Home > Rate-dependent effects of narrative interventions in a longitudinal study of individuals who use alcohol.

Craft, William H and Dwyer, Candice L and Tomlinson, Devin C and Yeh, Yu-Hua and Tegge, Allison N and Bickel, Warren K (2023) Rate-dependent effects of narrative interventions in a longitudinal study of individuals who use alcohol. Alcohol: Clinical and Experimental Research, 47, (3), pp. 566-576. doi: 10.1111/acer.15020.

External website: https://onlinelibrary.wiley.com/doi/10.1111/acer.1...

BACKGROUND: Delay discounting (DD), the decrease in reward valuation as a function of delay to receipt, is a key process undergirding alcohol use. Narrative interventions, including episodic future thinking (EFT), have decreased delay discounting and demand for alcohol. Rate dependence, the relationship between a baseline rate and change in that rate after an intervention, has been evidenced as a marker of efficacious substance use treatment, but whether narrative interventions have rate-dependent effects needs to be better understood. We investigated the effects of narrative interventions on delay discounting and hypothetical demand for alcohol in this longitudinal, online study.

METHODS: Individuals (n = 696) reporting high- or low-risk alcohol use were recruited for a longitudinal 3-week survey via Amazon Mechanical Turk. Delay discounting and alcohol demand breakpoint were assessed at baseline. Individuals returned at weeks 2 and 3 and were randomized into the EFT or scarcity narrative interventions and again completed the delay discounting tasks and alcohol breakpoint task. Oldham's correlation was used to explore the rate-dependent effects of narrative interventions. Study attrition as a function of delay discounting was assessed.

RESULTS: Episodic future thinking significantly decreased, while scarcity significantly increased delay discounting relative to baseline. No effects of EFT or scarcity on the alcohol demand breakpoint were observed. Significant rate-dependent effects were observed for both narrative intervention types. Higher delay discounting rates were associated with a greater likelihood of attrition from the study.

CONCLUSION: The evidence of a rate-dependent effect of EFT on delay discounting rates offers a more nuanced, mechanistic understanding of this novel therapeutic intervention and can allow more precise treatment targeting by demonstrating who is likely to receive the most benefit from it.

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