, 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



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.


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.


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.


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.


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.


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



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)


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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

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