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Future thinking to decrease real-world drinking in alcohol use disorder: Repairing reinforcer pathology in a

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Episodic future thinking (EFT) significantly reduced alcohol consumption in individuals with alcohol use disorder (AUD) by expanding the temporal window of reinforcement. This remote intervention proved feasible and acceptable for reducing drinking behaviors.

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Area of Science:

  • Psychology
  • Neuroscience
  • Behavioral Science

Background:

  • Reinforcer Pathology theory suggests reducing delay discounting via episodic future thinking (EFT) decreases alcohol consumption.
  • Evidence for EFT's effectiveness in real-world settings for alcohol use disorder (AUD) is limited.
  • Remote delivery methods for psychological interventions require further investigation.

Purpose of the Study:

  • To examine the effect of remotely delivered EFT on reducing real-world alcohol consumption in individuals with AUD.
  • To assess the feasibility and acceptability of a remote EFT intervention for AUD.
  • To test the Reinforcer Pathology theory in a practical, remote setting.

Main Methods:

  • A randomized proof-of-concept field trial was conducted with 52 individuals diagnosed with moderate to severe AUD.
  • Participants were randomized to either episodic future thinking (EFT) or episodic recent thinking (ERT) delivered remotely.
  • Alcohol consumption and delay discounting rates were measured pre- and post-intervention.

Main Results:

  • EFT significantly reduced daily alcohol consumption by -2.18 drinks compared to ERT's -0.52 drinks (p = .031).
  • Reductions in delay discounting rates predicted decreased alcohol consumption, even after controlling for demographic and addiction history variables (coef. = .424, p = .030).
  • Overall satisfaction with the remote intervention was high (3.92/5), indicating feasibility and acceptability.

Conclusions:

  • Remotely delivered EFT is an effective intervention for reducing alcohol consumption in individuals with AUD.
  • Findings support Reinforcer Pathology theory by demonstrating EFT's ability to expand the temporal window of reinforcement.
  • The remote delivery model is feasible, acceptable, and offers a promising avenue for clinical deployment in AUD treatment.