Experimental manipulations of behavioral economic demand for addictive commodities: a meta‐analysis

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.

Relative expected value of drugs versus competing rewards underpins vulnerability to and recovery from addiction

“…Table 1 columns 6–9 list studies which tested the impact of an experimental manipulation (drug cues, outcome devaluation, costs, and negative mood induction) on drug choice, to determine if dependence severity was associated with sensitivity to these manipulations (for a meta-analysis of experimental manipulations impacting drug demand metrics see [ 35 ]). The studies in column 6 tested the prediction of cue-reactivity theory, that dependence would be associated with greater sensitivity to cue-induced increases in drug choice.…”

Relative expected value of drugs versus competing rewards underpins vulnerability to and recovery from addiction

“…The robustness of the association between dependence severity and drug choice across multiple designs and samples suggests that greater relative drug value may underpin dependence universally, consistent the economic demand task, and with the economic decision model. Table 1 columns 6-9 list studies which tested the impact of an experimental manipulation (drug cues, outcome devaluation, costs, and negative affect induction) on drug choice, to determine if dependence severity was associated with sensitivity to these manipulations (for a metaanalysis of experimental manipulations impacting drug demand metrics see [35]). The studies in column 6 tested the prediction of cue-reactivity theory, that dependence would be associated with greater sensitivity to cue-induced increases in drug choice.…”

Intravenous Alcohol Administration Selectively Decreases Rate of Change in Elasticity of Demand in Individuals With Alcohol Use Disorder

“…Finally, single‐item measures of intensity, O max , and breakpoint increased after exposure to alcohol cues in heavy drinkers (Owens et al, 2015). Dynamic effects of environmental cues on drug demand have also been observed for other psychoactive drugs and a recent meta‐analysis revealed these effects to be of medium effect size (Acuff et al, 2020), but with considerable heterogeneity. These divergent findings may be due to differences in APT assessments (hypothetical vs. real) and methodological considerations (e.g., ceiling effects), but clarification of cue effects in this domain is clearly warranted.…”