Time-Based Prospective Memory Predicts Engagement in Risk Behaviors Among Substance Users: Results From Clinical and Nonclinical Samples

Abstract

Deficits in prospective memory (PM; i.e., enacting previously learned actions at the right occasion) and risky decision-making (i.e., making choices with a high chance of undesirable/dangerous outcomes) are both common amongst individuals with substance use disorders (SUD). Previous research has raised the possibility of a specific relationship between PM and risk-taking, and the present study aimed to systematically study if PM provides unique variance in the prediction of risky decision-making. Two samples were included: 1) a group of 45 individuals with SUD currently in treatment, and 2) a nonclinical group of 59 university students with high-risk drinking and/or substance use. Regression analyses indicated that time-based, but not event-based, PM predicted increased risky behavior (e.g., risky sexual practices and criminal behaviors) in both groups after controlling for demographic, psychiatric, and substance use variables, as well as other neuropsychological functions. The current findings contribute to the growing literature supporting the role of PM as a predictor of everyday functioning, and suggest that cognitive rehabilitation may be an important avenue of research as an adjunct to traditional substance use treatment, particularly in addressing the potential adverse effects of PM deficits in the implementation of treatment-related homework activities and risk management strategies.

The effects of HIV disease and older age on laboratory-based, naturalistic, and self-perceived symptoms of prospective memory: does retrieval cue type and delay interval matter?

“…Indeed, many laboratory-based PM measures are commonly criticized as having too many trials without sufficient spacing, thereby perhaps reflecting measures of sustained/divided attention rather than PM per se (Brandimonte, Ferrante, Feresin, & Delbello, 2001). The MIST, on the other hand, is a well-validated clinical PM measure that demonstrates evidence of construct validity in both HIV (Carey et al, 2006; Woods et al, 2006; 2007) and aging (e.g., Kamat et al, 2014; Woods et al, 2013, 2014). Further, scales on the MIST demonstrate evidence of convergent (e.g., Morgan et al, 2012) and ecological (Poquette et al, 2013) validity in both HIV and substance abuse (Weinborn et al, 2011).…”

“…Similarly, the various PRMQ subscales have been shown to be predictive of real-world outcomes in HIV (e.g., Woods et al, 2008) and aging (Woods et al, 2013; 2014) and has been widely used both in healthy and clinical populations (e.g., Smith 2000; Weinborn et al, 2011; Woods et al, 2007) with high internal reliability and construct validity (Crawford et al, 2003). Concordantly, we are certain that our measures prove to be reliable and valid measures of PM.…”

Offending: Drug-related expertise and decision making

“…A possible outcome of greater diversity is a decreased likelihood that the skills necessary for expertise in any single crime genre will be developed. There is also an increased likelihood of dysfunctional expertise due to errors in judgment (e.g., an overestimation of ability in a new situation; Chi, 2006) or maladaptive/risky decision-making (e.g., from the psychopharmacological effects of drug use; Weinborn et al, 2013). As will be discussed below, the extent to which expertise is compromised in drug-related crime may also be a function of the individual's level and type of drug consumption (Hart, Marvin, Silver, & Smith, 2012;Wang et al, 2004).…”

Allowing brief delays in responding improves event-based prospective memory for young adults living with HIV disease

“…This specific type of event-based PM task is also of clear relevance to younger HIV-infected adults who are faced with the challenges of multiple competing demands in the context of developing independence in everyday functioning (e.g., household management, employment) while simultaneously managing a chronic disease (e.g., attending medical appointments, adhering to medication regimens), often in the context of major psychosocial stressors (e.g., stigma, lower socioeconomic status) and comorbidities (e.g., substance use). For instance, the realization of the intention to engage in safe sex (e.g., condoms) and drug use (e.g., clean needles) behaviors can require the disengagement from habitual, highly engaging and rewarding risk behaviors (Weinborn, Bucks, Stritzke, Leighton, & Woods, 2013). …”