Testing the Reinforcer Pathology Theory: A New Insight into Novel Targets for Drug Addiction

• Main Author: Athamneh, Liqa
• Other Authors: Graduate School
• Format: Others
• Published: Virginia Tech 2021
• Subjects: Reinforcer Pathology; addiction; health risk behaviors; episodic future thinking; mating; narrative theory
• Online Access: http://hdl.handle.net/10919/103734

Despite decades of effort in developing evidence-based treatments, drug addiction remains one of the most problematic and enduring public health crises. Developing a new generation of theoretically-derived interventions constitutes an important clinical and scientific gap that, if addressed, may open innovative treatment opportunities. Based on the Reinforcer Pathology theory, altering the temporal window over which reinforcers are integrated (i.e., measured by delay discounting) would alter drug valuation and consumption. The first investigation—in 2 separate studies— test the Reinforcer Pathology theory by examining the effect of expanding and constricting the temporal window of integration using two mating narratives (long-term and short-term relationships, respectively) on cigarette valuation among cigarette smokers. The second investigation, test the Reinforcer Pathology theory by assessing the effect of remotely delivered Episodic Future Thinking (EFT) narratives (expands the temporal window) on real-world alcohol consumption among individuals with alcohol use disorder (AUD). Together, these investigations supported the Reinforcer Pathology theory and demonstrated its relevance for understanding and intervening in addiction. The current findings provide scientific justification to further investigate Reinforcer Pathology based interventions that expand the temporal window to change drug valuation and consumption. The construction of multi-component treatments that incorporate Reinforcer Pathology based interventions to systematically alter the temporal window may provide a novel intervention to reduce alcohol consumption. === Doctor of Philosophy === The following studies provide evidence that altering the temporal widow (how far in the future one can imagine and integrate into the present) would alter drug valuation. In the following studies, we used narratives describing long-term or short-term mating relationships (Study 1) and Episodic Future Thinking (EFT; represents one's capability to pre-experience the future; Study 2) to alter the valuation of cigarettes and alcohol, respectively. In the first study, cigarette smokers who read and vividly imagined long-term romance relationship narrative (expands the temporal window) valued cigarettes less than control (imagined looking for a lost key). In contrast, those who read and vividly imagined a short-term sexual encounter (shortens the temporal window) valued cigarettes more than controls. The second study employed EFT (expands the temporal window) as a strategy to reduce alcohol consumption, in real-world settings, over two weeks in individuals with alcohol use disorder. The study found that expanding the temporal window using EFT reduced alcohol consumption. Together, these two studies provide support to employing interventions that extend the temporal window to change drug valuation and consumption. The construction of multi-component treatments that incorporate interventions expanding the temporal window may reduce drug consumption.