Rationale Delayed reward discounting (DRD) is a behavioral economic index of impulsivity and numerous studies have examined DRD in relation to addictive behavior. To synthesize the findings across the literature, the current review is a meta-analysis of studies comparing DRD between criterion groups exhibiting addictive behavior and control groups. Objectives The meta-analysis sought to characterize the overall patterns of findings, systematic variability by sample and study type, and possible small study (publication) bias. Methods Literature reviews identified 310 candidate articles from which 46 studies reporting 64 comparisons were identified (total N=56,013). Results From the total comparisons identified, a small magnitude effect was evident (d=.15; p<.00001) with very high heterogeneity of effect size. Based on systematic observed differences, large studies assessing DRD with a small number of self-report items were removed and an analysis of 57 comparisons (n=3,329) using equivalent methods and exhibiting acceptable heterogeneity revealed a medium magnitude effect (d=.58; p<.00001). Further analyses revealed significantly larger effect sizes for studies using clinical samples (d=.61) compared with studies using nonclinical samples (d=.45). Indices of small study bias among the various comparisons suggested varying levels of influence by unpublished findings, ranging from minimal to moderate. Conclusions These results provide strong evidence of greater DRD in individuals exhibiting addictive behavior in general and particularly in individuals who meet criteria for an addictive disorder. Implications for the assessment of DRD and research priorities are discussed.

ABSTRACT. Objective:This meta-analysis examined 53 controlled trials of cognitive-behavioral treatment (CBT) for adults diagnosed with alcohol-or illicit-drug-use disorders. The aims were to provide an overall picture of CBT treatment effi cacy and to identify client or treatment factors predictive of CBT effect magnitude. Method: The inverse variance weighted effect size (Hedges' g) was calculated for each study and pooled using fi xed and random effects methods. Potential study-level moderators were assessed in subgroup analyses by primary drug, type of CBT, and type of comparison condition. In addition, seven client and treatment variables were examined in meta-regression analyses. Results: Across studies, CBT produced a small but statistically signifi cant treatment effect (g = 0.154, p < .005). The pooled effect was somewhat lower at 6-9 months (g = 0.115, p < .005) and continued to diminish at 12-month follow-up (g = 0.096, p < .05). The effect of CBT was largest in marijuana studies (g = 0.513, p < .005) and in studies with a no-treatment control as the comparison condition (g = 0.796, p < .005). Metaregression analyses indicated that the percentage of female participants was positively associated and the number of treatment sessions was negatively associated with effect size. Conclusions: The fi ndings demonstrate the utility of CBT across a large and diverse sample of studies and under rigorous conditions for establishing effi cacy. CBT effects were strongest with marijuana users, when CBT was compared with no treatment, and may be larger with women than with men and when delivered in a brief format. (J. Stud. Alcohol Drugs 70: 516-527, 2009) C OGNITIVE-BEHAVIORAL TREATMENT (CBT) models are among the most extensively evaluated interventions for alcohol-or illicit-drug-use disorders. Based primarily on Marlatt and Gordon's (1985; Marlatt and Donovan, 2005) model of relapse prevention, these treatments target cognitive, affective, and situational triggers for substance use and provide skills training specifi c to coping alternatives. CBT treatment for alcohol or illicit drug use often includes the following strategies: (1) identifying intrapersonal and interpersonal triggers for relapse, (2) coping-skills training, (3) drug-refusal skills training, (4) functional analysis of substance use, and (5) increasing nonuse-related activities. These models have been manualized (e.g., Kadden et al., 1992;Monti et al., 1989) and adapted for implementation in a variety of clinical capacities. Further, CBT interventions have been tested in Stage III research to examine their utility in the "real-world" context, possible adaptations, and costeffectiveness (National Institute on Drug Abuse, 1992; cited from Carroll and Onkin, 2005). As argued by Carroll and Rounsaville (2007), the addictions fi eld would benefi t from greater and continued attention devoted to the dissemination of research-based substance-use treatments. Review data to guide such efforts, however, are needed.CBT interventions for substance-use disorde...

The authors sought to further validate a cigarette purchase task (CPT), a self-report analogue of a progressive-ratio operant schedule, for the assessment of the relative reinforcing efficacy (RRE) of nicotine in smokers. The measure was assessed in terms of its correspondence to typically observed operant behavior, convergent validity, and divergent validity. Participants were 33 individuals (58% male, age M = 19.30 years) who smoked at least weekly (M = 5.31 cigarettes/day) and underwent a single assessment session. Data from the CPT exhibited the predicted inverse relationship between consumption and price, the predicted relationship between consumption and expenditure, and a heterogeneous pattern of interrelationships among the indices of reinforcement. In addition, 2 indices from the measure, intensity of demand and maximum expenditure for cigarettes, exhibited robust convergent and divergent validity. Although this is an incipient research area and the current study used a relatively small sample, these findings support the validity of a CPT as a time- and cost-efficient method for assessing nicotine reinforcement. Theoretical implications of the findings, limitations, and future directions are also discussed.

A behavioral economic approach to alcohol use disorders (AUDs) emphasizes both individual and environmental determinants of alcohol use. The current study examined individual differences in alcohol demand (i.e., motivation for alcohol under escalating conditions of price) and delayed reward discounting (i.e., preference for immediate small rewards compared to delayed larger rewards) in 61Correspondence regarding this study should be addressed to James MacKillop, PhD, Department of Psychology, University of Georgia, Athens, GA 30602; or via at jmackill@uga.edu. Lara Ray is now at the University of California, Los Angeles. Publisher's Disclaimer:The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/abn. NIH Public AccessAuthor Manuscript J Abnorm Psychol. Author manuscript; available in PMC 2011 February 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript heavy drinkers (62% with an AUD). In addition, based on theoretical accounts that emphasize the role of craving in reward valuation and preferences for immediate rewards, craving for alcohol was also examined in relation to these behavioral economic variables and the alcohol-related variables. Intensity of alcohol demand and delayed reward discounting were significantly associated with AUD symptoms, but not with quantitative measures of alcohol use, and were also moderately correlated with each other. Likewise, craving was significantly associated with AUD symptoms, but not with alcohol use, and was also significantly correlated with both intensity of demand and delayed reward discounting. These findings further emphasize the relevance of behavioral economic indices of motivation to alcohol use disorders and the potential importance of craving for alcohol in this relationship. KeywordsAlcohol; Behavioral Economics; Discounting; Demand; CravingBehavioral economics integrates the principles of psychology and economics to understand how individuals make transactions with the world Camerer, 1999). The approach has been extensively applied to both normal and abnormal behavior, particularly in the area of alcohol use disorders (AUDs) and other substance use disorders (Vuchinch & Heather, 2003). As it is applied to substance use, behavioral economics has made major contributions to characterizing how environmental factors, such as increases in cost or the presence of alternative reinforcers, affect alcohol and other substance use (Bigelow, Cohen, Liebson, & Faillace, 1972;Higgins, Bickel, & Hughes, 1994;Winger, Galuska, & Hursh, 2007). Behavioral economics also recog...

These findings may help to explain previous research suggesting that naltrexone is more effective among individuals with the G allele. A medication that reduces feelings of euphoria after alcohol consumption may be more successful among individuals with a genetic predisposition to greater feelings of euphoria after consuming alcohol.

This study advances the knowledge of mechanisms of action of naltrexone and genetic moderators of response to this pharmacotherapy.

Background-Despite initial reports of a decline in use in the early 2000s, methamphetamine remains a significant public health concern with known neurotoxic and neurocognitive effects to the user. The goal of this review is to update the literature on methamphetamine use and addiction since its assent to peak popularity in 1990s.Methods-Specifically, we first review recent epidemiological reports with a focus on methamphetamine accessibility, changes in use and disorder prevalence rates over time, and accurate estimates of the associated burden of care to the individual and society. Second, we review methamphetamine pharmacology literature with emphasis on the structural and functional neurotoxic effects associated with repeated use of the drug. Third, we briefly outline the findings on methamphetamine-related neurocognitive deficits as assessed via behavioral and neuroimaging paradigms. Lastly, we review the clinical presentation of methamphetamine addiction and the evidence supporting the available psychosocial and pharmacological treatments within the context of an addiction biology framework.Conclusion-Taken together, this review provides a broad-based update of the available literature covering methamphetamine research over the past two decades and concludes with recommendations for future research.

Rationale-Behavioral economic demand curves are quantitative representations of the relationship between consumption of a drug and its cost. Demand curves provide a multidimensional assessment of reinforcement, but the relationships among the various indices of reinforcement have been largely unstudied.Objectives-The objective of the study is to use exploratory factor analysis to examine the underlying factor structure of the facets of alcohol reinforcement generated from an alcohol demand curve.Materials and methods-Participants were 267 weekly drinkers [76% female; age M=20.11 (SD=.1.51); drinks/week M=14.33 (SD=11.82)] who underwent a single group assessment session. Alcohol demand curves were generated via an alcohol purchase task, which assessed consumption at 14 levels of prices from $0 to $9. Five facets of demand were generated from the measure [intensity, elasticity, P max (maximum inelastic price), O max (maximum alcohol expenditure), and breakpoint], using both observed and derived calculations. Principal components analysis was used to examine the latent structure among the variables.Results-The results revealed a clear two-factor solution, which were interpreted as "Persistence," reflecting sensitivity to escalating price, and "Amplitude," reflecting the amount consumed and spent. The two factors were generally quantitatively distinct, although O max loaded on both.Conclusions-These findings suggest that alcohol reinforcement as measured via a demand curve is binary in nature, with separate dimensions of price-sensitivity and volumetric consumption. If