Evaluating effects of episodic future thinking on valuation of delayed reward in cocaine use disorder: a pilot study

ABSTRACT

Background: Episodic future thinking (EFT; i.e., envisioning oneself in future contexts) has been demonstrated to reduce discounting of future reward in healthy adults. While this approach has the potential to support future-oriented decision-making in substance use recovery, the impact of EFT on discounting behavior in illicit stimulant users has not yet been evaluated.

Objectives: This pilot study aimed to (1) assess the feasibility of utilizing EFT methods in individuals with cocaine use disorder (CUD) and (2) conduct preliminary measurement of the EFT effect on discounting behavior in this population.

Methods: Eighteen treatment-seeking individuals with CUD (17 males) were interviewed about positive and neutral events expected to occur at a range of future latencies. Future event information identified by participants was subsequently included on a subset of trials in an intertemporal choice task to promote EFT; within-subject differences in discounting between standard and EFT conditions were evaluated.

Results: Participants identified relevant events and demonstrated decreased discounting of future reward when event descriptors were included (relative to discounting without event descriptors; p = .039). It was further noted that most events identified by participants were goals, rather than plans or significant dates.

Conclusion: While methods previously used to study the effect of EFT on discounting behavior in healthy individuals are also effective in individuals with CUD, methodological factors – including types of events identified – should be carefully considered in future work. These preliminary findings suggest that EFT can reduce impulsive decision-making in cocaine use disorder and may therefore have therapeutic value.

KEYWORDS:

• delay discounting
• episodic future thinking
• self-control
• behavioral economics
• cocaine addiction

Additional information

Funding

This research was supported by pilot funding from the VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC, Director: D. Oslin; Pittsburgh Site Director: G. Haas), VA Pittsburgh Healthcare System. Dr. Forster was additionally supported by funding from IK2 CX001807/CX/CSRD VA during preparation of the current manuscript. The contents do not represent the views of the Department of Veterans Affairs, Department of Defense, or the United States Government. None of the authors have any financial conflicts of interest or other relevant disclosures to declare; VA Office of Research and Development [IK2 CX001807/CX/CSRD VA].