Delayed reward discounting predicts treatment response for heavy drinkers receiving smoking cessation treatment
Delayed reward discounting predicts treatment response for heavy drinkers receiving smoking cessation treatment
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DOI：
10.1016/j.drugalcdep.2009.04.020
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发表时间：
2009-10-01
影响因子：
4.2
通讯作者：
Kahler, Christopher W.
中科院分区：
文献类型：
--
作者：
MacKillop, James;Kahler, Christopher W.
延迟奖励折扣（Delayed Reward Discounting，DRD）是一种行为经济学的冲动指数，反映了个体基于时间延迟而对奖励贬值的程度。相对于较大的延迟奖励，更倾向于较小的即时奖励）。与非吸烟者相比，当前吸烟者表现出更大的DRD，但与戒烟者相比也表现出更大的DRD，这表明DRD与成功戒烟呈负相关，或者戒烟本身会降低DRD。在一项随机对照戒烟试验的寻求治疗的吸烟者（n = 57，61%男性，85%白人）样本中，本研究前瞻性地检查了DRD的一般金钱和三个等级与参与者首次戒烟时间的关系。使用考克斯比例风险回归的生存分析显示，DRD预测首次失效的天数（ps <0.05 - 0.01），并且在协变量分析中，除了小幅度折扣外，在尼古丁依赖、感觉寻求和收入之外也是如此。此外，二分比较显示，在两周和八周的随访访视中，已经失效的个体的冲动基线折扣明显更多。这些发现表明，高水平的DRD反映了戒烟治疗反应不良的风险因素。评估的变量之间的相互关系和临床策略，以改善吸烟者谁是高DRD的结果进行了讨论。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Delayed reward discounting (DRD) is a behavioral economic index of impulsivity that reflects the extent to which an individual devalues a reward based on its delay in time (i.e.. preference for smaller immediate rewards relative to larger delayed rewards). Current smokers exhibit greater DRD compared to nonsmokers, but also exhibit greater DRD compared to ex-smokers, suggesting that either DRD is inversely associated with successful smoking cessation or that smoking cessation itself reduces DRD. In a sample of treatment-seeking smokers (n = 57, 61% male, 85% Caucasian) participating in a randomized controlled smoking cessation trial, the current study prospectively examined DRD for money in general and at three magnitudes in relation to time to the participants' first lapse to smoking. Survival analysis using Cox proportional-hazards regression revealed that DRD predicted days to first lapse (ps < .05-.01) and did so beyond nicotine dependence, sensation-seeking, and income in covariate analyses, with the exception of small magnitude discounting. In addition, dichotomous comparisons revealed significantly more impulsive baseline discounting for individuals who had lapsed by the two-week and eight-week follow-up visits. These findings indicate that high levels of DRD reflect a risk factor for poor smoking cessation treatment response. interrelationships among the variables assessed and clinical strategies to improve outcomes for smokers who are high in DRD are discussed. (C) 2009 Elsevier Ireland Ltd. All rights reserved.