Bleak present, bright future: II. Combined effects of episodic future thinking and scarcity on delay discounting in adults at risk for type 2 diabetes

Abstract

The present study sought to determine if episodic future thinking (EFT) can decrease delay discounting (DD) and demand for fast food under simulations of economic scarcity in adults at risk for diabetes (i.e., overweight/obese and with hemoglobin A1c values in, or approaching, the prediabetic range). Across two sessions, participants completed assessments of DD and food demand at baseline and while prompted to: (1) engage in either EFT or control episodic recent thinking, and (2) while reading a brief narrative describing either economic scarcity or neutral income conditions. Results showed that EFT significantly reduced DD, whereas the economic scarcity narrative significantly increased DD; no significant interaction between EFT and scarcity was observed. No significant effect of either EFT or scarcity was observed on food demand. We conclude that EFT decreases DD even when challenged by simulated economic scarcity in adults at risk for diabetes. The absence of a significant interaction between EFT and scarcity suggests that these variables operate independently to influence DD in opposing directions. Effects of EFT and economic scarcity on food demand require further study. The present study was registered on clinicaltrials.gov (NCT03664726).

Keywords: Delay discounting; Episodic future thinking; Income shock; Obesity; Prediabetes; Scarcity.

Conflict of interest statement

Conflict of Interest: Although the following activities/relationships do not create conflict of interests pertaining to this manuscript, in the interest of full disclosure, we would like to report the following: Warren K. Bickel is a principal of HealthSim, LLC; Notifius, LLC; BEAM Diagnostics, Inc.; and a partner for Red 5 Group, LLC. In addition, he serves on the scientific advisory board for Sober Grid, Inc.; Ria Health; US WorldMeds, LLC; and is a consultant for Alkermes, Inc. and Nektar Therapeutics. Dr. Mastrandrea received research funding from the Juvenile Diabetes Research Foundation, NovoNordisk, Sanofi Aventis, and AstraZeneca. The other authors do not declare any conflict of interest with respect to the authorship or publication of this article.

Figures

Figure 1.

Change in delay discounting (AUCord) between Session 1 (baseline) and Session 2 (interventions) in episodic thinking and income narrative conditions. Error bars represent standard error of the mean. Results indicated significant main effects of episodic thinking condition (p < .05) and income narrative (p < .01), with no significant interactions between factors.

Figure 2.

Change in demand intensity (square root Q0) and elasticity (log α) between Session 1 (baseline) and Session 2 (interventions) in episodic thinking and income narrative conditions. Error bars represent standard error of the mean. Results indicated no significant main effects or interactions between conditions for either measure.