Remember the Future: Working Memory Training Decreases Delay Discounting Among Stimulant Addicts

doi:10.1016/j.biopsych.2010.08.017

Biological Psychiatry

Volume 69, Issue 3, 1 February 2011, Pages 260-265

https://doi.org/10.1016/j.biopsych.2010.08.017 Get rights and content

Background

Excessive discounting of future rewards has been observed in a variety of disorders and has been linked both to valuation of the past and to memory of past events.

Methods

To explore the functionality of discounting and memory, we examined whether training of working memory would result in less discounting of future rewards. In this study, 27 adults in treatment for stimulant use were randomly assigned to receive either working memory training or control training according to a yoked experimental design. Measures of delay discounting and several other cognitive behaviors were assessed pre- and posttraining.

Results

Rates of discounting of delayed rewards were significantly reduced among those who received memory training but were unchanged among those who received control training; other cognitive assessments were not affected by memory training. Discount rates were positively correlated with memory training performance measures.

Conclusions

To our knowledge, this is the first study demonstrating that neurocognitive training on working memory decreases delay discounting. These results offer further evidence of a functional relationship between delay discounting and working memory.

Section snippets

Participants

Twenty-seven participants (20 male, seven female, mean age = 38.6 years) being treated for stimulant use at a substance-abuse treatment facility enrolled and completed all assessments. Stimulant abuse/dependence diagnosis was determined by clinical staff at the treatment facility using criteria established by the DSM-IV-TR (25) and documented to be consistent with the findings from aspects of Addiction Severity Index—5th Edition administered to all individuals in the facility as a component of

Results

Active and control training groups did not statistically differ on any demographic variables. Because of a marginal nonsignificant difference between the mean ages of the two groups (35.7 for active vs. 41.6 for control, t₂₅ = 1.89, p = .070), age was included as a covariate in subsequent analyses. When it was found not to affect inferences, age as a covariate was dropped from the final models.

Discussion

This study suggests that working memory training among stimulant-dependent individuals results in a decrease in discounting of delayed rewards consistent with previous reports of a relationship between working memory and delay discounting. This effect of training working memory was selective and did not affect any other pre- and posttraining measures. Moreover, the absence of any significant effects in the control group indicates that these effects are not related to attention, exposure to the

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Delay discounting (DD) indexes an individual’s preference for smaller immediate rewards over larger delayed rewards, and is considered a form of cognitive impulsivity. Cross-sectional studies have demonstrated that DD peaks in adolescence; longitudinal studies are needed to validate this putative developmental trend, and to determine whether DD assesses a temporary state, or reflects a more stable behavioral trait. In this study, 140 individuals aged 9–23 completed a delay discounting (DD) task and cognitive battery at baseline and every-two years thereafter, yielding five assessments over approximately 10 years. Models fit with the inverse effect of age best approximated the longitudinal trajectory of two DD measures, hyperbolic discounting (log[k]) and area under the indifference-point curve (AUC). Discounting of future rewards increased rapidly from childhood to adolescence and appeared to plateau in late adolescence for both models of DD. Participants with greater verbal intelligence and working memory displayed reduced DD across the duration of the study, suggesting a functional interrelationship between these domains and DD from early adolescence to adulthood. Furthermore, AUC demonstrated good to excellent reliability across assessment points that was superior to log(k), with both measures demonstrating acceptable stability once participants reached late adolescence. The developmental trajectories of DD we observed from childhood through young adulthood suggest that DD may index cognitive control more than reward sensitivity, and that despite modest developmental changes with maturation, AUC may be conceptualized as a trait variable related to cognitive control vs impulsivity.
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Substance use disorder and obesogenic eating: Does working memory training strengthen ability to abstain from unwanted behaviors? A systematic review
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Abstaining from unwanted behaviors requires a sufficient balance between the executive and impulsive cognitive systems. Working memory (WM) is a vital component of both systems, identified in a wide range of research as the central and dominant component of executive function. WM potentially modulates the desires, tendencies, and behaviors specific to and seen in individuals with substance use disorder (SUD) and obesogenic eating (OE). Compared to healthy populations, research has shown individuals with SUD, as well as those who display OE, to have some degree of executive dysfunction, and both conditions have far-reaching health care implications. Additionally, these deficits are associated with impulsive behavior. Research has proposed that impulsive and so-called reward-driven responses could be altered through cognitive therapy and that both SUD and OE could benefit from working memory training (WMT).
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Archival ReportRemember the Future: Working Memory Training Decreases Delay Discounting Among Stimulant Addicts

Background

Methods

Results

Conclusions

Section snippets

Participants

Results

Discussion

Eat Behav

Appetite

Drug Alcohol Depend

Drug Alcohol Depend

Trends Cogn Sci

Drug Alcohol Depend

Impulsivity: The Behavioral and Neurological Science of Discounting

Toward a behavioral economics understanding of drug dependence: Delay discounting processes

Addiction

A review of delay-discounting research with humans: Relations to drug use and gambling

Behav Pharmacol

Discount rates and risky sexual behavior among teenagers and young adults

J Risk Uncertainty

Toward the study of trans-disease processes: A novel approach with special reference to the study of co-morbidity

J Dual Diagn

Discounting of past outcomes

Exp Clin Psychopharmacol

Altering the magnitude of delay discounting by pathological gamblers

J Appl Behav Anal

Patients with hippocampal amnesia cannot imagine new experiences

Proc Natl Acad Sci USA

Disinhibitory psychopathology and delay discounting in alcohol dependence: Personality and cognitive correlates

Exp Clin Psychopharmacol

Individual differences in delay discounting: Relation to intelligence, working memory, and anterior prefrontal cortex

Psychol Sci

The Science of Self-Control

Temporal construal

Psychol Review

Cognitive rehabilitation in schizophrenia: A quantitative analysis of controlled studies

Psychopharmacology

A review of cognitive training in schizophrenia

Schizophr Bull

Neuropsychological deficits in chronic cocaine abusers

Int J Neurosci

Archival Report
Remember the Future: Working Memory Training Decreases Delay Discounting Among Stimulant Addicts