Clinical trial NCT04128761: Decreasing the Temporal Window in Individuals with Alcohol Use Disorder
Official title: Reinforcer Pathology 1B: Decreasing the Temporal Window
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Alcohol Use Disorder
Keywords: Delay Discounting
Behavioral Economic Demand
Scarcity Narrative
Alcohol Craving
Lead sponsor: Virginia Polytechnic Institute and State University
Sponsor class: OTHER
Collaborators: name: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
name: McMaster University
name: Arizona State University
name: Carilion Clinic
name: University of Kentucky
First posted: 2019-10-16
Enrollment: 161
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: BASIC_SCIENCE

Brief summary: In the absence of sufficient monetary resources, individuals must attend to immediate, minimum needs (e.g., food, shelter). This constricts one's temporal window and engenders neglect of the future. In observational studies, scarcity is associated with higher rates of delay discounting. Additionally, socioeconomic status is inversely associated with alcohol use disorder and related problems. Experimentally, scarcity shortens attention, impedes cognitive function, and increases delay discounting in multiple populations. Moreover, scarcity increases demand for fast foods in the obese and increases craving for alcohol in problem drinkers. These data suggest that economic scarcity worsens both components of reinforcer pathology (delay discounting and alcohol overvaluation), thus increasing vulnerability to alcohol use disorder. However, studies investigating the effects of scarcity on alcohol demand discounting rate have been limited. The purpose of Aim 1b is to examine effects of decreasing the temporal window and its concomitant effects on alcohol valuation (demand, and craving) and delay discounting.

Detailed description: Participants will be randomly assigned to experimental or control groups, balanced by discounting rates and sex. We plan to have 112 participants complete the study, based on our power analysis. Participants will complete two online sessions. During the first session, they will complete the baseline assessments. During the second session, they will complete the same assessments after being exposed to the scarcity or control narratives (both in audio format).

The assessment will include delay discounting and demand tasks, and measures of alcohol craving. Participants will also complete assessments of their stress and mood response to the narrative intervention, using the Stress Appraisal Measure (SAM) and PANAS for two purposes. That is, 1) to monitor participant safety, 2) to measure the mediating ability of affect on changes in the temporal window.

Eligibility criteria: Inclusion Criteria:

* High-risk or harmful drinking (AUDIT\>15)
* 21 years of age or older
* Desire to quit or cut down on their drinking, but do not have proximate plans to enroll in treatment for AUD during the study period

Exclusion Criteria:

* having a current unmanaged psychotic disorder
* reporting current pregnancy or lactation
* having dementia

Primary outcomes:
measure: Change in Delay Discounting
timeFrame: At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)
measure: Change in Alcohol Demand
timeFrame: At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)
measure: Change in Alcohol Craving
timeFrame: At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)
Secondary outcomes:
measure: Change in Stress Appraisal Measure
timeFrame: At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)
measure: Change in Positive and Negative Affect Schedule
timeFrame: At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)
Other outcomes:
Locations:
city: Roanoke
country: United States
facility: Fralin Biomedical Research Institute at VTC
state: Virginia
Study officials:
affiliation: Fralin Biomedical Research Institute at VTC
name: Warren K Bickel, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Fralin Biomedical Research Institute at VTC
name: Stephen M LaConte, PhD
role: PRINCIPAL_INVESTIGATOR
References: