health issues surrounding cannabis legalization. We have synthesized the research presented herein and comment on vital considerations for subsequent MPT work, including recommendations for a unified approach to using the MPT in subsequent research.
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Affiliation(s)
- Elizabeth R Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912, USA.
- Department of Behavioral and Social Sciences, Brown University School of Public Heath, Providence, RI, 02912, USA.
| | - Lidia Z Meshesha
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02912, USA
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18
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Bickel WK, Athamneh LN, Snider SE, Craft WH, DeHart WB, Kaplan BA, Basso JC. Reinforcer Pathology: Implications for Substance Abuse Intervention. Curr Top Behav Neurosci 2020; 47:139-162. [PMID: 32462615 DOI: 10.1007/7854_2020_145] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The rate at which individuals discount future rewards (i.e., discounting rate) is strongly associated with their propensity for substance abuse as well as myriad other negative health behaviors. An excessive preference for immediately available rewards suggests a shortened time horizon in which immediate rewards are overvalued and future, potentially negative consequences are undervalued. This review outlines Reinforcer Pathology Theory (i.e., the interaction between excessive preference for immediately available rewards and the overvaluation of a particular commodity that offers brief, intense reinforcement), its neurobiological/behavioral underpinnings, and its implications for treating substance use disorders. In doing so, the current review provides an overview of a variety of ways in which interventions have been used to manipulate aspects of reinforcer pathology in an individual, including narrative theory, framing manipulations, and neuromodulation (e.g., working memory training, TMS) which may serve as promising avenues for the modulation of the temporal window and/or valuation of reinforcers.
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Affiliation(s)
- Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute, Roanoke, VA, USA. .,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute, Roanoke, VA, USA.
| | - Liqa N Athamneh
- Addiction Recovery Research Center, Fralin Biomedical Research Institute, Roanoke, VA, USA.,Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Sarah E Snider
- Addiction Recovery Research Center, Fralin Biomedical Research Institute, Roanoke, VA, USA
| | - William H Craft
- Addiction Recovery Research Center, Fralin Biomedical Research Institute, Roanoke, VA, USA.,Graduate Program in Translational Biology, Medicine, and Health, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - William B DeHart
- Addiction Recovery Research Center, Fralin Biomedical Research Institute, Roanoke, VA, USA
| | - Brent A Kaplan
- Addiction Recovery Research Center, Fralin Biomedical Research Institute, Roanoke, VA, USA
| | - Julia C Basso
- Addiction Recovery Research Center, Fralin Biomedical Research Institute, Roanoke, VA, USA
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19
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Joyner KJ, Meshesha LZ, Dennhardt A, Borsari B, Martens MP, Murphy JG. High Opportunity Cost Demand as an Indicator of Weekday Drinking and Distinctly Severe Alcohol Problems: A Behavioral Economic Analysis. Alcohol Clin Exp Res 2019; 43:2607-2619. [PMID: 31661166 PMCID: PMC6904428 DOI: 10.1111/acer.14206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/25/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Behavioral economic theory views addiction as a reinforcer pathology characterized by excessive demand for drugs relative to alternatives. Complementary to this theory, Lamb and Ginsburg (Pharmacology Biochemistry and Behavior, 164, 2018, 62) describe addiction as a behavioral allocation disorder and predict that decisions to drink under increasingly stringent constraints are a central indicator of addiction. This study used a modified demand-curve paradigm to examine alcohol demand in the context of a next-day contingency (high opportunity cost demand) as a specific indicator of a severe pattern of alcohol problems. METHODS Participants were 370 undergraduates (61.1% female, 86.5% white, Mage = 18.8) reporting multiple past-month heavy drinking episodes (5/4 drinks per occasion for men/women) who completed 2 versions of an alcohol purchase task (APT), along with measures of past-month alcohol use and problems. In 1 APT (low opportunity cost), students imagined they had no next-day responsibilities, and in the other APT (high opportunity cost), they imagined having a 10:00 am test the next day. Item-response theory analyses were used to determine mild and severe alcohol problems from the Young Adult Alcohol Consequences Questionnaire (Journal of Studies on Alcohol, 67, 2006, 169), and the most and least severe binge drinking days throughout the week. RESULTS Low opportunity cost demand (β = 0.15, p = 0.02) significantly predicted beyond high opportunity cost demand for the least severe problems, and high opportunity cost demand (β = 0.17, p = 0.009) significantly predicted beyond low opportunity cost demand for the most severe problems. Similarly, low opportunity cost demand (β = 0.26, p < 0.001) was more highly associated with weekend drinking, whereas high opportunity cost demand (β = 0.21, p = 0.001) was more highly associated with weekday drinking. CONCLUSIONS The current results suggest high opportunity cost alcohol demand is a distinct marker of severe alcohol problems among college student heavy drinkers.
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Affiliation(s)
- Keanan J. Joyner
- Florida State University, Department of Psychology, 1107 W Call St., Tallahassee, FL, 32304, USA
| | - Lidia Z. Meshesha
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Providence, RI, 02912, USA
| | - Ashley Dennhardt
- University of Memphis, Department of Psychology, 400 Innovation Dr., Memphis, TN 38152, USA
| | - Brian Borsari
- Mental Health Service (116B), San Francisco VA Medical Center, 4150 Clement St., San Francisco CA 94121 and Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA 94143
| | - Matthew P. Martens
- University of Missouri, Department of Educational, School, and Counseling Psychology, 203 Jesse Hall, Columbia, MO, 65211, USA
| | - James G. Murphy
- University of Memphis, Department of Psychology, 400 Innovation Dr., Memphis, TN 38152, USA
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20
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Zvorsky I, Nighbor TD, Kurti AN, DeSarno M, Naudé G, Reed DD, Higgins ST. Sensitivity of hypothetical purchase task indices when studying substance use: A systematic literature review. Prev Med 2019; 128:105789. [PMID: 31400376 PMCID: PMC6879840 DOI: 10.1016/j.ypmed.2019.105789] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/30/2019] [Accepted: 08/06/2019] [Indexed: 01/09/2023]
Abstract
Hypothetical Purchase Tasks (HPTs) simulate demand for a substance as a function of escalating price. HPTs are increasingly used to examine relationships between substance-related correlates and outcomes and demand typically characterized using a common battery of indices (Intensity, Omax, Pmax, Breakpoint, Elasticity). This review examines the relative sensitivity of the HPT indices. Reports were identified using the search term "purchase task" in PubMed and Web of Science. For inclusion, reports had to be original studies in English, examine relationships between HPT indices and substance-related correlates or outcomes, and appear in a peer-reviewed journal through December 2017. Indices were compared using effect sizes (Cohen's d) and the proportion of studies in which statistically significant relationships were observed. The search identified 1274 reports with 114 (9%) receiving full-text review and 82 (6%) meeting inclusion criteria. 41 reports examined alcohol, 34 examined cigarettes/nicotine products, and 10 examined other substances. Overall, statistically significant relationships between HPT indices and substance-related correlates and outcomes were most often reported for Intensity (88.61%, 70/79), followed by Omax (81.16%, 56/69), Elasticity (72.15%, 57/59), Breakpoint (62.12%, 41/66), and Pmax (48.08%; 25/52). The largest effect sizes were observed for Intensity (0.75 ± 0.04, CI 0.67-0.84) and Omax (0.64 ± 0.04, CI 0.56-0.71), followed by Elasticity (0.44 ± 0.04, CI 0.37-0.51), Breakpoint (0.30 ± 0.03, CI 0.25-0.36), and Pmax (0.25 ± 0.04, CI 0.18-0.33). Patterns were largely consistent across substances. In conclusion, HPTs can be highly effective in revealing relationships between demand and substance-related correlates and outcomes, with Intensity and Omax exhibiting the greatest sensitivity.
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Affiliation(s)
- Ivori Zvorsky
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America
| | - Tyler D Nighbor
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America
| | - Allison N Kurti
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America
| | - Michael DeSarno
- Department of Biomedical Statistics, University of Vermont, United States of America
| | - Gideon Naudé
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, United States of America
| | - Derek D Reed
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, United States of America
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America.
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21
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Teeters JB, Meshesha LZ, Dennhardt AA, Murphy JG. Elevated Demand and Proportionate Substance-related Reinforcement are Associated with Driving after Cannabis Use. Canadian Journal of Addiction 2019; 10:42-50. [DOI: 10.1097/cxa.0000000000000062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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22
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Salzer AR, Gelino BW, Reed DD. Left-digit pricing effects in a high-resolution examination of hypothetical operant demand for alcohol. Behav Processes 2019; 165:51-57. [DOI: 10.1016/j.beproc.2019.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/09/2019] [Accepted: 05/17/2019] [Indexed: 12/30/2022]
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23
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Nighbor TD, Zvorsky I, Kurti AN, Skelly JM, Bickel WK, Reed DD, Naudé GP, Higgins ST. Examining interrelationships between the Cigarette Purchase Task and delay discounting among pregnant women. J Exp Anal Behav 2019; 111:405-415. [PMID: 30681144 PMCID: PMC6508990 DOI: 10.1002/jeab.499] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 01/02/2019] [Indexed: 11/11/2022]
Abstract
Two common behavioral economic simulation tasks used to study cigarette smoking are the Cigarette Purchase Task, a measure of cigarette demand, and delay discounting, a measure of the subjective value of rewards as a function of delays to delivery. Few studies have evaluated whether combining these tasks enhances understanding of smoking beyond either alone. The current study represents an initial evaluation of the intersection between cigarette demand indices and delay discounting among pregnant smokers by examining associations between these measures and whether a woman makes antepartum quit attempts before entering prenatal care (a reliable predictor of eventual quitting). Participants were 159 pregnant women enrolled in a smoking-cessation trial. Low O max and shallow discounting were each associated with antepartum quit attempts. Participants were next categorized into four subgroups (low O max , shallow discounting; low O max , steep discounting; high O max , shallow discounting; high O max , steep discounting) using median splits. Those with shallow discounting and low O max were more likely to have made quit attempts than each of the other three subgroups. That is, steep discounting appears to undermine the association of low O max and efforts to quit smoking during pregnancy while high O max overshadows any protective influence associated with shallow discounting.
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Affiliation(s)
- Tyler D. Nighbor
- Vermont Center on Behavior and Health
- Department of Psychiatry, University of Vermont
| | - Ivori Zvorsky
- Vermont Center on Behavior and Health
- Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Allison N. Kurti
- Vermont Center on Behavior and Health
- Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Joan M. Skelly
- Department of Medical Biostatistics, University of Vermont
| | - Warren K. Bickel
- Addiction Recovery Research Center, Virginia Tech Carillion Research Institute
| | - Derek D. Reed
- Department of Applied Behavioral Science, University of Kansas
| | - Gideon P. Naudé
- Department of Applied Behavioral Science, University of Kansas
| | - Stephen T. Higgins
- Vermont Center on Behavior and Health
- Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
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24
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Lindgren KP, Hendershot CS, Ramirez JJ, Bernat E, Rangel-Gomez M, Peterson KP, Murphy JG. A dual process perspective on advances in cognitive science and alcohol use disorder. Clin Psychol Rev 2019; 69:83-96. [PMID: 29680185 PMCID: PMC6181791 DOI: 10.1016/j.cpr.2018.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
There is a tremendous global and national (US) burden associated with alcohol misuse and alcohol use disorder (AUD). Further, of the mental health disorders, AUD has the widest treatment gap. Thus, there is a critical need for improved understanding of the etiology, maintenance, and treatment of AUD. The application of cognitive science to the study of AUD has a longstanding history of attempting to meet this need. In this selective review, we identified and focused on four domains of recent (i.e., in the last decade) applications of cognitive science to the study of AUD: implicit cognitive biases, executive function, behavioral economic approaches to alcohol decision making, and functional connectivity neuroimaging. We highlighted advances within these four domains and considered them in the context of dual process models of addiction, which focus on the contribution and interplay of two complementary neurocognitive systems (impulsive and control systems). Findings across the domains were generally consistent with dual process models. They also suggest the need for further model refinements, including integrating behavioral economic approaches and findings from functional connectivity neuroimaging studies. Research evaluating candidate interventions associated with these domains is emergent but promising, suggesting important directions for future research.
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Affiliation(s)
- Kristen P Lindgren
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Christian S Hendershot
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jason J Ramirez
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Edward Bernat
- Department of Psychology, University of Maryland, College Park, MD, USA
| | | | - Kirsten P Peterson
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, TN, USA
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25
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Abstract
Many negative outcomes associated with alcohol consumption stem from individual decision making, such as the decision whether or not to drive after drinking. Understanding biases in decision making as they relate to alcohol, and measuring variability in decision strategies across individuals, can be a tool for improving policy. For alcohol-related policy, both addiction and the acute effects of intoxication are potential sources of bias or heterogeneity in decision strategy, and we provide a brief primer on how they can affect decision making. We then discuss two alcohol policy domains, alcohol impaired driving and excessive consumption. We review potential implications of major findings in decision making research for each of these domains, and point out how policy could take account of biases and variability in decision making.
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26
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Patel H, Reed DD, Mackillop J, Amlung M. Clarifying the Relation Between Alcohol Demand and Alcohol-related Relative Reinforcement and Driving After Drinking in a Canadian Community Sample. Canadian Journal of Addiction 2019; 10:16-23. [DOI: 10.1097/cxa.0000000000000048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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27
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Acuff SF, MacKillop J, Murphy JG. Applying behavioral economic theory to problematic Internet use: An initial investigation. Psychol Addict Behav 2019; 32:846-857. [PMID: 30451521 DOI: 10.1037/adb0000404] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The widespread availability of the Internet has had profound social, educational, and economic benefits. Yet, for some, Internet use can become compulsive and problematic. The current study seeks to apply a behavioral economic framework to Internet use, testing the hypothesis that, similar to other addictive behaviors, problematic Internet use is a reinforcer pathology, reflecting an overvaluation of an immediately acquirable reward relative to prosocial and delayed rewards. Data were collected through Amazon's Mechanical Turk data collection platform. A total of 256 adults (Mage = 27.87, SD = 4.79; 58.2% White, 23% Asian; 65.2% had an associate degree or greater) completed the survey. Measures of delay discounting, consideration of future consequences, Internet demand, and alternative reinforcement all contributed unique variance in predicting both problematic Internet use and Internet craving. In aggregate models controlling for all significant predictors, alternative reinforcement and future valuation variables contributed unique variance. Individuals with elevated demand and discounting were at greatest risk for problematic Internet use. Consistent with behavioral economic research among substance abusing samples, individuals engaging in heavy Internet use report elevated motivation for the target behavior coupled with diminished motivation for other potentially rewarding activities, especially those associated with delayed reward. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | - James MacKillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University/St Joseph's Healthcare Hamilton
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28
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Kaplan BA, Foster RNS, Reed DD, Amlung M, Murphy JG, MacKillop J. Understanding alcohol motivation using the alcohol purchase task: A methodological systematic review. Drug Alcohol Depend 2018; 191:117-140. [PMID: 30099174 DOI: 10.1016/j.drugalcdep.2018.06.029] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/27/2018] [Accepted: 06/29/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Alcohol Purchase Task (APT) is a behavioral economic assessment of alcohol demand (i.e., motivation for consumption during escalating levels of response cost) using simulated marketplace survey techniques. While the APT is often used and widely cited, to date, there has yet to be a systematic review elucidating the variability in administering and analyzing the APT. The purpose of the current paper is to address this knowledge gap in the literature by cataloging the various purchase task methodologies and providing recommendations and future areas of inquiry. METHODS The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology was utilized (Prospero: No. CRD42017072159). Searches through Google Scholar, PsychINFO, PubMed, and SpringerLink databases identified 47 empirical articles referencing the use of an APT and published through the year 2016. Articles were coded for demographic and procedural characteristics, structural characteristics of the APT itself, and characteristics of data analysis. RESULTS Results indicate substantial variation within categories and suggest that there is no standard approach to administering the APT or analyzing the responses generated from it. The results underscore the need for researchers to report as much information as possible related to administration, instructions, price structuring, and analytical approach, as we found that many articles did not provide these details. CONCLUSION Enhancing the transparency of APT methods and analyses in published reports will aid in reproducibility as well as future meta-analytic studies of alcohol demand that could lead to the development of best-practice recommendations for this procedure.
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Affiliation(s)
- Brent A Kaplan
- Virginia Tech Carilion Research Institute, Virginia Polytechnic Institute and State University, Roanoke, VA USA; Department of Applied Behavioral Science, University of Kansas, Lawrence, KS USA.
| | - Rachel N S Foster
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS USA
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS USA
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, TN USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
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29
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Acuff SF, Soltis KE, Dennhardt AA, Berlin KS, Murphy JG. Evaluating Behavioral Economic Models of Heavy Drinking Among College Students. Alcohol Clin Exp Res 2018; 42:1304-1314. [PMID: 29757460 DOI: 10.1111/acer.13774] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 04/30/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Heavy drinking among college students is a significant public health concern that can lead to profound social and health consequences, including alcohol use disorder. Behavioral economics posits that low future orientation and high valuation of alcohol (alcohol demand) combined with deficits in alternative reinforcement increase the likelihood of alcohol misuse. Despite this, no study has examined the incremental utility of all 3 variables simultaneously in a comprehensive model. METHODS This study uses structural equation modeling to test the associations between behavioral economic variables-alcohol demand (latent), future orientation (measured with a delay discounting task and the Consideration of Future Consequences [CFC] scale), and proportionate substance-related reinforcement-and alcohol consumption and problems among 393 heavy drinking college students. Two models are tested as follows: (i) an iteration of the reinforcer pathology model that includes an interaction between future orientation and alcohol demand; and (ii) an alternative model evaluating the interconnectedness of behavioral economic variables in predicting problematic alcohol use. RESULTS The interaction effects in Model 1 were nonsignificant. Model 2 suggests that greater alcohol demand and proportionate substance-related reinforcement are associated with greater alcohol consumption and problems. Furthermore, CFC was associated with alcohol-related problems and lower proportionate substance-related reinforcement but was not significantly associated with alcohol consumption or alcohol demand. Finally, greater proportionate substance-related reinforcement was associated with greater alcohol demand. CONCLUSIONS Our results support the validity of the behavioral economic reinforcer pathology model as applied to young adult heavy drinking.
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Affiliation(s)
- Samuel F Acuff
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Kathryn E Soltis
- Department of Psychology, The University of Memphis, Memphis, Tennessee
| | | | | | - James G Murphy
- Department of Psychology, The University of Memphis, Memphis, Tennessee
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Voss AT, Soltis K, Dennhardt AA, Martens MP, Murphy JG. Protective behavioral strategies mediate the relationship between behavioral economic risk factors and alcohol-related problems. Exp Clin Psychopharmacol 2018; 26:58-64. [PMID: 29323504 PMCID: PMC5794516 DOI: 10.1037/pha0000169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Behavioral economic measures of alcohol reward value and future orientation have received support as predictors of alcohol consumption, alcohol-related problems, and response to intervention. Protective behavioral strategies (PBS) have been shown to be a significant mediator between a variety of risk factors and alcohol-related problems. The current article examines direct and mediating associations between measures of alcohol reward value (proportionate substance-related activity participation and enjoyment) and future orientation, use of PBS, and alcohol-related problems. Participants were 393 undergraduates (39.2% male, 78.9% Caucasian) who reported at least 2 past-month binge drinking episodes (5 and 4 drinks for men and women, respectively). This study is a secondary analysis of data collected previously as part of a brief intervention study. Alcohol reward value and future orientation were significantly associated with both protective behavioral strategies and alcohol problems. PBS was a significant partial mediator between these variables and alcohol-related problems after controlling for gender, level of alcohol consumption, and sensation seeking. This study provides support for the hypothesis that high levels of reinforcement from alcohol relative to alternatives and low consideration of the future may lead to patterns of dysregulated drinking with few harm-reduction strategies that increase risk for alcohol problems. In addition to directly targeting PBS, brief alcohol interventions for college students should attempt to increase future orientation and substance-free activities. (PsycINFO Database Record
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Affiliation(s)
- Andrew T. Voss
- University of Memphis, Department of Psychology, 400 Innovation Dr., Memphis, TN 38152, USA
| | - Kathryn Soltis
- University of Memphis, Department of Psychology, 400 Innovation Dr., Memphis, TN 38152, USA
| | - Ashley A. Dennhardt
- University of Memphis, Department of Psychology, 400 Innovation Dr., Memphis, TN 38152, USA
| | - Matthew P. Martens
- University of Missouri, Department of Educational, School, and Counseling Psychology, Columbia, MO, 65211, USA
| | - James G. Murphy
- University of Memphis, Department of Psychology, 400 Innovation Dr., Memphis, TN 38152, USA
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Amlung M, Morris DH, Hatz LE, Teeters JB, Murphy JG, McCarthy DM. Drinking-and-Driving-Related Cognitions Mediate the Relationship Between Alcohol Demand and Alcohol-Impaired Driving. J Stud Alcohol Drugs 2017; 77:656-60. [PMID: 27340971 DOI: 10.15288/jsad.2016.77.656] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Elevated behavioral economic demand for alcohol has been shown to be associated with drinking and driving in college students. The present study sought to clarify the underlying mechanisms of this relationship by examining whether drinking-and-driving-related cognitions (e.g., attitudes, perceptions, and normative beliefs) mediate the association between alcohol demand and drinking and driving. METHOD A total of 134 young adult social drinkers completed an alcohol purchase task and measures of perceived dangerousness of drinking and driving, normative beliefs about drinking and driving, and perceived driving limit (i.e., perceived number of drinks one could consume and still drive safely). The frequency of drinking and driving in the past year was assessed via self-report. RESULTS Individuals who reported drinking and driving exhibited greater alcohol demand (intensity, Omax, and elasticity) compared with those who did not engage in drinking and driving. Increased demand was also correlated with more favorable drinking-and-driving cognitions. Indirect effects tests revealed that perceived driving limit partially mediated the relationship between alcohol demand and drinking-and-driving behavior, even after accounting for drinking level, sex, and delay discounting. CONCLUSIONS These findings provide further support for the utility of behavioral economic theory in understanding drinking-and-driving behavior. In particular, they provide evidence for one mechanism-drinking-and-driving-related cognitions-by which alcohol demand influences drinking and driving. Additional research using longitudinal and experimental designs is required to confirm this model and to identify other potential mediators.
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Affiliation(s)
- Michael Amlung
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - David H Morris
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Laura E Hatz
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Jenni B Teeters
- Department of Psychology, University of Memphis, Memphis, Tennessee
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, Tennessee
| | - Denis M McCarthy
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
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Dennhardt AA, Murphy JG, McDevitt-Murphy ME, Williams JL. Drinking motives mediate the relationship between alcohol reward value and alcohol problems in military veterans. Psychol Addict Behav 2017; 30:819-826. [PMID: 28068111 DOI: 10.1037/adb0000197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Elevated alcohol reward value (RV) has been linked to higher levels of drinking and alcohol-related consequences, and there is evidence that specific drinking motives may mediate the relationship between demand and problematic alcohol use in college students, making these variables potentially important indicators of risk for high RV and alcohol problems. The present study evaluated these relationships in a high-risk sample of military veterans. Heavy-drinking (N = 68) veterans of Operations Enduring Freedom or Iraqi Freedom (OEF/OIF) completed the alcohol purchase task (APT) measure of alcohol demand (RV), and standard assessments of alcohol consumption, alcohol-related problems, and drinking motives. RV was associated with overall alcohol consequences, interpersonal alcohol consequences, social responsibility consequences and impulse control consequences. Mediation analyses indicated significant mediation of the relationships between RV and a number of problem subscales by social motives, coping-anxiety motives, coping-depression motives and enhancement motives. This suggests that individuals who have a high valuation of alcohol may have increased motivation to drink in social, mood-enhancement, and coping situations, resulting in increased alcohol-related consequences. Demand and drinking motives should be examined as potential indicators of need for intervention services and as treatment targets in veterans. (PsycINFO Database Record
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Amlung M, Vedelago L, Acker J, Balodis I, MacKillop J. Steep delay discounting and addictive behavior: a meta-analysis of continuous associations. Addiction 2017; 112:51-62. [PMID: 27450931 PMCID: PMC5148639 DOI: 10.1111/add.13535] [Citation(s) in RCA: 307] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/27/2016] [Accepted: 07/15/2016] [Indexed: 12/19/2022]
Abstract
AIMS To synthesize continuous associations between delayed reward discounting (DRD) and both addiction severity and quantity-frequency (QF); to examine moderators of these relationships; and to investigate publication bias. METHODS Meta-analysis of published studies examining continuous associations between DRD and addictive behaviors. Published, peer-reviewed studies on addictive behaviors (alcohol, tobacco, cannabis, stimulants, opiates and gambling) were identified via PubMed, MEDLINE and PsycInfo. Studies were restricted to DRD measures of monetary gains. Random-effects meta-analysis was conducted using Pearson's r as the effect size. Publication bias was evaluated using fail-safe N, Begg-Mazumdar and Egger's tests, meta-regression of publication year and effect size and imputation of missing studies. RESULTS The primary meta-analysis revealed a small magnitude effect size that was highly significant (r = 0.14, P < 10-14 ). Significantly larger effect sizes were observed for studies examining severity compared with QF (P = 0.01), but not between the type of addictive behavior (P = 0.30) or DRD assessment (P = 0.90). Indices of publication bias suggested a modest impact of unpublished findings. CONCLUSIONS Delayed reward discounting is associated robustly with continuous measures of addiction severity and quantity-frequency. This relation is generally robust across type of addictive behavior and delayed reward discounting assessment modality.
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Affiliation(s)
- Michael Amlung
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton; 100 West 5 St, Hamilton, Ontario, Canada L8N 3K7
| | - Lana Vedelago
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton; 100 West 5 St, Hamilton, Ontario, Canada L8N 3K7
| | - John Acker
- Center for Integrated Healthcare, Syracuse VA Medical Center; Syracuse, NY 13210 USA
| | - Iris Balodis
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton; 100 West 5 St, Hamilton, Ontario, Canada L8N 3K7
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton; 100 West 5 St, Hamilton, Ontario, Canada L8N 3K7,Homewood Research Institute, Homewood Health Centre; 150 Delhi St, Guelph, Ontario, Canada N1E 6K9
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Aston ER, Metrik J, Amlung M, Kahler CW, MacKillop J. Interrelationships between marijuana demand and discounting of delayed rewards: Convergence in behavioral economic methods. Drug Alcohol Depend 2016; 169:141-147. [PMID: 27810657 PMCID: PMC5140845 DOI: 10.1016/j.drugalcdep.2016.10.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/09/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Distinct behavioral economic domains, including high perceived drug value (demand) and delay discounting (DD), have been implicated in the initiation of drug use and the progression to dependence. However, it is unclear whether frequent marijuana users conform to a "reinforcer pathology" addiction model wherein marijuana demand and DD jointly increase risk for problematic marijuana use and cannabis dependence (CD). METHODS Participants (n=88, 34% female, 14% cannabis dependent) completed a marijuana purchase task at baseline. A delay discounting task was completed following placebo marijuana cigarette (0% THC) administration during a separate experimental session. RESULTS Marijuana demand and DD were quantified using area under the curve (AUC). In multiple regression models, demand uniquely predicted frequency of marijuana use while DD did not. In contrast, DD uniquely predicted CD symptom count while demand did not. There were no significant interactions between demand and DD in either model. CONCLUSIONS These findings suggest that frequent marijuana users exhibit key constituents of the reinforcer pathology model: high marijuana demand and steep discounting of delayed rewards. However, demand and DD appear to be independent rather than synergistic risk factors for elevated marijuana use and risk for progression to CD. Findings also provide support for using AUC as a singular marijuana demand metric, particularly when also examining other behavioral economic constructs that apply similar statistical approaches, such as DD, to support analytic methodological convergence.
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Affiliation(s)
- Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903,Providence Veterans Affairs Medical Center, Providence, RI, 02908
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7 Canada
| | - Christopher W. Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903
| | - James MacKillop
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903,Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 3K7 Canada,Homewood Research Institute, Guelph, ON N1E 6K9
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Abstract
Alcohol and drug use peaks during young adulthood and can interfere with critical developmental tasks and set the stage for chronic substance misuse and associated social, educational, and health-related outcomes. There is a need for novel, theory-based approaches to guide substance abuse prevention efforts during this critical developmental period. This paper discusses the particular relevance of behavioral economic theory to young adult alcohol and drug misuse, and reviews of available literature on prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that decisions to use drugs and alcohol are related to the relative availability and price of both alcohol and substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drugs. Behavioral economic measures of motivation for substance use are based on relative levels of behavioral and economic resource allocation towards drug versus alternatives, and have been shown to predict change in substance use over time. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including brief interventions that increase future orientation and engagement in rewarding alternatives to substance use. Prevention approaches that increase engagement in constructive future-oriented activities among young adults (e.g., educational/vocational success) have the potential to reduce future health disparities associated with both substance abuse and poor educational/vocational outcomes.
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Ramirez JJ, Dennhardt AA, Baldwin SA, Murphy JG, Lindgren KP. Alcohol-approach inclinations and drinking identity as predictors of behavioral economic demand for alcohol. Exp Clin Psychopharmacol 2016; 24:356-366. [PMID: 27379444 PMCID: PMC5048495 DOI: 10.1037/pha0000086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Behavioral economic demand curve indices of alcohol consumption reflect decisions to consume alcohol at varying costs. Although these indices predict alcohol-related problems beyond established predictors, little is known about the determinants of elevated demand. Two cognitive constructs that may underlie alcohol demand are alcohol-approach inclinations and drinking identity. The aim of this study was to evaluate implicit and explicit measures of these constructs as predictors of alcohol demand curve indices. College student drinkers (N = 223, 59% female) completed implicit and explicit measures of drinking identity and alcohol-approach inclinations at 3 time points separated by 3-month intervals, and completed the Alcohol Purchase Task to assess demand at Time 3. Given no change in our alcohol-approach inclinations and drinking identity measures over time, random intercept-only models were used to predict 2 demand indices: Amplitude, which represents maximum hypothetical alcohol consumption and expenditures, and Persistence, which represents sensitivity to increasing prices. When modeled separately, implicit and explicit measures of drinking identity and alcohol-approach inclinations positively predicted demand indices. When implicit and explicit measures were included in the same model, both measures of drinking identity predicted Amplitude, but only explicit drinking identity predicted Persistence. In contrast, explicit measures of alcohol-approach inclinations, but not implicit measures, predicted both demand indices. Therefore, there was more support for explicit, versus implicit, measures as unique predictors of alcohol demand. Overall, drinking identity and alcohol-approach inclinations both exhibit positive associations with alcohol demand and represent potentially modifiable cognitive constructs that may underlie elevated demand in college student drinkers. (PsycINFO Database Record
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Abstract
BACKGROUND Behavioral economics and neuroeconomics bring together perspectives and methods from psychology, economics, and cognitive neuroscience to understand decision making and choice behavior. Extending an operant behavioral theoretical framework, these perspectives have increasingly been applied to understand the alcohol use disorders (AUDs), and this review surveys the theory, methods, and findings from this approach. The focus is on 3 key behavioral economic concepts: delay discounting (i.e., preferences for smaller immediate rewards relative to larger delayed rewards), alcohol demand (i.e., alcohol's reinforcing value), and proportionate alcohol-related reinforcement (i.e., relative amount of psychosocial reinforcement associated with alcohol use). FINDINGS Delay discounting has been linked to AUDs in both cross-sectional and longitudinal studies and has been investigated cross-sectionally using neuroimaging. Alcohol demand and proportionate alcohol-related reinforcement have both been robustly associated with drinking and alcohol misuse cross-sectionally, but not over time. Both have also been found to predict treatment response to brief interventions. Alcohol demand has also been used to enhance the measurement of acute motivation for alcohol in laboratory studies. Interventions that focus on reducing the value of alcohol by increasing alternative reinforcement and response cost have been found to be efficacious, albeit in relatively small numbers of randomized controlled trials (RCTs). Mediators and moderators of response to these interventions have not been extensively investigated. FUTURE DIRECTIONS The application of behavioral economics and neuroeconomics to AUDs has given rise to an extensive body of empirical work, although significant gaps in knowledge remain. In particular, there is a need for more longitudinal investigations to clarify the etiological roles of these behavioral economic processes, especially alcohol demand and proportionate alcohol reinforcement. Additional RCTs are needed to extend and generalize the findings for reinforcement-based interventions and to investigate mediators and moderators of treatment success for optimization. Applying neuroeconomics to AUDs remains at an early stage and has been primarily descriptive to date, but has high potential for important translational insights into the future. The same is true for using these behavioral economic indicators to understand genetic influences on AUDs.
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Affiliation(s)
- James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, Peter Boris Centre for Addictions Research, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Homewood Research Institute, Homewood Health Centre, Guelph, Ontario, Canada
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