Association for Behavior Analysis International

Many behaviors posing significant risks to public health are characterized by repeated decisions to forego better long-term outcomes for immediate temptations. This steep discounting of delayed outcomes is correlated with addictions (e.g., substance abuse, obesity) and impactful behaviors such as seatbelt use and early sexual activity. As evidence accumulates that steep delay discounting plays a causal role in these maladaptive behaviors, researchers have begun identifying experimental methods for reducing discounting. This presentation will provide a systematic review of this literature, highlighting successes and areas in which further research is needed.

High levels of impulsivity (delay discounting [DD], relative preference for smaller but immediate rewards over larger but delayed rewards) are associated with various psychopathologies including alcohol use disorder. Data indicate that there are genetic influences on DD and on the development of alcohol use disorder, but the genetic relationships amongst DD and alcohol consumption and other heritable features of alcohol response are unclear. This presentation will describe several techniques used to examine the role of genetics in behavior in animal models and a series of studies using them to examine the genetically-based co-relationships between excessive alcohol use and steep delay discounting. In these studies, male mice were exposed to the adjusting amount procedure (Richards et al. 1997, J Exp Anal Behav, 67, 353-366). This procedures requires mice to choose between a small, immediate sucrose-solution reward and a larger sucrose-solution reward that is delayed 0, 2, 4, 8 or 12 s on different sessions. In one study, behavior for 11 inbred strains was assessed, and genetic correlations with ethanol-associated endophenotypes derived. Other studies assessed DD in lines selected for differing levels of ethanol withdrawal symptomatology or ethanol consumption, and correlations between DD and responses to passively administered ethanol in a heterogeneous mouse stock to identify novel phenotypic targets. Data suggest that DD has a heritable component in mice, and is genetically associated with chronic withdrawal and consumption, but that effect sizes are small. Implications for human alcohol use and delay discounting will be discussed and knowledge gaps identified.

Board certified behavior analysts; licensed psychologists; graduate students.

Board certified behavior analysts; licensed psychologists; graduate students.

Contingency management (CM) interventions are efficacious options for substance abuse treatments, but they are rarely implemented in clinical, non-research settings. In this presentation, we briefly review the evidence support for CM and introduce prize-based CM. We will highlight work that supports CM’s generalizability across diverse patient characteristics and settings. We will conclude with a discussion of potential implementation barriers and examples of real-world implementation efforts.

Contingency management is one of the most efficacious interventions to promote drug abstinence. Traditionally, contingency management has been delivered in person so that clinicians can confirm drug abstinence and provide access to additional therapeutic services. Now, new technologies not only permit remote confirmation of abstinence, but also remote delivery of incentives. I will discuss several technology-based tools to assess substance use, and new ways to deliver contingency management to promote tobacco and alcohol abstinence. These new tools have the potential to dramatically increase access while maintaining high levels of treatment fidelity. They also allow new ways of arranging contingencies that harness natural, online communities and consequences. Overall, there are unprecedented opportunities to link technology with contingency management to promote drug abstinence.

Board certified behavior analysts; licensed psychologists; graduate students.

Board certified behavior analysts; licensed psychologists; graduate students.

Poverty is a pervasive risk factor underlying poor health, including drug addiction and HIV. This presentation will review research on the utility of operant conditioning to address the interrelated problems of poverty, drug addiction, and HIV. Our research has shown that operant reinforcement using financial incentives can promote abstinence from cocaine and heroin in low-income adults with long histories of drug addiction and adherence to antiretroviral medications in low-income adults living with HIV. Our research has also shown that financial incentives are most effective when high-magnitude incentives are used, and that long-duration abstinence reinforcement can serve as an effective maintenance intervention. The utility of operant conditioning to promote behaviors needed to escape poverty is less clear, but research on an operant employment-based intervention called the therapeutic workplace shows some promise. In the therapeutic workplace, low-income or unemployed adults are hired and paid to work. To promote drug abstinence and/or medication adherence, employment-based reinforcement is arranged in which participants are required to provide drug-free urine samples and/or take prescribed medication to maintain access to the workplace and maximum pay. Because many low-income adults lack skills needed for gainful employment, the therapeutic workplace offers job-skills training and employment phases through which participants progress sequentially. Our research has shown that employment-based reinforcement within the therapeutic workplace can promote and maintain drug abstinence, medication adherence, work, and other adaptive behaviors that people need to move out of poverty. The therapeutic workplace could serve as a model anti-poverty program, particularly for people with histories of drug addiction or other health problems, although more research on the therapeutic workplace is needed that targets poverty directly.

Board certified behavior analysts; licensed psychologists; graduate students.