Self-control as measured by delay discounting is greater among successful weight losers than controls.

Long-term weight loss maintenance is likely to require strong self-control in order to sustain changes in behavior patterns. We, therefore, tested the hypothesis that those who have successfully maintained weight loss may have superior self-control compared to control participants. Self-control was assessed using a delay discounting task through a webbased assessment of members of the National Weight Control Registry (NWCR: N = 757; non-obese = 605; obese = 152) and control participants (Control N = 443; nonobese = 236; obese = 207) from Amazon's Mechanical Turk. Both NWCR members that were currently obese (t = 5.42, p < 0.001) and nonobese (t = 5.28, p < 0.001) discounted the future less than control participants with comparable weight statuses. These results are indicative of higher levels of self-control behaviors in individuals that have lost and successfully maintained weight loss. Thus, successful weight losers may exhibit stronger self-control, as measured through discounting of future rewards, However, further research is needed to determine whether strong selfcontrol enables individuals to succeed at weight loss maintenance or develops as a consequence.

To drink or to drink less? Distinguishing between effects of implementation intentions on decisions to drink and how much to drink in treatment-seeking individuals with alcohol use disorder.

INTRODUCTION: For many people with alcohol use disorders, alcohol drinking is a highly ingrained and automatized behavior with negative long-term health consequences. Implementation intentions, a behavioral intervention that links high-risk drinking situations with alternative, healthier responses, provide a means to intervene on habitual drinking behaviors. Here, a pilot treatment using implementation intentions was assessed with remote assessments and treatment prompts. METHODS: Treatment-seeking individuals with alcohol use disorder between the ages of 18 and 65 were recruited from the community from October 2014 to November 2016. Participants (N=35) were quasi-randomly assigned to complete either active (n=18) or control (n=17) two-week implementation intention interventions. Active implementation intentions linked high-risk situations with alternative responses whereas the control condition selected situations and responses but did not link these together. Daily ecological momentary interventions of participant-tailored implementation intentions were delivered via text message. Alcohol consumption was assessed once daily with self-reported ecological momentary assessments (EMAs) of drinks consumed the previous day and thrice daily remotely submitted breathalyzer samples to assess reliability of self-reports. RESULTS: On drinking days (80% of days), the active implementation intentions group reduced alcohol consumption during the intervention period compared to the control condition; however the difference between consumption was not observed at one-month follow-up. DISCUSSION: The implementation intention intervention was associated with a 1.09 drink per day decrease in alcohol consumption on drinking days compared to a decrease of 0.29 drinks per day in the control condition. Future studies may combine implementation intentions with other treatments to help individuals to reduce alcohol consumption.

Cross-commodity delay discounting of alcohol and money in alcohol users.

Despite real-world implications, the pattern of delay discounting in alcohol users when the commodities now and later differ has not been well characterized. In this study, 60 participants on Amazon's Mechanical Turk completed the Alcohol Use Disorder Identification Test (AUDIT) to assess severity of use and completed four delay discounting tasks between hypothetical, equivalent amounts of alcohol and money available at five delays. The tasks included two cross-commodity (alcohol now-money later and money now-alcohol later) and two same-commodity (money now-money later and alcohol now-alcohol later) conditions. Delay discounting was significantly associated with clinical cutoffs of the AUDIT for both of the cross-commodity conditions but not for either of the same-commodity delay discounting tasks. The cross-commodity discounting conditions were related to severity of use wherein heavy users discounted future alcohol less and future money more. The change in direction of the discounting effect was dependent on the commodity that was distally available suggesting a distinctive pattern of discounting across commodities when comparing light and heavy alcohol users.

Substance Use in Rural Central Appalachia: Current Status and Treatment Considerations.

The burden of substance use and especially the unmatched rates of overdoses in rural Central Appalachia highlight the need for innovative approaches to curb the initiation to drug misuse and to address current substance use disorders. Effective substance use interventions involve a thorough understanding of the region. In Central Appalachia, many of the barriers to treatment are shared with other rural and impoverished areas, including a lack of access to health care and lack of health care providers with specialized training. Parts of Appalachia also present their own considerations, including the challenges of fostering trust and encouraging treatment-seeking in communities with dense, long-term, place-based social and family networks. Current policies and interventions for substance use have been largely inadequate in the region, as evidenced by continued increases in substance use and substance-related deaths, especially related to nonmedical prescription drug use and increasing heroin use. The authors discuss ways in which rural life, poverty, identity, and values in Appalachia have influenced substance use and treatment and propose strategies and interventions to improve outcomes.

Toward a laboratory model for psychotherapeutic treatment screening: Implementation intentions and incentives for abstinence in an analog of smoking relapse.

Despite reductions in cigarette smoking in the United States, approximately 40 million Americans are smokers. Innovative interventions are needed to help remaining smokers quit. To develop innovative interventions, precise and effective tools are needed. Here, a laboratory model of smoking relapse is assessed for its ability to detect increased resistance to smoking across 2 interventions and for its sensitivity to differing degrees of effectiveness. Nicotine-deprived participants (N = 36) completed, in randomized order, 4 smoking resistance sessions with and without implementation intentions and monetary incentives. A Cox proportional hazard mixed-effects model indicated significant differences between condition, χ²(3) = 64.87, p < .001, and the Questionnaire on Smoking Urges, χ²(1) = 4.86, p = .03. Comparisons between conditions were used to estimate the effect size of each condition on delay to smoking reinitiation. The implementation intentions intervention had a small effect (d = 0.32), the monetary incentives had a large effect (d = 0.89) and the combination of both interventions had a large effect size (d = 1.20). This initial investigation of the smoking resistance paradigm showed sensitivity to smoking reinitiation across intervention conditions. Individuals resisted smoking significantly more in the presence of monetary incentives and implementation intentions than without these interventions. These results provide support for further examination of these interventions in more translational settings and the use of this laboratory analog to screen future interventions and treatment packages. (PsycINFO Database Record

Neurocognitive dysfunction in addiction: Testing hypotheses of diffuse versus selective phenotypic dysfunction with a classification-based approach.

Neurocognitive dysfunctions are frequently identified in the addictions. These dysfunctions may indicate either diffuse dysfunction or may represent separate facets that have differential importance to the addiction phenotype. In a sample (n = 260) of alcohol and/or stimulant users and controls we measured responses across 7 diverse neurocognitive measures. These measures were Continuous Performance, Delay Discounting, Iowa Gambling, Stroop, Tower, Wisconsin Card Sorting, and Letter Number Sequencing. Comparisons were then made between the drug-dependent groups and controls using analysis of variance and also using a machine learning approach to classify participants based on task performance as substance-dependent or controls in 1 tree and as alcohol and/or stimulant users or controls in a second tree. The analysis of variance showed significant differences between groups on the Delay Discounting (p < .001), Iowa Gambling (p < .001), Letter Number Sequencing (p < .001), and Wisconsin Card Sorting (p < .05) tasks. The first classification tree correctly classified between substance-dependent or controls for 88.3% of participants and classified between alcohol and/or stimulant users or controls for 63.9% of participants. Delay discounting was the first split in both trees and in the substance-dependent and control tree. The analysis of variance results largely replicate previous findings. The machine learning classification tree analysis provides evidence to support the hypothesis that different measures of neurocognitive dysfunction represent different processes. Among them, delay discounting was the most robust in categorizing drug dependence. (PsycINFO Database Record

Novel Therapeutics for Addiction: Behavioral and Neuroeconomic Approaches.

The maturing fields of behavioral- and neuro-economics provides conceptual understanding of the Competing Neurobehavioral Decision Systems theory (CNDS) and reinforcer pathology (i.e. high valuation of and excessive preference for drug reinforcers) allowing us to coherently categorize treatments into a theoretically comprehensive framework of addiction. In this chapter, we identify and clarify how existing and novel interventions can ameliorate reinforcer pathology in light of the CNDS and be leveraged to treat addiction.

Some current dimensions of the behavioral economics of health-related behavior change.

Health-related behaviors such as tobacco, alcohol and other substance use, poor diet and physical inactivity, and risky sexual practices are important targets for research and intervention. Health-related behaviors are especially pertinent targets in the United States, which lags behind most other developed nations on common markers of population health. In this essay we examine the application of behavioral economics, a scientific discipline that represents the intersection of economics and psychology, to the study and promotion of health-related behavior change. More specifically, we review what we consider to be some core dimensions of this discipline when applied to the study health-related behavior change. Behavioral economics (1) provides novel conceptual systems to inform scientific understanding of health behaviors, (2) translates scientific understanding into practical and effective behavior-change interventions, (3) leverages varied aspects of behavior change beyond increases or decreases in frequency, (4) recognizes and exploits trans-disease processes and interventions, and (5) leverages technology in efforts to maximize efficacy, cost effectiveness, and reach. These dimensions are overviewed and their implications for the future of the field discussed.

Comorbid depression, antisocial personality, and substance dependence: Relationship with delay discounting.

BACKGROUND: Within the field of addiction, as many as four-fifths of individuals in treatment for substance use disorder have co-existing lifetime psychopathology and as high as two-thirds have current psychopathology. Among substance-dependent individuals, excessive delay discounting is pervasive. Despite evidence of excessive discounting across substance use disorders, few studies have investigated the impact of co-occurring psychopathologies and SUD on delay discounting. METHODS: We compared delay discounting in currently abstaining substance users with (a) SUD (n=166), (b) SUD and managed major depressive disorder (MDD; n=44), (c) SUD and antisocial personality disorder (APD; n=35), (d) SUD and managed MDD and APD (n=22) and (e) no SUD or co-occurring psychopathology (n=60). RESULTS: All groups with SUD discounted future delayed rewards significantly more than healthy controls (p<0.001 in each case, d=0.686, 0.835, 1.098 and 1.650, respective to groups a-d above). Individuals with both APD and SUD and individuals with MDD, APD, and SUD discounted future rewards significantly more than substance users without comorbid psychopathology (p=0.029, d=0.412 and p<0.001, d=0.964, respectively). CONCLUSIONS: Overall, individuals with multiple psychopathologies in addition to substance use have exacerbated deficits in discounting of the future, above and beyond that observed in substance use alone. Increased discounting in combined substance and psychopathology profiles suggest a greater chance of treatment failure and therefore may necessitate individualized treatment using adjunctive interventions to achieve better treatment outcomes.

Neural signatures of third-party punishment: evidence from penetrating traumatic brain injury.

The ability to survive within a cooperative society depends on impartial third-party punishment (TPP) of social norm violations. Two cognitive mechanisms have been postulated as necessary for the successful completion of TPP: evaluation of legal responsibility and selection of a suitable punishment given the magnitude of the crime. Converging neuroimaging research suggests two supporting domain-general networks; a mentalizing network for evaluation of legal responsibility and a central-executive network for determination of punishment. A whole-brain voxel-based lesion-symptom mapping approach was used in conjunction with a rank-order TPP task to identify brain regions necessary for TPP in a large sample of patients with penetrating traumatic brain injury. Patients who demonstrated atypical TPP had specific lesions in core regions of the mentalizing (dorsomedial prefrontal cortex [PFC], ventromedial PFC) and central-executive (bilateral dorsolateral PFC, right intraparietal sulcus) networks. Altruism and executive functioning (concept formation skills) were significant predictors of TPP: altruism was uniquely associated with TPP in patients with lesions in right dorsolateral PFC and executive functioning was uniquely associated with TPP in individuals with lesions in left PFC. Our findings contribute to the extant literature to support underlying neural networks associated with TPP, with specific brain-behavior causal relationships confirming recent functional neuroimaging research.

Impulsivity and polysubstance use: A systematic comparison of delay discounting in mono-, dual-, and trisubstance use.

Understanding the association between polysubstance use and impulsivity is pertinent to treatment planning and efficacy. Delay discounting, a measure of impulsivity, supplies the rate at which a reinforcer loses value as the temporal delay to its receipt increases. Excessive delay discounting has been widely observed among drug-using individuals, though the impact of using more than 1 substance has been only minimally studied. Here, after controlling for demographic variables, we systematically compared delay discounting in community controls, heavy smokers, and alcohol- and cocaine-dependent individuals to assess the impact of non-, mono-, dual-, and trisubstance use. All substance-using groups discounted significantly more than did community controls (p < .05). Additionally, groups that smoked cigarettes in addition to another substance dependency discounted significantly more than did the group that smoked cigarettes only (p < .05). Last, trisubstance users who were alcohol-dependent, cocaine-dependent, and heavy cigarette smokers discounted significantly more than did heavy smokers (p < .01). However, trisubstance users did not discount significantly more than did any dual-substance group. Trisubstance use was associated with greater impulsivity than was monosubstance smoking but exhibited no greater impulsivity than did dual-substance use, suggesting a ceiling effect on discounting when more than 2 substances are in use. The present study suggests that smokers who engage in additional substance use may experience worse treatment outcomes, given that excessive discounting is predictive of poor therapeutic outcomes in several studies.

Therapeutic Opportunities for Self-Control Repair in Addiction and Related Disorders: Change and the Limits of Change in Trans-Disease Processes.

Contemporary neuro-economic approaches hypothesize that self-control failure results from drugs annexing normal learning mechanisms that produce pathological reward processing and distort decision-making as a result from the dysregulation of two valuation systems. An emphasis on processes shared across different diseases and disorders is at odds with the contemporary approach that assumes unique disease etiologies and treatments. Studying trans-disease processes can identify mechanisms that operate in multiple disease states and ascertain if factors that influence processes in one disease state may be applicable to all disease states. In this paper we review the dual model of self-control failure, the Competing Neurobehavioral Decision Systems approach, the relationship of delay discounting to the relative control of these two systems, and evidence that the executive system can be strengthened. Future research that could result in more potent interventions for executive system improvement and potential constraints on the repair of self-control failure are discussed.

Computerized Working-Memory Training as a Candidate Adjunctive Treatment for Addiction.

Alcohol and other drug dependencies are, in part, characterized by deficits in executive functioning, including working memory. Working-memory training is a candidate computerized adjunctive intervention for the treatment of alcoholism and other drug dependencies. This article reviews emerging evidence for computerized working memory training as an efficacious adjunctive treatment for drug dependence and highlights future challenges and opportunities in the field of working-memory training, including duration of training needed, persistence of improvements and utility of booster sessions, and selection of patients based on degree of deficits.

The behavioral- and neuro-economic process of temporal discounting: A candidate behavioral marker of addiction.

Addiction science would benefit from the identification of a behavioral marker. A behavioral marker could reflect the projected clinical course of the disorder, function as a surrogate measure of clinical outcome, and/or may be related to biological components that underlie the disorder. In this paper we review relevant literature, made possible with the early and sustained support by NIDA, to determine whether temporal discounting, a neurobehavioral process derived from behavioral economics and further explored through neuroeconomics, may function as a behavioral marker. Our review suggests that temporal discounting 1) identifies individuals who are drug-dependent, 2) identifies those at risk of developing drug dependence, 3) acts as a gauge of addiction severity, 4) correlates with all stages of addiction development, 5) changes with effective treatment, and 6) may be related to the biological and genetic processes that underlie addiction. Thus, initial evidence supports temporal discounting as a candidate behavioral marker. Additional studies will be required in several areas for a more conclusive determination. Confirmation that temporal discounting functions as a behavioral marker for addiction could lead to 1) a screen for new treatments, 2) personalization of prevention and treatment interventions, and 3) the extension of temporal discounting as a behavioral marker for other etiologically similar disorders. This article is part of a Special Issue entitled 'NIDA 40th Anniversary Issue'.

Immunohistochemical characterization of axonal sprouting in mice.

PURPOSE: Transgenic manipulation of mouse physiology facilitates the preclinical study of genetic risk factors, neural plasticity, and reactive processes accompanying Alzheimer's disease. Alternatively, entorhinal cortex lesions (ECLs) model pathophysiological denervation and axonal sprouting in rat. Given reports of anatomical differences between the mouse and rat hippocampus, application of the ECL paradigm to transgenic mice first requires comprehensive characterization of axonal sprouting in the wild-type. METHODS: Adult male C57BL/6 mice sustained unilateral transections of the perforant pathway. Subjects were sacrificed at 1, 4, 10, 18, and 28 days postlesion, and hippocampal sections were stained for AChE, the postsynaptic terminal marker drebrin, and the presynaptic terminal proteins SNAP-25, GAP-43, synapsin, and synaptophysin. To examine synaptic turnover and reinnervation, ipsilateral-to-contralateral staining densities were determined within the dentate molecular layer, and shrinkage-corrected ratios were compared to 28 day-yoked sham cases. RESULTS: At 28 days postlesion, ipsilateral terminal marker densities exhibited significant depression. In contrast, qualitative analyses at earlier time points suggested altered AChE staining patterns and increased SNAP-25 and synapsin immunoreactivity in the inner molecular layer (IML) of the dentate gyrus. CONCLUSIONS: C57BL/6 mice exhibit synaptic reorganization following perforant path transections. The IML may provide a key target for evaluation and intervention in ECL mouse models.

Impact of system management on vegetative treatment system effluent concentrations.

Beef feedlots of all sizes are looking for more cost-effective solutions for managing feedlot runoff. Vegetative treatment systems are one potential option, but require performance evaluation for use on concentrated animal feeding operations. The performance of six vegetative treatment systems on open beef feedlots throughout Iowa was monitored from 2006 through 2009. These feedlots had interim, National Pollution Discharge Elimination System permits that allowed the use of vegetative treatment systems to control and treat runoff from the open feedlots. This manuscript focuses on making within site comparisons, i.e., from year-to-year and component-to-component within a site, to evaluate how management changes and system modifications altered performance. The effectiveness, in terms of effluent concentration reductions, of each system was evaluated; nutrient concentration reductions typically ranged from 60 to 99% during treatment in the vegetative components of the vegetative treatment systems. Monitoring results showed a consistent improvement in system performance during the four years of study. Much of this improvement can be attributed to improved management techniques and system modifications that addressed key performance issues. Specifically, active control of the solid settling basin outlet improved solids retention and allowed the producers to match effluent application rates to the infiltration rate of the vegetative treatment area, reducing the occurrence of effluent release. Additional improvements resulted from system maturation, increased operator experience, and the addition of earthen flow spreaders within the vegetative treatment area to slow flow and provide increased effluent storage within the treatment area, and switching to active management of settling basin effluent release.

Oxytocin selectively increases perceptions of harm for victims but not the desire to punish offenders of criminal offenses.

The neuropeptide oxytocin functions as a hormone and neurotransmitter and facilitates complex social cognition and approach behavior. Given that empathy is an essential ingredient for third-party decision-making in institutions of justice, we investigated whether exogenous oxytocin modulates empathy of an unaffected third-party toward offenders and victims of criminal offenses. Healthy male participants received intranasal oxytocin or placebo in a randomized, double-blind, placebo-controlled, between-subjects design. Participants were given a set of legal vignettes that described an event during which an offender engaged in criminal offenses against victims. As an unaffected third-party, participants were asked to rate those criminal offenses on the degree to which the offender deserved punishment and how much harm was inflicted on the victim. Exogenous oxytocin selectively increased third-party decision-makers' perceptions of harm for victims but not the desire to punish offenders of criminal offenses. We argue that oxytocin promoted empathic concern for the victim, which in turn increased the tendency for prosocial approach behavior regarding the interpersonal relationship between an unaffected third-party and a fictional victim in the criminal scenarios. Future research should explore the context- and person-dependent nature of exogenous oxytocin in individuals with antisocial personality disorder and psychopathy, in whom deficits in empathy feature prominently.