A web-based episodic specificity and future thinking session modulates delay discounting in cannabis users.

Abstract

Episodic future thinking (EFT), a brief intervention involving mental simulation of positive future events, improves delay discounting (DD) in nicotine and alcohol dependent individuals. This study is the first to assess effects of a single-session, online episodic training (ET) on constructs that might impact cannabis use and cannabis use disorder. A sample of 200 active cannabis users recruited via Amazon Mechanical Turk were randomized to an EFT group (n ϭ 102) or an episodic recent thinking control group (ERT; n ϭ 98). A novel episodic specificity induction (ES) was included to enhance quality of episodic thinking for the ET group, and an ES attention control was provided to the ERT group (control training group; CT). Quality and manipulation ratings of event excitement, vividness, importance, and enjoyment of trainings were collected in addition to DD tasks (gains and losses) and readiness to change cannabis use. The ET group reported higher overall quality and manipulation ratings than did the CT group (p Ͻ .001, d ϭ 0.79). DD of gains was lower in the ET relative to those of the CT group after controlling for relevant variables (p ϭ .003, d ϭ 0.48), unlike DD of losses (p ϭ .50, d ϭ 0.11). The ET group showed larger pre/post increases in readiness to change, but they were not statistically significant (p ϭ .069, d ϭ 0.26). These effects, following a session of online ET, suggests that ET may positively impact factors related to reduction in cannabis use. Differential effects of EFT and ES components on DD and the development of ET as an adjunctive mHealth intervention targeting reduction in cannabis use appears warranted.

The Effects of Cannabis Use Frequency and Episodic Specificity Training on the Recall of Specific and Rewarding Events

“…Our findings are congruent with other brief intervention studies that observed improvement in specificity of events among those with Major Depressive Disorder and Schizophrenia ( 6 , 30 ). Of potential importance to the health behavior treatment field, is to determine if ESI can improve engagement in Episodic Future Thinking (EFT), a brief intervention currently being tested for reducing nicotine, alcohol, and cannabis use and improving healthy food choices ( 22 – 24 , 31 ). Episodic Future Thinking is an intervention that prompts participants to create and imagine positive, personally relevant future events and is thought to be a product of episodic memory processes and the ability to focus on the future ( 18 , 32 ).…”

“…Episodic Future Thinking is an intervention that prompts participants to create and imagine positive, personally relevant future events and is thought to be a product of episodic memory processes and the ability to focus on the future ( 18 , 32 ). Through strengthening episodic memory processes, administering ESI prior to EFT may improve engagement in EFT, thus improving DD and potentially increasing the impact on reductions in cannabis use and other substances ( 22 ).…”

“…Episodic Specificity Induction prompted recollection of episodic details through open-ended text responses related to the who (e.g., “Who was in the video?” “What were they wearing?”), what (e.g., “What was the video about?”), and when (“In what order did the events of the video occur?”) of the video ( 1 , 22 ). The ESI involves watching a 2-min video of a woman giving a tour of her tiny house, and participants could not move to the next step in the training until the entire 2-min had elapsed ( 22 ). Participants then type answers to each of seven questions about episodic details from the tiny house video (e.g., “What did the people in the video look like?,” “What happened in the video, in order?”).…”

Imagining the Future to Reshape the Past: A Path to Combine Cue Extinction and Memory Reconsolidation With Episodic Foresight for Addiction Treatment

“…In light of these advances and seminal findings, several experimental studies and clinical trials investigated the therapeutic effects of EFT on reducing delay discounting and consequent maladaptive behaviors and reported positive health-related outcomes as a result of engaging in EFT in people with alcohol use disorder, overweight, obese and prediabetic individuals, cigarette smokers, cannabis users, and people with cocaine use disorder (55)(56)(57)(58)(59)(60)(61). Moreover, EFT training for individuals with addictive behaviors is suggested to improve the efficiency of other psychosocial interventions aiming to attain emotional reappraisal and correction (62).…”

Development of Goal Management Training+ (GMT+) for Methamphetamine Use Disorder Through Collaborative Design: A Process Description

“…EFT involves imagining future events through guided instruction and aims to promote a longer-term mindset 29 . EFT has shown efficacy at improving preference for larger delayed rewards over smaller immediate rewards in substance-using populations 30,31 . The language was updated to target a younger adult population (previously aimed at older adults) and is more aligned with therapeutic and conversational dialogue, rather than educational training language.…”