Behavioral economic predictors of brief alcohol intervention outcomes.

Abstract

Objective The present study attempted to determine if behavioral economic indices of elevated alcohol reward value, measured before and immediately after a brief alcohol intervention, predict treatment response. Method Participants were 133 heavy drinking college students (49.6% female, 51.4% male; 64.3% Caucasian, 29.5% African American) who were randomized to one of three conditions: motivational interviewing plus personalized feedback (BMI), computerized personalized feedback intervention (e-CHUG), and assessment only. Results Baseline levels of alcohol demand significantly predicted drinks per week and alcohol problems at 1-month (demand intensity= maximum expenditure) and 6-month (relative discretionary expenditures on alcohol) follow-up. BMI and e-CHUG were associated with an immediate post-session reduction in alcohol demand (p < .001, ηρ2 = .29) that persisted at the 1-month follow-up, with greater post-session reductions in the BMI condition (p = .02, ηρ2 = .06). Reductions in demand intensity and Omax (maximum expenditure) immediately post-intervention significantly predicted drinking reductions at one-month follow up (p = .04, ΔR2 = .02 & p = .01, ΔR2 = .03, respectively). Reductions in relative discretionary expenditures on alcohol at 1-month significantly predicted drinking (p = .002, ΔR2 = .06,) and alcohol problem (p < .001, ΔR2 = .13) reductions at the 6-month follow-up. Conclusions These results suggest that behavioral economic reward value indices may function as risk factors for poor intervention response and as clinically-relevant markers of change in heavy drinkers.

Depressive Symptoms and Cigarette Demand as a Function of Induced Stress

“…Although we did not examine these relationships in the context of a quit attempt, considering that current depressive symptoms are associated with poor cessation outcomes 49,50 and that elevated alcohol demand is associated with poor alcohol intervention response, 51 our results suggest that one factor that could complicate a smoking cessation attempt for an individual with current elevated depressive symptoms is the heightened value of a cigarette to a smoker when experiencing increases in NA. For example, recent smoking cessation trials utilizing ecological momentary assessment throughout the course of a quit attempt have found that change in NA both prior to 52 and following initiation 53 of a quit attempt is predictive of success in quitting smoking.…”

Tobacco demand, delay discounting, and smoking topography among smokers with and without psychopathology

“…For example, interventions that enhance future time orientation (Sheffer et al, 2016) and present-focused attention/mindfulness (Ashe et al, 2015) or provide contingent reinforcement (Weidberg et al, 2015b) appear to reduce DD. Additionally, brief motivational (Dennhardt et al, 2015) or personalized feedback interventions (Murphy et al, 2015) reduce the rewarding value of substances. Smokers with psychopathology may benefit from pre-cessation intervention that specifically targets (reduce) tobacco demand and DD, whereby increasing ability to manage withdrawal-induced urge and craving to tobacco that onset following a quit attempt.…”

Latent factor structure of a behavioral economic marijuana demand curve

“…Substance demand indices derived from purchase tasks for general preferences are related to frequency of substance use and dependence symptoms (MacKillop et al 2010a; Aston et al 2015; MacKillop et al 2016) and are predictive of therapeutic treatment response (MacKillop and Murphy 2007; Murphy et al 2015; MacKillop et al 2016). State-orientated purchase tasks have been found to complement other state measures of acute motivation (MacKillop et al 2010b; Acker and MacKillop 2013; Metrik et al 2016).…”