Posttraumatic stress and delay discounting: a meta-analytic review

Abstract

Delay discounting—the extent to which individuals show a preference for smaller immediate rewards over larger delayed rewards—has been proposed as a transdiagnostic neurocognitive process across mental health conditions, but its examination in relation to posttraumatic stress disorder (PTSD) is comparatively recent. To assess the aggregated evidence for elevated delay discounting in relation to posttraumatic stress, we conducted a meta-analysis on existing empirical literature. Bibliographic searches identified 209 candidate articles, of which 13 articles with 14 independent effect sizes were eligible for meta-analysis, reflecting a combined sample size of N = 6897. Individual study designs included case-control (e.g. examination of differences in delay discounting between individuals with and without PTSD) and continuous association studies (e.g. relationship between posttraumatic stress symptom severity and delay discounting). In a combined analysis of all studies, the overall relationship was a small but statistically significant positive association between posttraumatic stress and delay discounting (r = .135, p < .0001). The same relationship was statistically significant for continuous association studies (r = .092, p = .027) and case-control designs (r = .179, p < .001). Evidence of publication bias was minimal. The included studies were limited in that many did not concurrently incorporate other psychiatric conditions in the analyses, leaving the specificity of the relationship to posttraumatic stress less clear. Nonetheless, these findings are broadly consistent with previous meta-analyses of delayed reward discounting in relation to other mental health conditions and provide further evidence for the transdiagnostic utility of this construct.

No effects of acute stress on monetary delay discounting: A systematic literature review and meta-analysis

“…Our findings do not exclude the possibility that there are links between chronic measures of stress and delay discounting ( Fields et al, 2014 ). Moreover, a recent meta-analysis found a link between post-traumatic stress symptoms and delay discounting ( Bird et al, 2023 ). However, when linking such chronic or lifetime measures of stress to delay discounting, it is often hard to infer causality and the direction of the effects given that these measures are strongly linked to other factors known to influence both delay discounting and stress levels, such as income and education ( Becker and Mulligan, 1997 ; Jaroni et al, 2004 ; Shamosh and Gray, 2008 ).…”

“…However, the authors included a wide range of studies in the meta-analysis, and used a broad definition of stress, notably including cross-sectional studies where stress was operationalized by self-reported questionnaire data, such as the Perceived Stress Scale ( Cohen et al, 1983 ), the Life Stress Checklist ( Wolfe and Kimerling, 1997 ), and measures of adverse life experiences ( Hamilton et al, 2013 ; Lovallo et al, 2013 ). Note, a more recent meta-analysis found a small (r = 0.14) but significant correlation between post-traumatic stress symptoms and delay discounting ( Bird et al, 2023 ). Only a minority of the studies included in Fields et al’s (2014) meta-analysis experimentally induced acute stress and compared the behaviour of a stress group to a non-stressed control group.…”

No Effects of Acute Stress on Monetary Delay Discounting: A Systematic Literature Review and Meta-Analysis

“…Moreover, a recent meta-analysis found a link between post-traumatic stress symptoms and delay discounting (Bird et al, 2023). However, when linking such chronic or lifetime measures of stress to delay discounting, it is often hard to infer causality and the direction of the effects given that these measures are strongly linked to other factors known to influence both delay discounting and stress levels, such as income and education (Becker & Mulligan, 1997;Jaroni et al, 2004;Shamosh & Gray, 2008).…”

“…However, the authors included a wide range of studies in the meta-analysis, and used a broad definition of stress, notably including cross-sectional studies where stress was operationalized by self-reported questionnaire data, such as the Perceived Stress Scale (Cohen et al, 1983), the Life Stress Checklist (Wolfe & Kimerling, 1997), and measures of adverse life experiences (Hamilton et al, 2013;Lovallo et al, 2013). Note, a more recent meta-analysis found a small (r = .14) but significant correlation between post-traumatic stress symptoms and delay discounting (Bird et al, 2023). Only a minority of the studies included in Fields et al's (2014) meta-analysis experimentally induced acute stress and compared the behaviour of a stress group to a nonstressed control group.…”