Changing Delay Discounting and Impulsive Choice: Implications for Addictions, Prevention, and Human Health

Abstract

Delay discounting describes the tendency to devalue delayed consequences or future prospects. The degree to which an individual discounts delayed events appears trait-like in that it is stable over time and across functionally similar situations. Steeply discounting delayed rewards is correlated with most substanceuse disorders, the severity of these disorders, rates of relapse to drug use, and a host of other maladaptive decisions affecting human health. Longitudinal data suggest steep delay discounting and high levels of impulsive choice are predictive of subsequent drug taking, which suggests (though does not establish) that reducing delay discounting could have a preventive health-promoting effect. Experimental manipulations that produce momentary or long-lasting reductions in delay discounting or impulsive choice are reviewed, and behavioral mechanisms that may underlie these effects are discussed. Shortcomings of each manipulation technique are discussed and areas for future research are identified. Although much work remains, it is clear that impulsive decision making can be reduced, despite its otherwise trait-like qualities. Such findings invite technique refinement, translational research, and hope.

Pharmacokinetics trumps pharmacodynamics during cocaine choice: a reconciliation with the dopamine hypothesis of addiction

“…In other words, low choice impulsivity would predispose to greater drug choice in rats. Obviously, this is the opposite of what we know about the relationship between choice impulsivity and vulnerability to drug use and addiction in people (Bickel et al, 2014;de Wit, 2009;Rung et al, 2019;Volkow & Baler, 2015). People who behave less impulsively in intertemporal choice settings are less, not more, vulnerable to use drugs and go on to develop addiction.…”

Pharmacokinetics trumps pharmacodynamics during cocaine choice: a reconciliation with the dopamine hypothesis of addiction

“…In other words, low choice impulsivity would predispose to greater drug choice in rats. Obviously, this is the opposite of what we know about the relationship between choice impulsivity and vulnerability to drug use and addiction in people [78][79][80][81]. People who behave less impulsively in intertemporal choice settings are less, not more, vulnerable to use drugs and go on to develop addiction.…”

Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications

“…It will be important to identify positive contextual factors such as neighborhood and school safety, as well as resilience [ 105 ] and develop community-based programs that promote these protective factors. Resiliency-building programs that reduce delay discounting may decrease addictive behaviors [ 220 ]. Meanwhile, socioeconomic differences in the quality of early life create “cumulative disadvantage” that contribute to gradients in health status [ 37 ].…”