Delay Discounting
Conditions
Keywords
intertemporal tradeoffs, delayed gratification, executive functioning, delay discounting, working memory
Brief summary
Many health-relevant decisions involve intertemporal (now vs. later) tradeoffs. Extensive literature indicates that many negative health and financial consequences suffered in mid-life are linked to adversity and disadvantage during early developmental periods of life. Individuals who continue to engage in these types of unhealthy behaviors despite awareness of the health consequences are exhibiting an inability to delay gratification. Delay discounting (DD) is quantified in human studies by determining the rate at which an individual discounts a delayed reward, while executive function (EF) is defined as the set of cognitive processes that are responsible for helping individuals manage life tasks and achieve goals. This research will attempt to reduce DD via EF training in a population of mid-life individuals with risk factors established during early-life disadvantage.
Detailed description
Many health-relevant decisions involve intertemporal (now vs. later) tradeoffs, where unhealthy choices involve immediate benefits and delayed costs, compared to healthy choices with immediate costs and delayed benefits. Reinforcement for unhealthy behaviors are immediate, while the reinforcement for healthier alternatives are delayed. Thus individuals who continue to engage in these types of unhealthy behaviors despite awareness of the health consequences are exhibiting an inability to delay gratification. Delay discounting (DD) is quantified in human studies by determining the rate at which an individual discounts a delayed reward, typically assessed by having subjects choose between a rewards available immediately and a larger reward available following a delay. For the purpose of this study, the investigators define executive function (EF) as the set of cognitive processes that are responsible for helping individuals manage life tasks and achieve goals (e.g., planning, working memory). The approach of targeting preference for immediate rewards (exhibited by elevated DD) is highly innovative. Multiple studies provide compelling evidence that strengthening EF may decrease DD. Extensive literature indicates that many negative health and financial consequences suffered in mid-life are linked to adversity and disadvantage during early developmental periods of life. By targeting a mechanism of various negative aging-related outcomes (elevated DD), the proposed research may have the novel impact on broadly remediating the health and wellness of mid-life individuals at increased risk for poor consequences due to early-life disadvantage. This research will attempt to reduce Delay Discounting via Executive Functioning training in a population of mid-life individuals with risk factors established during early-life disadvantage. DD, EF, and associated health behaviors/outcomes will be assessed at baseline, following training, and at 3- and 6-month follow-up. Participants will receive Active EF training, or Control training. Given the established effect of Active training in reducing DD in stimulant-dependent individuals, the study team expect reductions in DD, improvements in EF, and improvements in associated health behaviors/outcomes following Active training and at follow-up, with no improvements in the Control group.
Interventions
BEHAVIORALSequenced Recall of Digits--Auditory
Auditory digit sequence AT memory component.
BEHAVIORALSequenced Reverse Recall of Digits--Auditory
Reversed auditory digit sequence AT memory component.
BEHAVIORALSequenced Recall of Words--Visual
Visual word sequence AT memory component
BEHAVIORALVerbal Memory--Visual
word recognition AT memory component
Sponsors
University of Maryland, Baltimore
University of Florida
Michigan State University
National Institute on Aging (NIA)
University of Kansas
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
40 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Community members in neighborhoods of Baltimore, Maryland * Participants willing to participate in the 5-7 week program
Exclusion criteria
* Participants with a severe substance use disorder according to the DSM-5 with any substance other than tobacco * Participants with any significant medical or psychiatric condition which the training is not designed for (e.g., traumatic brain injury, dementia, significant learning disability, or schizophrenia) * Participants with severe depression
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Delay Discounting (DD) | Baseline; Week 6-8; Month 3; Month 6 | A binary choice procedure will be conducted on a personal computer to assess relative preference for immediate versus delayed rewards. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Letter Numbering Sequencing (LTC) | Baseline; Week 6-8; Month 3; Month 6 | The participant is given a mixed string of letters and numbers that must then be put into a sequential order of numbers followed by a sequential order of letters. |
| Change in Hopkins Verbal Learning Test | Baseline; Week 6-8; Month 3; Month 6 | Participants memorize a list of words presented auditorily, then are asked to recall or recognize as many words as possible, either immediately or following a delay. |
| Change in Tower of Hanoi (ToH) | Baseline; Week 6-8; Month 3; Month 6 | Participants must move the stack of disks from one peg to another while following specific rules. |
| Change in Iowa Gambling Task | Baseline; Week 6-8; Month 3; Month 6 | Participants are asked to choose to flip cards from one of 4 decks, where each deck is associated with a specific probability of winning and losing some money. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Starting the Conversation: Diet Questionnaire | Baseline; Week 6-8; Month 3; Month 6 | Assesses participants' diet |
| Change in blood pressure | Baseline; Week 6-8; Month 3; Month 6 | systolic and dystolic blood pressure |
| Change in lipid profile | Baseline; Week 6-8; Month 3; Month 6 | assessing abnormalties in lipids |
| Change in Timeline Follow-Back | Baseline; Week 6-8; Month 3; Month 6 | Assess relevant point prevalence of alcohol/tobacco/drug use. |
| Change in body expired carbon monoxide | Baseline; Week 6-8; Month 3; Month 6 | expired carbon monoxide (parts per million), a measure of recent cigarette smoking |
| Change in physical activity | Baseline; Week 6-8; Month 3; Month 6 | International Physical Activity Questionnaire (IPAQ) self-reported physical activity assessment |
| Change in body mass index | Baseline; Week 6-8; Month 3; Month 6 | body mass index, a ratio of weight (kg) and height (m) will be calculated as kg/m\^2 |
| Change in The Multidimensional Health Locus of Control | Baseline; Week 6-8; Month 3; Month 6 | An 18-item questionnaire assessing the perception of the underlying causes of health outcomes events. |
| Change in Chernyshenko Conscientiousness Scale (CCS) | Baseline; Week 6-8; Month 3; Month 6 | CCS is used to assess six facets of conscientiousness, ranking them on a scale of 1-4 with 4 being strongly agree. |
| Resource Utilization Measure | Baseline; Week 6-8; Month 3; Month 6 | Addresses if individuals accessed healthcare providers in the past thirty days, including visits to doctor's offices or seeing a mental health professional |
| Change in Patient Activation Measure | Baseline; Week 6-8; Month 3; Month 6 | Assesses how knowledgeable participants are about their health and how they can control it. |
Countries
United States
Contacts
Primary ContactRichard Yi, PhD
Backup ContactAnahi Collado, PhD
Outcome results
None listed