Reinforcer pathology II: Reward magnitude, reward delay, and demand for alcohol collectively relate to college students' alcohol related problems

Abstract

The reinforcer pathologies model of addiction posits that two characteristic patterns of operant behavior characterize addiction. Specifically, individuals suffering from addiction have elevated levels of behavioral economic demand for their substances of abuse and have an elevated tendency to devalue delayed rewards (reflected in high delay discounting rates). Prior research has demonstrated that these behavioral economic markers are significant predictors of many of college students' alcohol‐related problems. Delay discounting, however, is a complex behavioral performance likely undergirded by multiple behavioral processes. Emerging analytical approaches have isolated the role of participants' sensitivity to changes in reinforcer magnitude and changes in reinforcer delay. The current study uses these analytic approaches to compare participants' discounting of money versus alcohol, and to build regression models that leverage these new insights to predict a wider range of college students' alcohol related problems. Using these techniques, we were able to 1) demonstrate that individuals differed in their sensitivity to magnitudes of alcohol versus money, but not sensitivity to delays to those commodities and 2) that we could use our behavioral economic measures to predict a range of students' alcohol related problems.

Reinforcer pathology, probabilistic choice, and medication adherence in patients with multiple sclerosis

“…Consistent with the reinforcer pathologies model (Bickel & Athamneh, 2020; Bickel et al, 2020; Bickel et al, 2012; Bickel et al, 2011; Bickel et al, 2014; Jarmolowicz, Reed, DiGennaro Reed, et al, 2016), the interaction between behavioral economic demand and delay discounting rates was the most robust predictor of medication decision making. This specificity is notable given that most iterations of the reinforcer pathologies model (Bickel et al, 2011; Lemley et al, 2016; Reed, 2015; Stancato et al, 2020) omit probability discounting as a component (cf. Jarmolowicz, Reed, DiGennaro Reed, et al, 2016).…”

“…These developments have yielded actionable insights into the processes that drive negative health decision making in substance use disorder and obesity (Amlung et al, 2016;Epstein et al, 2010;Stein et al, 2017). Inductively, these findings have served as the foundation for theoretical models describing these conditions, such as the reinforcer pathologies model (Bickel et al, 2011(Bickel et al, , 2016Jarmolowicz, Reed, DiGennaro Reed, et al, 2016;Lemley et al, 2016;Reed, 2015;Stancato et al, 2020). Such models describe how behavioral economic processes-delay discounting, behavioral economic demand, and (to a lesser extent) probability discounting-interactively relate to clinical disorders, both in isolation and in the transdiagnostic features shared between them.…”

Reliability and validity of behavioral‐economic measures: A review and synthesis of discounting and demand

“…These domains are commonly known as excessive substance demand and steep delayed‐reinforcer discounting, respectively. Support for the reinforcer pathology model of addiction has come from human laboratory studies showing an interaction between excessive demand and steep discounting in people who use addictive substances (e.g., McIntyre‐Wood et al, 2021; Naudé et al, 2021; Stancato et al, 2020; Weidberg et al, 2019), although other studies have found nonsignificant interactions (e.g., Acuff et al, 2018; Aston et al, 2016). Behavioral economics research has also led to the development of novel interventions for substance use and addictive behaviors.…”

Value-based decision-making predicts alcohol use and related problems in young men

“…Chronic alcohol use may also be linked to low loss aversion ( Bernhardt et al, 2017 ), possibly independent of strong delay discounting ( Thrailkill et al, 2022 ). Conflicting reports on delay discounting and loss aversion have appeared, especially concerning non-dependent drinking ( Campbell et al, 2021 ; Herman and Duka, 2020 ; Mayhew et al, 2020 ; Poulton et al, 2022 ; Stancato et al, 2020 ; Tucker et al, 2021 ; Zorick et al, 2022 ). Delay discounting cannot reliably distinguish between different levels, patterns, or problems of non-dependent drinking ( Campbell et al, 2021 ; Herman and Duka, 2020 ; Mayhew et al, 2020 ; Poulton et al, 2022 ; Stancato et al, 2020 ; Tucker et al, 2021 ).…”

“…Conflicting reports on delay discounting and loss aversion have appeared, especially concerning non-dependent drinking ( Campbell et al, 2021 ; Herman and Duka, 2020 ; Mayhew et al, 2020 ; Poulton et al, 2022 ; Stancato et al, 2020 ; Tucker et al, 2021 ; Zorick et al, 2022 ). Delay discounting cannot reliably distinguish between different levels, patterns, or problems of non-dependent drinking ( Campbell et al, 2021 ; Herman and Duka, 2020 ; Mayhew et al, 2020 ; Poulton et al, 2022 ; Stancato et al, 2020 ; Tucker et al, 2021 ). Similarly, the scarce research on probability discounting indicates that risk-seeking for gains and risk aversion for losses are associated with moderate to severe Alcohol Use Disorder but possibly not with less problematic drinking ( Bernhardt et al, 2017 ).…”