Mikhail N. Koffarnus

Excessive discounting of delayed reinforcers as a trans-disease process contributing to addiction and other disease-related vulnerabilities: emerging evidence.

Delay discounting describes the devaluation of a reinforcer as a function of the delay until its receipt. Although all people discount delayed reinforcers, one consistent finding is that substance-dependent individuals tend to discount delayed reinforcers more rapidly than do healthy controls. Moreover, these higher-than-normal discounting rates have been observed in individuals with other behavioral maladies such as pathological gambling, poor health behavior, and overeating. This suggests that high rates of delay discounting may be a trans-disease process (i.e., a process that occurs across a range of disorders, making findings from one disorder relevant to other disorders). In this paper, we argue that delay discounting is a trans-disease process, undergirded by an imbalance between two competing neurobehavioral decision systems. Implications for our understanding of, and treatment for, this trans-disease process are discussed.

The Behavioral Economics of Substance Use Disorders: Reinforcement Pathologies and Their Repair

The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics.

CHANGING DELAY DISCOUNTING IN THE LIGHT OF THE COMPETING NEUROBEHAVIORAL DECISION SYSTEMS THEORY: A REVIEW

Excessively devaluing delayed reinforcers co-occurs with a wide variety of clinical conditions such as drug dependence, obesity, and excessive gambling. If excessive delay discounting is a trans-disease process that underlies the choice behavior leading to these and other negative health conditions, efforts to change an individuals discount rate are arguably important. Although discount rate is often regarded as a relatively stable trait, descriptions of interventions and environmental manipulations that successfully alter discount rate have begun to appear in the literature. In this review, we compare published examples of procedures that change discount rate and classify them into categories of procedures, including therapeutic interventions, direct manipulation of the executive decision-making system, framing effects, physiological state effects, and acute drug effects. These changes in discount rate are interpreted from the perspective of the competing neurobehavioral decision systems theory, which describes a combination of neurological and behavioral processes that account for delay discounting. We also suggest future directions that researchers could take to identify the mechanistic processes that allow for changes in discount rate and to test whether the competing neurobehavioral decision systems view of delay discounting is correct.

Identification of a dopamine transporter ligand that blocks the stimulant effects of cocaine.

There is a large unmet medical need for cocaine addiction treatments. Studies have indicated that the dopamine transporter (DAT) is the primary biological target of cocaine, and most drugs that have DAT affinity have behavioral effects like those of cocaine. However, analogs of benztropine have high DAT affinity and behavioral effects that show varying degrees of similarity to cocaine. We now report the discovery that a benztropine analog, JHW007, with high affinity for the DAT does not have cocaine-like behavioral effects and antagonizes the effects of cocaine. JHW007 occupied the DAT in vivo more slowly than did cocaine and had not reached an apparent plateau up to 270 min after injection. The in vivo binding of cocaine to the DAT suggested rate of DAT occupancy as an important contributor to its behavioral effects, and the slow association with the DAT may provide an explanation for JHW007 being relatively devoid of cocaine-like behavioral effects. The antagonism of cocaine suggests that DAT ligands with reduced cocaine-like activity can function as cocaine antagonists and suggests JHW007 as a lead for discovery of cocaine-abuse pharmacotherapeutics.

Effects of selective dopaminergic compounds on a delay-discounting task

Impulsivity is widely regarded as a multidimensional trait that encompasses two or more distinct patterns of behavior, and dopaminergic systems are implicated in the expression of impulsive behavior in both humans and animal subjects. Impulsive choice, or the tendency to choose rewards associated with relatively little or no delay, has been extensively studied in humans and animal subjects using delay-discounting tasks. Here, delay-discounting procedures were used to assess the effects of receptor-selective dopaminergic agonists, antagonists, and dopamine transporter ligands on choices of immediate versus delayed sucrose pellets. The effects of d-amphetamine, GBR 12909, apomorphine, SKF 81297, sumanirole, pramipexole, ABT-724, SCH 23390, L-741,626, PG01037, and L-745,870 were assessed in 24 Sprague–Dawley rats. The only drugs to affect impulsive choice selectively without altering undelayed choice were the D1-like antagonist, SCH 23390 (0.01 mg/kg), and the D4 partial agonist, ABT-724 (3.2 mg/kg), which both increased impulsive choice. The shared effects of these compounds may be explained by their localization within the prefrontal cortex on different groups of neurons. None of the selective agonists and antagonists tested reduced impulsive choice, so further research is needed to determine if direct dopaminergic agonists or antagonists may be therapeutically useful in the treatment of impulse-control disorders.

A 5-trial adjusting delay discounting task: accurate discount rates in less than one minute.

Individuals who discount delayed rewards at a high rate are more likely to engage in substance abuse, overeating, or problem gambling. Such findings suggest the value of methods to obtain an accurate and fast measurement of discount rate that can be easily deployed in variety of settings. In the present study, we developed and evaluated the 5-trial adjusting delay task, a novel method of obtaining a discount rate in less than 1 min. We hypothesized that discount rates from the 5-trial adjusting delay task would be similar and would correlate with discount rates from a lengthier task we have used previously, and that 4 known effects relating to delay discounting would be replicable with this novel task. To test these hypotheses, the 5-trial adjusting delay task was administered to 111 college students 6 times to obtain discount rates for 6 different commodities, along with a lengthier adjusting amount discounting task. We found that discount rates were similar and correlated between the 5-trial adjusting delay task and the adjusting amount task. Each of the 4 known effects relating to delay discounting was replicated with the 5-trial adjusting delay task to varying degrees. First, discount rates were inversely correlated with amount. Second, discount rates between past and future outcomes were correlated. Third, discount rates were greater for consumable rewards than with money, although we did not control for amount in this comparison. Fourth, discount rates were lower when

Using crowdsourcing to compare temporal, social temporal, and probability discounting among obese and non-obese individuals

0 amounts opposing the chosen time point were explicitly described. Results indicate that the 5-trial adjusting delay task is a viable, rapid method to assess discount rate.

A modified exponential behavioral economic demand model to better describe consumption data.

Previous research comparing obese and non-obese samples on the delayed discounting procedure has produced mixed results. The aim of the current study was to clarify these discrepant findings by comparing a variety of temporal discounting measures in a large sample of internet users (n=1163) obtained from a crowdsourcing service, Amazon Mechanical Turk (AMT). Measures of temporal, social-temporal (a combination of standard and social temporal), and probability discounting were obtained. Significant differences were obtained on all discounting measures except probability discounting, but the obtained effect sizes were small. These data suggest that larger-N studies will be more likely to detect differences between obese and non-obese samples, and may afford the opportunity, in future studies, to decompose a large obese sample into different subgroups to examine the effect of other relevant measures, such as the reinforcing value of food, on discounting.

Individual differences in discount rate are associated with demand for self-administered cocaine, but not sucrose

Behavioral economic demand analyses that quantify the relationship between the consumption of a commodity and its price have proven useful in studying the reinforcing efficacy of many commodities, including drugs of abuse. An exponential equation proposed by Hursh and Silberberg (2008) has proven useful in quantifying the dissociable components of demand intensity and demand elasticity, but is limited as an analysis technique by the inability to correctly analyze consumption values of zero. We examined an exponentiated version of this equation that retains all the beneficial features of the original Hursh and Silberberg equation, but can accommodate consumption values of zero and improves its fit to the data. In Experiment 1, we compared the modified equation with the unmodified equation under different treatments of zero values in cigarette consumption data collected online from 272 participants. We found that the unmodified equation produces different results depending on how zeros are treated, while the exponentiated version incorporates zeros into the analysis, accounts for more variance, and is better able to estimate actual unconstrained consumption as reported by participants. In Experiment 2, we simulated 1,000 datasets with demand parameters known a priori and compared the equation fits. Results indicated that the exponentiated equation was better able to replicate the true values from which the test data were simulated. We conclude that an exponentiated version of the Hursh and Silberberg equation provides better fits to the data, is able to fit all consumption values including zero, and more accurately produces true parameter values.

Employment-based reinforcement of adherence to depot naltrexone in unemployed opioid-dependent adults: a randomized controlled trial.

Substance abusers, including cocaine abusers, discount delayed rewards to a greater extent than do matched controls. In the current experiment, individual differences in discounting of delayed rewards in rats (choice of one immediate over three delayed sucrose pellets) were assessed for associations with demand for either sucrose pellets or an intravenous dose of 0.1 mg/kg/infusion cocaine. Twenty‐four male Sprague Dawley rats were split into three groups based on sensitivity to delay to reinforcement. Then, demand for sucrose pellets and cocaine was determined across a range of fixed‐ratio values. Delay discounting was then reassessed to determine the stability of this measure over the course of the experiment. Individual differences in impulsive choice were positively associated with elasticity of demand for cocaine, a measure of reinforcer value, indicating that rats having higher discount rates also valued cocaine more. Impulsive choice was not associated with the level of cocaine consumption as price approached 0 or with any parameter associated with demand for sucrose. Individual sensitivity to delay was correlated with the initial assessment when reassessed at the end of the experiment, although impulsive choice increased for this cohort of rats as a whole. These findings suggest that impulsive choice in rats is positively associated with valuation of cocaine, but not sucrose.