Rate-dependent effects of narrative interventions in a longitudinal study of individuals who use alcohol.
Rate-dependent effects of narrative interventions in a longitudinal study of individuals who use alcohol.
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DOI：
10.1111/acer.15020
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发表时间：
2023-02
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通讯作者：
W. H. Craft;Candice L. Dwyer;D. Tomlinson;Yu-Hua Yeh;A. Tegge;Warren K. Bickel
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作者：
W. H. Craft;Candice L. Dwyer;D. Tomlinson;Yu-Hua Yeh;A. Tegge;Warren K. Bickel
延迟折扣（DD），奖励价值的降低作为延迟接收的函数，是酒精使用的一个关键过程。叙述性干预措施，包括情景未来思考（EFT），减少了延迟折扣和对酒精的需求。比率依赖，即基线比率与干预后该比率变化之间的关系，已被证明是药物使用治疗有效的标志，但叙事干预是否具有比率依赖效应需要更好地理解。在这项纵向在线研究中，我们调查了叙事干预对延迟折扣和假设酒精需求的影响。方法通过Amazon Mechanical Turk招募报告高风险或低风险饮酒的个体（n = 696）进行为期3周的纵向调查。延迟折扣和酒精需求断点在基线进行评估。受试者在第2周和第3周返回，随机分为EFT或稀缺叙事干预组，并再次完成延迟折扣任务和酒精断点任务。运用Oldham相关理论探讨叙事干预的速率依赖效应。研究损耗作为延迟折扣的函数进行了评估。结果情景性未来思维显著减少，而稀缺性显著增加延迟折扣。没有观察到EFT或稀缺性对酒精需求断点的影响。两种叙事干预类型均观察到显著的速率依赖效应。研究表明，较高的延迟折扣率与更大的人员流失可能性相关。EFT对延迟折现率的率依赖效应的证据为这种新型治疗干预提供了更细致、更机械的理解，并可以通过证明谁可能从中获益最多来实现更精确的治疗目标。
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.