Advertisement

Psychopharmacology

, Volume 236, Issue 2, pp 775–785 | Cite as

The relationship between delay discounting and alcohol dependence in individuals with and without comorbid psychopathology

  • Joshua GowinEmail author
  • Matthew E. Sloan
  • Julia E. Swan
  • Reza Momenan
  • Vijay A. Ramchandani
Original Investigation

Abstract

Rationale

Alcohol use disorder (AUD) has been associated with greater discounting of delayed monetary rewards, but it is unclear whether this association is primarily related to alcohol consumption or is secondary to the presence of psychiatric comorbidities. It is also unclear if steeper rates of discounting are associated with greater AUD severity.

Objective

We sought to determine whether the presence of comorbid psychiatric disorders affected the relationship between AUD and delay discounting. We also examined whether more severe AUD was associated with greater delay discounting.

Methods

In this cross-sectional study, 793 adults completed a delay discounting task. Subjects were divided into four groups based on diagnosis: current AUD with psychiatric comorbidities (N = 226), current AUD without psychiatric comorbidities (N = 203), past AUD (N = 69), and healthy controls (N = 295). In those with AUD, we investigated the relationship between delay discounting and alcohol dependence symptom count and recent drinking history. We also compared individuals seeking treatment to non-treatment seeking individuals. Psychiatric comorbidities examined included mood disorders, anxiety disorders, and substance use disorders.

Results

After adjusting for age, sex, income, and education, individuals with current AUD showed significantly higher rates of delay discounting than healthy controls and individuals with a past diagnosis of AUD. The presence of comorbid psychiatric diagnoses was not associated with steeper discounting. Among those with AUD, there was no evidence for a continuous relationship between delay discounting and AUD severity or alcohol consumption. Finally, non-treatment seekers with AUD had steeper delay discounting than treatment seekers.

Conclusions

Individuals with AUD show steeper delay discounting than healthy adults, but the effect is small and there is no added effect from comorbid psychopathology or increased AUD severity. This suggests that steeper delay discounting may have a more limited effect on human alcohol use than previously supposed.

Keywords

Alcoholism Delay discounting Decision making Impulsivity Substance-related disorders Anxiety disorders Depression 

Notes

Acknowledgements

We are grateful to Melanie Schwandt for compiling the data set and maintaining the database, and to Michael Kerich and Betsy Davis for maintaining the computer systems used for collecting the delay discounting data. We thank the nursing staff and the research assistants who have helped collect the data, and to all the participants for their time and cooperation. We also thank Alexandria Jensen for assistance with the ordinal logistic regression model.

Funding information

This study was supported by the NIAAA Division of Intramural Clinical and Biological Research (Z1A AA000466) and a career development award (K99AA024778, PI: Gowin).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

213_2018_5113_MOESM1_ESM.docx (170 kb)
ESM 1 (DOCX 170 kb)

References

  1. Ainslie GW (1974) Impulse control in pigeons. J Exp Anal Behav 21:485–489CrossRefGoogle Scholar
  2. Amlung M, MacKillop J (2014) Clarifying the relationship between impulsive delay discounting and nicotine dependence. Psychol Addict Behav 28:761–768CrossRefGoogle Scholar
  3. Amlung M, Vedelago L, Acker J, Balodis I, MacKillop J (2017) Steep delay discounting and addictive behavior: a meta-analysis of continuous associations. Addiction 112:51–62CrossRefGoogle Scholar
  4. Asberg M, Montgomery SA, Perris C, Schalling D, Sedvall G (1978) A comprehensive psychopathological rating scale. Acta Psychiatr Scand Suppl 57:5–27CrossRefGoogle Scholar
  5. Bickel WK, Jarmolowicz DP, Mueller ET, Koffarnus MN, Gatchalian KM (2012) Excessive discounting of delayed reinforcers as a trans-disease process contributing to addiction and other disease-related vulnerabilities: emerging evidence. Pharmacol Ther 134:287–297CrossRefGoogle Scholar
  6. Bickel WK, Odum AL, Madden GJ (1999) Impulsivity and cigarette smoking: delay discounting in current, never, and ex-smokers. Psychopharmacology 146:447–454CrossRefGoogle Scholar
  7. Billings AG, Moos RH (1983) Psychosocial processes of recovery among alcoholics and their families: implications for clinicians and program evaluations. Addict Behav 8:205–218CrossRefGoogle Scholar
  8. Bjork JM, Hommer DW, Grant SJ, Danube C (2004) Impulsivity in abstinent alcohol-dependent patients: relation to control subjects and type 1-/type 2-like traits. Alcohol 34:133–150CrossRefGoogle Scholar
  9. Bobova L, Finn PR, Rickert ME, Lucas J (2009) Disinhibitory psychopathology and delay discounting in alcohol dependence: personality and cognitive correlates. Exp Clin Psychopharmacol 17:51–61CrossRefGoogle Scholar
  10. Field M, Christiansen P, Cole J, Goudie A (2007) Delay discounting and the alcohol Stroop in heavy drinking adolescents. Addiction 102:579–586CrossRefGoogle Scholar
  11. First M, Spitzer RL, Gibbon M, Williams JB (2002) Structured clinical interview for DSM-IV-TR Axis I disorders, research version, patient edition with psychotic Screen (SCID-I/PW/PSY SCREEN). biometrics research, New York state psychiatric institute, New YorkGoogle Scholar
  12. Giordano LA, Bickel WK, Loewenstein G, Jacobs EA, Marsch L, Badger GJ (2002) Mild opioid deprivation increases the degree that opioid-dependent outpatients discount delayed heroin and money. Psychopharmacology 163:174–182CrossRefGoogle Scholar
  13. Gowin JL, Sloan ME, Ramchandani VA, Paulus MP, Lane SD (2018) Differences in decision-making as a function of drug of choice. Pharmacol Biochem Behav 164:118–124CrossRefGoogle Scholar
  14. Gowin JL, Sloan ME, Stangl BL, Vatsalya V, Ramchandani VA (2017) Vulnerability for alcohol use disorder and rate of alcohol consumption. Am J Psychiatry 174:1094–1101CrossRefGoogle Scholar
  15. Grant B (1997) Barriers to alcoholism treatment: reasons for not seeking treatment in a general population sample. J Stud Alcohol 58:365–371CrossRefGoogle Scholar
  16. Grant BF, Goldstein RB, Saha TD, Chou SP, Jung J, Zhang H, Pickering RP, Ruan WJ, Smith SM, Huang B, Hasin DS (2015) Epidemiology of DSM-5 alcohol use disorder: results from the National Epidemiologic Survey on alcohol and related conditions III. JAMA Psychiatry 72:757–766CrossRefGoogle Scholar
  17. Green L, Fry AF, Myerson J (1994) Discounting of delayed rewards—a life-span comparison. Psychol Sci 5:33–36CrossRefGoogle Scholar
  18. Griswold MG, Fullman N, Hawley C, Arian N, Zimsen SR, Tymeson HD, Venkateswaran V, Tapp AD, Forouzanfar MH, Salama JS (2018) Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet 392:1015–1035CrossRefGoogle Scholar
  19. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO (1991) The Fagerström test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict 86:1119–1127CrossRefGoogle Scholar
  20. Kelly AB, Halford WK, Young RM (2000) Maritally distressed women with alcohol problems: the impact of a short-term alcohol-focused intervention on drinking behaviour and marital satisfaction. Addiction 95:1537–1549CrossRefGoogle Scholar
  21. Kishinevsky FI, Cox JE, Murdaugh DL, Stoeckel LE, Cook EW, Weller RE (2012) fMRI reactivity on a delay discounting task predicts weight gain in obese women. Appetite 58:582–592CrossRefGoogle Scholar
  22. Lagorio CH, Madden GJ (2005) Delay discounting of real and hypothetical rewards III: steady-state assessments, forced-choice trials, and all real rewards. Behav Process 69:173–187CrossRefGoogle Scholar
  23. MacKillop J, Amlung MT, Few LR, Ray LA, Sweet LH, Munafo MR (2011) Delayed reward discounting and addictive behavior: a meta-analysis. Psychopharmacology 216:305–321CrossRefGoogle Scholar
  24. MacKillop J, Miranda R, Monti PM, Ray LA, Murphy JG, Rohsenow DJ, McGeary JE, Swift RM, Tidey JW, Gwaltney CJ (2010) Alcohol demand, delayed reward discounting, and craving in relation to drinking and alcohol use disorders. J Abnorm Psychol 119:106–114CrossRefGoogle Scholar
  25. Mazur JE (1987) An adjusting procedure for studying delayed reinforcement. Commons, ML; Mazur, JE; Nevin, JA: 55–73Google Scholar
  26. McTeague LM, Huemer J, Carreon DM, Jiang Y, Eickhoff SB, Etkin A (2017) Identification of common neural circuit disruptions in cognitive control across psychiatric disorders. Am J Psychiatry 174:676–685CrossRefGoogle Scholar
  27. Miglin R, Kable JW, Bowers ME, Ashare RL (2017) Withdrawal-related changes in delay discounting predict short-term smoking abstinence. Nicotine Tob Res 19:694–702CrossRefGoogle Scholar
  28. Moody L, Franck C, Bickel WK (2016a) Comorbid depression, antisocial personality, and substance dependence: relationship with delay discounting. Drug Alcohol Depend 160:190–196CrossRefGoogle Scholar
  29. Moody L, Franck C, Hatz L, Bickel WK (2016b) Impulsivity and polysubstance use: a systematic comparison of delay discounting in mono-, dual-, and trisubstance use. Exp Clin Psychopharmacol 24:30–37CrossRefGoogle Scholar
  30. NIAAA (2004) NIAAA council approves definition of binge drinking. NIAAA Newslett 3Google Scholar
  31. Odum AL (2011) Delay discounting: trait variable? Behav Process 87:1–9CrossRefGoogle Scholar
  32. Reimers S, Maylor EA, Stewart N, Chater N (2009) Associations between a one-shot delay discounting measure and age, income, education and real-world impulsive behavior. Personal Individ Differ 47:973–978CrossRefGoogle Scholar
  33. Rounds JS, Beck JG, Grant DM (2007) Is the delay discounting paradigm useful in understanding social anxiety? Behav Res Ther 45:729–735CrossRefGoogle Scholar
  34. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD (2012) 2010 national and state costs of excessive alcohol consumption. Am J Prev Med 49:e73–e79CrossRefGoogle Scholar
  35. Shamosh NA, DeYoung CG, Green AE, Reis DL, Johnson MR, Conway ARA, Engle RW, Braver TS, Gray JR (2008) Individual differences in delay discounting relation to intelligence, working memory, and Anterior Prefrontal Cortex. Psychol Sci 19:904–911CrossRefGoogle Scholar
  36. Smyth A, Teo KK, Rangarajan S, O'Donnell M, Zhang XH, Rana P, Leong DP, Dagenais G, Seron P, Rosengren A, Schutte AE, Lopez-Jaramillo P, Oguz A, Chifamba J, Diaz R, Lear S, Avezum A, Kumar R, Mohan V, Szuba A, Wei L, Yang W, Jian B, McKee M, Yusuf S, Investigators P (2015) Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality: a prospective cohort study. Lancet 386:1945–1954CrossRefGoogle Scholar
  37. Sobell LC, Sobell MB (1992) Timeline follow-back Measuring alcohol consumption. Springer, pp 41–72Google Scholar
  38. Spielberger CD (1983) Manual for the State-Trait Anxiety Inventory STAI (form Y)(" self-evaluation questionnaire")Google Scholar
  39. Svanborg P, Asberg M (1994) A new self-rating scale for depression and anxiety-states based on the comprehensive psychopathological rating-scale. Acta Psychiatr Scand 89:21–28CrossRefGoogle Scholar
  40. Swann AC, Bjork JM, Moeller FG, Dougherty DM (2002) Two models of impulsivity: relationship to personality traits and psychopathology. Biol Psychiatry 51:988–994CrossRefGoogle Scholar
  41. Vuchinich RE, Simpson CA (1998) Hyperbolic temporal discounting in social drinkers and problem drinkers. Exp Clin Psychopharmacol 6:292–305CrossRefGoogle Scholar
  42. Wilhelm CJ, Mitchell SH (2009) Strain differences in delay discounting using inbred rats. Genes Brain Behav 8:426–434CrossRefGoogle Scholar
  43. Wittmann M, Leland DS, Paulus MP (2007) Time and decision making: differential contribution of the posterior insular cortex and the striatum during a delay discounting task. Exp Brain Res 179:643–653CrossRefGoogle Scholar
  44. Woolverton WL, Myerson J, Green L (2007) Delay discounting of cocaine by rhesus monkeys. Exp Clin Psychopharmacol 15:238–244CrossRefGoogle Scholar
  45. Wright HF, Mills DS, Pollux PMJ (2012) Behavioural and physiological correlates of impulsivity in the domestic dog (Canis familiaris). Physiol Behav 105:676–682CrossRefGoogle Scholar
  46. Yoon JH, Higgins ST, Heil SH, Sugarbaker RJ, Thomas CS, Badger GJ (2007) Delay discounting predicts postpartum relapse to cigarette smoking among pregnant women. Exp Clin Psychopharmacol 15:176–186CrossRefGoogle Scholar

Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2018

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of Colorado School of MedicineDenverUSA
  2. 2.Section on Human Psychopharmacology, Division of Intramural Clinical and Biological ResearchNational Institute on Alcohol Abuse and AlcoholismBethesdaUSA
  3. 3.Clinical NeuroImaging Research Core, Office of the Clinical DirectorNational Institute on Alcohol Abuse and AlcoholismBethesdaUSA

Personalised recommendations