Quantifying the subjective cost of self-control in humans

Since Odysseus committed to resisting the Sirens, mechanisms to limit self-control failure have been a central feature of human behavior. Psychologists have long argued that the use of self-control is an effortful process and, more recently, that its failure arises when the cognitive costs of self-control outweigh its perceived benefits. In a similar way, economists have argued that sophisticated choosers can adopt "precommitment strategies" that tie the hands of their future selves in order to reduce these costs. Yet, we still lack an empirical tool to quantify and demonstrate the cost of self-control. Here, we develop and validate an economic decision-making task to quantify the subjective cost of self-control by determining the monetary cost a person is willing to incur in order to eliminate the need for self-control. We find that humans will pay to avoid having to exert self-control in a way that scales with increasing levels of temptation and that these costs appear to be modulated both by motivational incentives and stress exposure. Our psychophysical approach allows us to index moment-to-moment self-control costs at the within-subject level, validating important theoretical work across multiple disciplines and opening avenues of self-control research in healthy and clinical populations.

Transcranial Direct Current Stimulation (tDCS) over the Frontopolar Cortex (FPC) Alters the Demand for Precommitment

Caving into temptation leads to deviation from the planned path, which reduces our performance, adds trouble to our daily life, and can even bring about psychiatric disorders. Precommitment is an effective way to remedy the failure of willpower by removing the tempting short-term option. This paper aims to test the neural mechanisms of precommitment through a monetary task that excluded the interference of heterogeneous individual preferences and complements present researches. We examined whether transcranial direct current stimulation (tDCS) over the frontopolar cortex (FPC) could affect the demand for precommitment. The participants were required to make a decision regarding whether they were willing to precommit to binding later-lar ger rewards and remove the sooner-smaller rewards. Three conditions, including no precommitment, loose precommitment and strict precommitment, were established to perform a comprehensive investigation. We found that tDCS over the FPC altered the demand for precommitment in the condition involving loose precommitment with the control of delay discounting, specifically, anodal stimulation led to more precommitment, whereas cathodal stimulation reduced the demand for precommitment. Our findings established a causal correlation between the FPC and willingness to precommit and suggested a feasible method to enhance self-control in addition to exercising willpower.

Leveraging behavioral economics to promote treatment adherence: A primer for the practicing dermatologist

The problem of suboptimal treatment adherence among patients with dermatologic or other diseases has not been adequately addressed in health care. Despite a wide range of efficacious therapies, nonadherence remains a primary driver of suboptimal clinical outcomes. Novel solutions to address this unmet need can be found in behavioral economics. By leveraging our understanding of human decision-making, we may better promote treatment adherence, thereby improving quality of life and decreasing economic burdens. Behavioral economics has been studied extensively in relation to topics such as health policy and health behaviors; however, there is a dearth of research applying this approach to chronic diseases and only a handful within dermatology. We conducted a scoping review in PubMed to identify articles that discuss behavioral economics and its application to treatment adherence in dermatologic patients, with a particular focus on psoriasis, followed by a summary of key ethical considerations. We found that such principles can be employed in cost-effective, scalable interventions that improve patient adherence to a range of medical therapies and lifestyle modifications.

Self-control and Task Timing Shift Self-efficacy and Influence Willingness to Engage in Effortful Tasks

Self-efficacy constitutes a key factor that influences people's inclination to engage in effortful tasks. In this study, we focus on an interesting interplay between two prominent factors known to influence engagement in effortful tasks: the timing of the task (i.e., whether the task is scheduled to take place in the near or distant future) and individuals' levels of self-control. Across three studies, we show that these two factors have an interacting effect on self-efficacy. Low self-control (LSC) individuals report higher self-efficacy for distant-future effortful tasks than for near-future tasks, whereas high self-control (HSC) individuals report higher self-efficacy for near-future tasks than for distant future tasks. We further demonstrate how self-efficacy then molds individuals' willingness to engage in those effortful tasks. Given that a particular task may comprise effortful aspects alongside more enjoyable aspects, we show that the effects we observe emerge with regard to a task whose effortful aspects are salient and that the effects are eliminated when the enjoyable aspects of that same task are highlighted.

The impact of precommitment on risk-taking while gambling: A preliminary study

Background and aims Precommitment refers to the ability to prospectively restrict the access to temptations. This study examined whether risk-taking during gambling is decreased when an individual has the opportunity to precommit to his forthcoming bet. Methods Sixty individuals participated in a gambling task that consisted of direct choice (simply chose one monetary option among four available ones, ranging from low-risk to high-risk options) or precommitment trials (before choosing an amount, participants had the opportunity to make a binding choice that made high-risk options unavailable). Results We found that participants utilized the precommitment option, such that risk-taking was decreased on precommitment trials compared to direct choices. Within the precommitment trials, there was no significant difference in risk-taking following decisions to restrict versus non-restrict. Discussion These findings suggest that the opportunity to precommit may be sufficient to reduce the attractiveness of risk. Conclusions Present results might be exploited to create interventions aiming at enhancing one's ability to anticipate self-control failures while gambling.

Don'T let me do that! - models of precommitment

Precommitment, or taking away a future choice from oneself, is a mechanism for overcoming impulsivity. Here we review recent work suggesting that precommitment can be best explained through a distributed decision-making system with multiple discounting rates. This model makes specific predictions about precommitment behavior and is especially interesting in light of the emerging multiple-systems view of decision-making, in which functional systems with distinct neural substrates use different computational strategies to optimize decisions. Given the growing consensus that impulsivity constitutes a common point of breakdown in decision-making processes, with common neural and computational mechanisms across multiple psychiatric disorders, it is useful to translate precommitment into the common language of temporal difference reinforcement learning that unites many of these behavioral and neural data.

Precommitting to serve the underserved

In many countries worldwide, especially in sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. Then we defend these scholarships against ethical worries that they constitute slavery contracts; rely on involuntary, biased, or unauthorized early consent by a young signatory; put excessive strains on signed commitments; give rise to domination; and raise suspicion of slavery contracts. Importantly, we find that scholarships involving far longer commitment than current practice allows would also withstand these worries. Policymakers should consider introducing conditional scholarships, including long-term versions, as a means to increasing the supply of physicians to medically underserved areas.

A reinforcement learning model of precommitment in decision making

Addiction and many other disorders are linked to impulsivity, where a suboptimal choice is preferred when it is immediately available. One solution to impulsivity is precommitment: constraining one's future to avoid being offered a suboptimal choice. A form of impulsivity can be measured experimentally by offering a choice between a smaller reward delivered sooner and a larger reward delivered later. Impulsive subjects are more likely to select the smaller-sooner choice; however, when offered an option to precommit, even impulsive subjects can precommit to the larger-later choice. To precommit or not is a decision between two conditions: (A) the original choice (smaller-sooner vs. larger-later), and (B) a new condition with only larger-later available. It has been observed that precommitment appears as a consequence of the preference reversal inherent in non-exponential delay-discounting. Here we show that most models of hyperbolic discounting cannot precommit, but a distributed model of hyperbolic discounting does precommit. Using this model, we find (1) faster discounters may be more or less likely than slow discounters to precommit, depending on the precommitment delay, (2) for a constant smaller-sooner vs. larger-later preference, a higher ratio of larger reward to smaller reward increases the probability of precommitment, and (3) precommitment is highly sensitive to the shape of the discount curve. These predictions imply that manipulations that alter the discount curve, such as diet or context, may qualitatively affect precommitment.