Effects of episodic future thinking on reinforcement pathology during smoking cessation treatment among individuals with substance use disorders

Abstract Rationale Reinforcer pathology (RP) is a theoretical model based on two processes: delay discounting (DD) and drug demand. Given that RP has been shown to have a predictive value on smoking behaviors, several studies have explored which interventions can reduce RP. Consistent with the RP framework, episodic future thinking (EFT) has shown effects on treatment outcomes and RP processes. The vast majority of studies that assess the effects of EFT on RP consist of experimental studies, and no previous research has tested these effects in a clinical sample of smokers. Objectives The primary aim of this study was to assess the effects of EFT on RP throughout the course of a smoking cessation intervention in smokers with substance use disorders (SUDs). Methods Participants were randomized to cognitive behavior therapy (CBT) + EFT (n = 39) or CBT + EFT + contingency management (n = 33). Cotinine, frequency of EFT practices, cigarette purchase task (CPT), and DD were evaluated in treatment sessions. Mixed-effects model repeated measures analysis was used to explore DD and CPT in-treatment changes as a function of EFT practices and cotinine levels. Results Greater practice of the EFT component significantly reduced cigarette demand (p < .020) as well as DD (p = .003). Additionally, a greater reduction in cotinine levels coupled with greater EFT practice led to a greater decrease in cigarette demand (p < .014). Conclusions EFT reduced the two facets of RP in treatment-seeking smokers with SUDs.

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Episodic future thinking for smoking cessation in individuals with substance use disorder: Treatment feasibility and acceptability

Journal of Substance Abuse Treatment ◽

10.1016/j.jsat.2020.108259 ◽

2021 ◽

Vol 123 ◽

pp. 108259

Author(s):

Gema Aonso-Diego ◽

Alba González-Roz ◽

Víctor Martínez-Loredo ◽

Andrea Krotter ◽

Roberto Secades-Villa

Keyword(s):

Smoking Cessation ◽

Substance Use ◽

Substance Use Disorder ◽

Episodic Future Thinking ◽

Future Thinking ◽

Substance Use Disorder Treatment ◽

Disorder Treatment

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Smoking cessation treatment outcomes among people with and without mental and substance use disorders: An observational real-world study

European Psychiatry ◽

10.1016/j.eurpsy.2018.02.005 ◽

2018 ◽

Vol 52 ◽

pp. 22-28 ◽

Cited By ~ 10

Author(s):

João Mauricio Castaldelli-Maia ◽

Aline Rodrigues Loreto ◽

Bruna Beatriz Sales Guimarães-Pereira ◽

Carlos Felipe Cavalcanti Carvalho ◽

Felipe Gil ◽

...

Keyword(s):

Smoking Cessation ◽

Substance Use ◽

Substance Use Disorders ◽

Tobacco Use ◽

Psychiatric Treatment ◽

Nicotine Patch ◽

Treatment Success ◽

Smoking Cessation Treatment ◽

Tobacco Treatment ◽

Cessation Treatment

AbstractBackground:There is a lack of studies evaluating smoking cessation treatment protocols which include people with and without mental and substance use disorders (MSUD), and which allows for individuals with MSUD undergoing their psychiatric treatment.Methods:We compared treatment success between participants with (n = 277) and without (n = 419) MSUD among patients in a 6-week treatment provided by a Brazilian Psychosocial Care Center (CAPS) from 2007 to 2013. Sociodemographic, medical and tobacco use characteristics were assessed at baseline. Tobacco treatment consisted of 1) group cognitive behavior therapy, which included people with and without MSUD in the same groups, and 2) pharmacotherapy, which could include either nicotine patches, nicotine gum, bupropion or nortriptyline. For participants with MSUD, tobacco treatment was integrated into their ongoing mental health treatment. The main outcome was 30-day point prevalence abstinence, measured at last day of treatment.Results:Abstinence rates did not differ significantly between participants with and without MSUD (31.1% and 34.4%, respectively). Variables that were significantly associated with treatment success included years smoking, the Heaviness of Smoking Index, and use of nicotine patch or bupropion.Conclusions:The inclusion of individuals with and without MSUD in the same protocol, allowing for individuals with MSUD undergoing their psychiatric treatment, generates at least comparable success rates between the groups. Predictors of treatment success were similar to those found in the general population. Facilities that treat patients with MSUD should treat tobacco use in order to reduce the disparities in morbidity and mortality experienced by this population.

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Integrating Episodic Future Thinking into Virtual Reality to Mitigate Substance Use Disorders: A Theoretical Framework

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181319631026 ◽

2019 ◽

Vol 63 (1) ◽

pp. 2282-2286

Author(s):

Tianzi Wang ◽

Alexandra M. Mellis ◽

Nathan Lau ◽

Warren Bickel

Keyword(s):

Substance Use ◽

Virtual Reality ◽

Substance Use Disorders ◽

Schema Theory ◽

Theoretical Framework ◽

Term Treatment ◽

Episodic Future Thinking ◽

Future Thinking ◽

Individual Values ◽

Long Term Treatment

Substance use disorders present major health risks and economic burdens, while current healthcare systems face insufficient resources and accessibility deficiencies that challenge long term treatment for chronic diseases. This paper presents a theoretical approach of integrating the concept of episodic future thinking into immersive virtual reality to treat substance use disorders. Episodic future thinking can extend the temporal window over which an individual values rewards, rebalancing the impulsive and executive decision systems and thereby reducing the valuation of substances of abuse. In theory, virtual reality can enhance episodic future thinking by providing realistic cues and contexts. We propose using schema theory to guide the design of virtual reality for facilitating episodic future thinking. Future work should focus on developing and evaluating a proof-of-concept of this theoretical framework.

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