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Karolina Lempert, PhD - Manipulating intertemporal choice in healthy participants: successes and limitations
Intertemporal choices, often between smaller, immediate and larger, delayed rewards, are ubiquitous and frequently consequential. Aberrant intertemporal choices underlie many societal and psychiatric problems. Until recently, it has generally been believed that intertemporal preferences are stable traits. However, the latest research has shown that these choices are actually malleable and can vary depending on the situation. Laboratory manipulations of intertemporal choice have primarily been focused on promoting more future-oriented decisions. They fall into two general categories: changing how the choice is framed, or changing the state of the decision-maker at the time of choice.
Framing effects that have been successful in increasing patience include highlighting the opportunity cost of foregoing the delayed reward (e.g., the “hidden-zero” effect; Radu et al., 2011) and presenting the delayed reward as the default option (e.g., the “delay/speedup asymmetry” effect; Weber et al., 2007). I will present some of my own research showing that it is sufficient just to alter the choice sets preceding the choice at hand to make the delayed reward a default option (Lempert et al., 2015), since people are more likely to select options that are less variable from trial to trial. Therefore, there are several ways to design choice architecture to “nudge” people toward more beneficial choices in the long-term.
There is also some evidence that a person’s affective or cognitive state prior to intertemporal choice can “carry over” and influence these choices. The most reliable strategy to promote patient decision-making is to encourage prospection, or the imagination of future experiences, prior to choice. But it is unknown exactly how this manipulation works. One possibility is that simply activating the neural circuitry involved in both memory retrieval and prospection is sufficient to increase delayed reward choice. To test this, we investigated whether recalling positive memories is also a viable manipulation for promoting more far-sighted choice. Indeed, participants chose more later, larger rewards after retrieving positive past experiences. This was not the case when memories were negative, or when individuals imagined novel positive scenes unrelated to their memories (Lempert et al., 2017). However, attempts to replicate this positive-memory effect in different contexts (e.g, on Amazon mTurk), with different mediators (e.g., field vs. observer perspective), and in different populations (e.g., in older adults) have been unsuccessful. Thus, more work remains to be done to identify the precise conditions under which such “carryover” effects exist.
In sum, despite the relative stability of intertemporal preferences, intertemporal choices have been shown to be malleable. However, framing effects have had more success than “carryover” effects, which have been inconsistent and limited. More work also remains to be done to translate manipulations that are effective in healthy participants in the lab into real-world contexts and psychiatric populations.
Alison Miller, PhD – Future Orientation in Children.
Poor self-regulation is hypothesized to contribute to unhealthy behaviors across the lifespan. Future Orientation (FO) is an aspect of self-regulation that is closely related to temporal discounting and is hypothesized to relate to motivation. FO has been associated with positive health and educational outcomes, each of which are characterized by engaging in activities that may not be preferred (e.g., exercise; homework) to achieve a long-term or future goal.
Middle-to-late childhood is a unique developmental period in which to examine FO. Capacity for future-oriented thinking is emerging, and children are assuming increased responsibility for their own behaviors. Further, as most children are not yet engaging in excessive risk-taking, from a prevention perspective, this is a compelling stage at which to intervene to enhance FO capacity. Engaging in episodic future thinking (EFT), or actively imagining and verbalizing future plans in a vivid and concrete manner, has been suggested as a strategy to promote FO, as EFT involves mentally projecting to “make the future become the present” (Schacter et al., 2017). Little work has sought to enhance FO in children. This was the goal of the current study.
Method. We engaged 9-12 year-olds in an EFT intervention (Miller et al., 2018). We implemented the intervention as an RCT with 123 children who were participants in a longitudinal cohort. The intervention was delivered three times across a 5-week period. The interventionist asked the child to describe three upcoming future events, providing support to generate examples and prompting to use details (e.g., “make me really understand what it would be like to be there”). FO outcomes included child self-reported questionnaires (Delay Choice, Koffarnus, 2014; Self-Efficacy, Kupst, 2015; Future Time Perspective, Zimbardo, 2015) and responses to a similar interview where children described future events. The interview was audiotaped and later coded using an adaptation of prior coding systems (Addis et al., 2008). FO indicators were use of future-oriented language using rich descriptive detail, vivid imagery, and referencing mental states (i.e., “episodic”; Kappa≥.78 for all codes).
Results. Children who received the EFT intervention used an average of 15.6 (SD 5.7) more episodic words from pre- to post-test compared to 5.3 fewer such words (SD 5.4) for children who did not receive EFT (p<.01). No differences were seen for questionnaire-based measures (all p’s>.10).
Discussion. Recent work on development of episodic prospection (Coughlin et al., 2017) suggested 9-11 year-olds could name specific events situated in time and space, but with limited contextual details. Our results suggest that the EFT intervention improved children’s ability to use “episodic” language with vivid details when describing a future event. Further, this interview-based assessment may be a more effective way to elicit FO-related speech from children, compared to more abstract questionnaire-based assessments.
Johannes Haushofer, PhD – What Motivates Health Behavior: Preferences, Beliefs, or Constraints? Evidence from Psychological Interventions in Kenya
We test the effect of light-touch psychological interventions on health-related behaviors and psychological outcomes using a randomized con-trolled trial among 3750 young women in rural Kenya. A two-session executive function intervention ("EF") aimed to relax cognitive constraints; a two-session time preference intervention ("TP") aimed to reduce present bias and impatience; and an information treatment ("INF") aimed to correct incorrect beliefs about the benefits of health behaviors. Three months after the interventions, the EF and TP interventions lead to significant 18 percent and 27 percent increases, respectively, relative to a pure control ("PC") group in the share of households who have chlorinated their drinking water. This increase was accompanied by significant 27 percent (EF) and 32 percent (TP) reductions in the number of diarrhea episodes in children relative to the information treatment. The TP intervention also significantly increased the share of individuals who save regularly by 38 percent. The information treatment, which delivered the same information about the benefits of chlorination as the active interventions, did not significantly affect these outcomes, and in some cases, affected them significantly less. The EF intervention improved performance on a planning lab task (Tower of London) relative to the information group. The TP intervention did not affect time preferences. Both interventions increased self-efficacy, i.e. beliefs about one's own ability to achieve desirable outcomes. Together, these results suggest that psychological interventions can affect health behaviors, possibly through mechanisms including self-efficacy.
Scott Halpern, MD, PhD – Temporal discounting and behavioral phenotyping: toward personalization of smoking cessation interventions
Temporal discounting is a normal human cognitive process whereby rewards that are presented in the future hold greater sway over our behavior than do rewards of equal size that can only be realized in the future. The temptation to smoke has been attributed, in part, to temporal discounting because smoking entails immediate rewards (the pleasures of smoking) despite reduced future rewards (in the form of reduced health). Indeed, prior work has shown that smokers have steeper (more severe) temporal discounting functions than do non-smokers, and that among smokers, those with steeper discounting functions are less likely to quit than are smokers with less steep discounting tendencies. Financial incentives have been shown to promote smoking cessation in a series of high-impact trials, perhaps because they enhance future rewards, thereby countering the immediate pleasures of smoking. This theory would hold that financial incentives ought to operate most strongly among those smokers with the steepest temporal discounting. This talk will review available evidence in support of this hypothesis, and point toward future work that could more definitively confirm or refute it.