title: Excessive discounting of delayed reinforcers as a trans-disease process contributing to addiction and other disease-related vulnerabilities: emerging evidence.
abstract: Delay discounting describes the devaluation of a reinforcer as a function of the delay until its receipt. Although all people discount delayed reinforcers, one consistent finding is that substance-dependent individuals tend to discount delayed reinforcers more rapidly than do healthy controls. Moreover, these higher-than-normal discounting rates have been observed in individuals with other behavioral maladies such as pathological gambling, poor health behavior, and overeating. This suggests that high rates of delay discounting may be a trans-disease process (i.e., a process that occurs across a range of disorders, making findings from one disorder relevant to other disorders). In this paper, we argue that delay discounting is a trans-disease process, undergirded by an imbalance between two competing neurobehavioral decision systems. Implications for our understanding of, and treatment for, this trans-disease process are discussed.
authors.affiliation: Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA 24016, USA. wkbickel@vt.edu
authors.forename: Warren K
authors.initials: WK
authors.lastname: Bickel
authors.forename: David P
authors.initials: DP
authors.lastname: Jarmolowicz
authors.forename: E Terry
authors.initials: ET
authors.lastname: Mueller
authors.forename: Mikhail N
authors.initials: MN
authors.lastname: Koffarnus
authors.forename: Kirstin M
authors.initials: KM
authors.lastname: Gatchalian
mesh_terms: D003657:Decision Making / Q000187:drug effects / Q000502:physiology; D005715:Gambling / Q000150:complications / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D013287:Illicit Drugs / Q000494:pharmacology; D007175:Impulsive Behavior / Q000150:complications / Q000523:psychology*; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D009434:Neural Pathways / Q000503:physiopathology*; D009765:Obesity / Q000150:complications / Q000523:psychology; D012054:Reinforcement, Psychology; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*; D013997:Time Factors
chemical_list: D013287:Illicit Drugs