Decreasing the Temporal Window in Individuals With Alcohol Use Disorder (RP1B)

Reinforcer Pathology 1B: Decreasing the Temporal Window

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.

Study Overview

• Status: Completed
• Conditions: Alcohol Use Disorder
• Intervention / Treatment: Behavioral: Scarcity Narrative; Behavioral: Neutral Narrative

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) for two purposes. That is, 1) to monitor participant safety, 2) to measure the mediating ability of affect on changes in the temporal window.

• Study Type: Interventional
• Enrollment (Actual): 124
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Virginia
    • Roanoke, Virginia, United States, 24016
      • Fralin Biomedical Research Institute at VTC

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Scarcity Narrative; Participants assigned to the scarcity group will be asked to listen and consider a hypothetical narrative about a sudden loss of resources.	Behavioral: Scarcity Narrative; Participants are presented with a hypothetical scarcity narrative and asked to listen and consider the scenario.
Sham Comparator: Neutral Narrative; Participants assigned to the neutral group will be asked to listen and consider a hypothetical narrative about a neutral change in resources.	Behavioral: Neutral Narrative; Participants are presented with a hypothetical neutral narrative and asked to listen and consider the scenario.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Delay Discounting (DD) Rates	DD rates were measured using an adjusting amount task where participants were presented with hypothetical choices between smaller immediate or larger later amounts of money after a range of delays (1 day-25 years). Individual indifference points were calculated for each delay and then used to estimate DD rates for each participant using Mazur's (1987) equation: V = A/(1+kD), where V is the value of the indifference point, A is the amount of the larger delayed reward, k is the discounting rate, and D is the delay. Discounting rates (k) were then natural-logarithmically transformed (ln(k)). Higher ln(k) indicates steeper discounting and greater reward devaluation with increases in delay, while a lower ln(k) reflects shallower discounting and less reward devaluation with increases in delay. Changes in ln(k) were compared within-subjects between S1 and S2. Average ln(k) was calculated for each session (S1 and S2) in each condition (scarcity or neutral).	At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)
Intensity of Alcohol Demand	Participants completed a hypothetical Alcohol Purchase Task where they had to indicate how many drinks they would purchase at different prices ($0 to $80 per drink). The number of drinks purchased at $0 was used to calculate the intensity of demand. Changes in intensity of alcohol demand were compared within-subjects between Session 1 and Session 2, and between narrative type (scarcity or neutral).	At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)
Change in Alcohol Craving	A brief questionnaire (the Alcohol Urges Questionnaire) will be used to assess alcohol craving. The Alcohol Urges Questionnaire is an 8-item survey that produces scores between 8-56, where higher scores indicate greater craving. Change in alcohol craving will be compared within-subjects between Session 1 and Session 2. The scores will be compared between groups (arms) across sessions.	At the first session (S1; baseline measures) and Session 2 (S2; occurs approximately 2-3 days after S1)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Stress Appraisal Measure	The Stress Appraisal Measure will be used to measure acute stress induced by the intervention. This measure is a 28-item survey that produces scores between 28-140, where higher scores indicate greater stress. Change scores were compared between groups during Session 2, to assess differences in stress level as a function of the narrative presented.	Session 2 (occurs approximately 2-3 days after baseline [S1])

Collaborators and Investigators

• Sponsor: Virginia Polytechnic Institute and State University
• Collaborators: National Institute on Alcohol Abuse and Alcoholism (NIAAA); McMaster University; Carilion Clinic; University of Kentucky; Arizona State University
• Investigators: Principal Investigator: Stephen M LaConte, PhD, Fralin Biomedical Research Institute at VTC

Study record dates

Study Major Dates

• Study Start (Actual): September 21, 2023
• Primary Completion (Actual): May 28, 2024
• Study Completion (Actual): May 28, 2024

Study Registration Dates

• First Submitted: October 10, 2019
• First Submitted That Met QC Criteria: October 15, 2019
• First Posted (Actual): October 16, 2019

Study Record Updates

• Last Update Posted (Estimated): December 17, 2025
• Last Update Submitted That Met QC Criteria: December 2, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Alcohol Craving; Delay Discounting; Behavioral Economic Demand; Scarcity Narrative
• Additional Relevant MeSH Terms: Mental Disorders; Substance-Related Disorders; Chemically-Induced Disorders; Alcohol-Related Disorders; Alcoholism
• Other Study ID Numbers: #23-621; R01AA027381-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

Investigators will adhere to all NIH requirements regarding data sharing. Participant data collected in this project will be de-identified and made available on a shared secured data repository. We will also share the analysis results. As part of this process, all investigators will be required to agree to the following conditions: 1) will adhere to the reporting responsibilities; 2) will not redistribute the data beyond the requesting individual and named collaborators; 3) will give appropriate acknowledgement; 4) will not use the data for commercial purposes; and 5) will obtain appropriate ethical approvals.

Results from research conducted will be shared and disseminated, including: regular project meetings, annual meetings, symposia, workshops, and/or conferences for related groups. Manuscripts will be written and submitted for publication in peer-reviewed journals/conferences, following the NIH Public Access Policy guidelines. All necessary ethical approvals will be obtained.

• IPD Sharing Time Frame: Data will be made available upon request after dissemination of results.
• IPD Sharing Access Criteria: Data requests will be reviewed by the principal investigator and data will be shared with the expectation of acknowledgment of funding source and primary study team.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No