The Phenotype of Recovery III: Delay Discounting Predicts Abstinence Self-Efficacy Among Individuals in Recovery From Substance Use Disorders

• Published in: Psychology of addictive behaviors 2019-05, Vol.33 (3), p.310-317
• Main Authors: Athamneh, Liqa N., DeHart, William B., Pope, Derek, Mellis, Alexandra M., Snider, Sarah E., Kaplan, Brent A., Bickel, Warren K.
• Format: Article
• Language: English
• Subjects: Abstinence; Addictions; Adult; Arousal; Behavior, Addictive - psychology; Behavior, Addictive - therapy; Candidates; Clinical outcomes; Craving; Delay Discounting; Delay Discounting - physiology; Discounting; Drug Abstinence; Drug abuse; Drug Usage; Drug use; Emotions; Ethnicity; Female; Human; Humans; Intensive care; Intensive treatment; Intention; Male; Marital status; Medical treatment; Middle Aged; Negative emotions; Phenotype; Phenotypes; Positive emotions; Principal components analysis; Prognosis; Questionnaires; Race; Recovery; Relapse; Relapse (Disorders); Self Efficacy; Substance Use Disorder; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; Surveys and Questionnaires; Treatment Outcome; Treatment Outcomes
• ISSN: 0893-164X; 1939-1501
• DOI: 10.1037/adb0000460

Abstinence self-efficacy (ASE) and delay discounting predict treatment outcomes and risk of relapse. Associations between delay discounting and ASE among individuals in recovery from substance use have not been investigated. Data from 216 individuals in recovery from substance abuse recruited from The International Quit & Recovery Registry, an ongoing online data collection program used to understand addiction and how people succeed in recovery, were included in the analysis. Discounting rates were assessed using an adjusting-delay task, and ASE was assessed using the Relapse Situation Efficacy Questionnaire (RSEQ). Delay discounting was a significant predictor of ASE, even after controlling for age, gender, race, ethnicity, annual income, education level, marital status, and primary addiction. Context-specific factors of relapse included Negative Affect, Positive Affect, Restrictive Situations (to drug use), Idle Time, Social-Food Situations, Low Arousal, and Craving. A principal component analysis of RSEQ factors in the current sample revealed that self-efficacy scores were primarily unidimensional and not situation specific. The current study expands the generality of delay discounting and indicates that discounting rates predict ASE among individuals in recovery from substance use disorders. This finding supports the recent characterizations of delay discounting as a candidate behavioral marker of addiction and may serve as a basis to better identify and target subgroups that need unique or more intensive interventions to address higher risks of relapse and increase their likelihood of abstinence.