Effects of episodic future thinking on reinforcement pathology during smoking cessation treatment among individuals with substance use disorders

Ángel García-Pérez,Gema Aonso-Diego,Sara Weidberg,Roberto Secades-Villa

doi:10.1007/s00213-021-06057-6

Ángel García-Pérez, Gema Aonso-Diego + Show 2 more

Open Access

https://doi.org/10.1007/s00213-021-06057-6

Copy DOI

Journal: Psychopharmacology	Publication Date: Jan 12, 2022
Citations: 9	License type: open-access

Affiliation: University of Oviedo

Abstract

RationaleReinforcer pathology (RP) is a theoretical model based on two processes: delay discounting (DD) and drug demand. Given that RP has been shown to have a predictive value on smoking behaviors, several studies have explored which interventions can reduce RP. Consistent with the RP framework, episodic future thinking (EFT) has shown effects on treatment outcomes and RP processes. The vast majority of studies that assess the effects of EFT on RP consist of experimental studies, and no previous research has tested these effects in a clinical sample of smokers.ObjectivesThe primary aim of this study was to assess the effects of EFT on RP throughout the course of a smoking cessation intervention in smokers with substance use disorders (SUDs).MethodsParticipants were randomized to cognitive behavior therapy (CBT) + EFT (n = 39) or CBT + EFT + contingency management (n = 33). Cotinine, frequency of EFT practices, cigarette purchase task (CPT), and DD were evaluated in treatment sessions. Mixed-effects model repeated measures analysis was used to explore DD and CPT in-treatment changes as a function of EFT practices and cotinine levels.ResultsGreater practice of the EFT component significantly reduced cigarette demand (p < .020) as well as DD (p = .003). Additionally, a greater reduction in cotinine levels coupled with greater EFT practice led to a greater decrease in cigarette demand (p < .014).ConclusionsEFT reduced the two facets of RP in treatment-seeking smokers with SUDs.

Highlights

Reinforcer pathology (RP) is a novel theoretical model in the field of addictions that allows us to understand substance use disorders (SUDs) based on two processes: (1) delay discounting (DD) and (2) drug demand (Bickel et al 2014, 2019, 2020)
Cigarette demand and DD were related to some smoking variables, such as cigarettes per day
Effect of tobacco use reduction and treatment condition on DD and cigarette demand The results showed that cotinine levels were significantly associated with some cigarette demand indices

Summary

Introduction

Reinforcer pathology (RP) is a novel theoretical model in the field of addictions that allows us to understand substance use disorders (SUDs) based on two processes: (1) delay discounting (DD) and (2) drug demand (Bickel et al 2014, 2019, 2020). There are several interventions for smoking cessation (i.e., contingency management (CM), cognitive-behavioral therapy (CBT), varenicline, and low-nicotine cigarettes) that— despite not being primarily aimed at decreasing the two processes of RP—reduce DD (García-Pérez et al 2020; Secades-Villa et al 2014; Weidberg et al 2015; Yi et al 2008) and/or cigarette demand (Green and Ray 2018; Higgins et al 2018; McClure et al 2012; Murphy et al 2017; Schlienz et al 2014; Smith et al 2017; Weidberg et al 2018). In substance users, EFT has been shown to reduce DD rates (Athamneh et al 2021; Bulley and Gullo 2017; Chiou and Wu 2017; Forster et al 2021; Mellis et al 2019; Patel and Amlung 2020; Snider et al 2016; Sofis et al 2020; Stein et al 2016, 2018) and drug demand indices (Athamneh et al 2021; Bulley and Gullo 2017; Patel and Amlung 2020; Snider et al 2016, 2018; Voss et al 2021)

Objectives

Results

Conclusion