Delay discounting rates: A strong prognostic indicator of smoking relapse

Abstract

Recent evidence suggests that several dimensions of impulsivity and locus of control are likely to be significant prognostic indicators of relapse. We compared the relative strengths of associations among delay discounting rates, dimensions of trait impulsiveness from the Barratt Impulsiveness Scale - 11, locus of control, nicotine dependence, and stress level with days to relapse among smokers after an intensive multicomponent cognitive-behavioral treatment for tobacco dependence. We used Cox proportional hazard regressions to model days to relapse with each of the following: delay discounting of $100, delay discounting of $1,000, six subscales of the Barratt Impulsiveness Scale (BIS), Rotter’s Locus of Control (RLOC), Fagerstrom Test for Nicotine Dependence (FTND), and the Perceived Stress Scale (PSS). Standardized regression coefficients and hazard ratios (HRs) were used to assess the relative strength and direction of the associations along with a bootstrap method to determine 95% confidence intervals. We then examined the extent to which the measures retained associations with days to relapse while accounting for nicotine dependence and stress level. Our findings indicate that the $100 delay discounting rate had the strongest association with days to relapse, but was only significantly stronger than nicotine dependence. Discounting rates maintained significant associations with days to relapse when combined with the FTND and the PSS, but the BIS subscales and the RLOC did not. These findings indicate that delay discounting is independently associated with relapse and adds to what is already accounted for by nicotine dependence and stress level. These findings signify that delay discounting is a productive new target for enhancing treatment for tobacco dependence. Adding an intervention designed to decrease discounting rates to a comprehensive treatment for tobacco dependence has the potential to decrease relapse rates.

Heterogeneity in the Effects of Reward- and Deposit-based Financial Incentives on Smoking Cessation

“…The importance of temporal discounting in predicting response to financial incentive programs complements and extends prior research showing that individuals who more strongly discount future rewards are more likely to smoke (24,25) and less likely to quit smoking in response to other, non-incentive-based interventions (28,29).…”

Neuroanatomical foundations of delayed reward discounting decision making

“…Future studies should attempt to extend these findings in clinical populations and determine if GMV in these regions is associated with the etiology or prognosis of clinical disorders. This is an important question to be addressed given robust evidence that DRD preferences predict treatment response (MacKillop and Kahler, 2009; Sheffer et al, 2014) and highly impulsive DRD appears to be a trans-disease process that is relevant not only to addiction, but other psychiatric disorders (Liu et al, 2012; Urošević et al, 2016; Weller et al, 2014) and health behaviors (Amlung et al, 2016a; Celio et al, 2016; Daugherty and Brase, 2010). …”

The Recovery from Alcohol Consumption: Analysis of the Construct of Relapse

“…Anderson, Ramo, Schulte, Cummins, & Brown, 2008;Brown, Saraganian, Tremblay, & Annis, 2002;Moore et al, 2014;Tate, Brown, Glasner, Unrod, & McQuaid, 2006), and may limit the comprehension of relapse processes by assuming that a singular definition is appropriate to describe relapse processes under different conditions. For example, a general inspection suggests that the lapse/relapse distinction is more common in the analyses of smoking problems than in alcohol; in fact, only the lapse comes into the analysis when smoking is the treated problem (Muraven, 2010;Sheffer et al, 2014). On the contrary, in the literature on alcohol, as results showed, a small proportion of the studies distinguish between lapse and relapse.…”