Delayed reward discounting and addictive behavior: a meta-analysis
Open accessAbstract
Rationale Delayed reward discounting (DRD) is a behavioral economic index of impulsivity and numerous studies have examined DRD in relation to addictive behavior. To synthesize the findings across the literature, the current review is a meta-analysis of studies comparing DRD between criterion groups exhibiting addictive behavior and control groups.Objectives The meta-analysis sought to characterize the overall patterns of findings, systematic variability by sample and study type, and possible small study (publication) bias.Methods Literature reviews identified 310 candidate articles from which 46 studies reporting 64 comparisons were identified (total N=56,013).Results From the total comparisons identified, a small magnitude effect was evident (d= .15; p< .00001) with very high heterogeneity of effect size. Based on systematic observed differences, large studies assessing DRD with a small number of self-report items were removed and an analysis of 57 comparisons (n=3,329) using equivalent methods and exhibiting acceptable heterogeneity revealed a medium magnitude effect (d= .58; p< .00001). Further analyses revealed significantly larger effect sizes for studies using clinical samples (d= .61) compared with studies using nonclinical samples (d=.45). Indices of small study bias among the various comparisons suggested varying levels of influence by unpublished findings, ranging from minimal to moderate.Conclusions These results provide strong evidence of greater DRD in individuals exhibiting addictive behavior in general and particularly in individuals who meet criteria for an addictive disorder. Implications for the assessment of DRD and research priorities are discussed.
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Numerous studies have examined delayed reward discounting in substance use disorder.
“Delayed reward discounting is a behavioural economic index of impulsivity and numerous studies have examined delayed reward discounting in substance use disorder [33, 34].”
From P300 and delay-discounting in obsessive–compulsive disorder (2022) · cites this paper as [33]
As a group, individuals who smoke consistently show higher DD rates than controls do.
“For example, as a group, individuals who smoke consistently show higher DD rates than controls do (Amlung & MacKillop, 2014; MacKillop et al., 2011).”
From Behavioral trainings and manipulations to reduce delay discounting: A systematic review (2019) · cites this paper as MacKillop et al., 2011
Discount rate is highly correlated with a variety of health behaviors and disorders, with medium effect sizes across studies.
“Supporting this belief, discount rate is highly correlated with a variety of health behaviors and disorders, with medium effect sizes across studies (Amlung, Petker, Jackson, Balodis, & MacKillop, 2016; Jackson & MacKillop, 2016; MacKillop et al., 2011).”
From Behavioral trainings and manipulations to reduce delay discounting: A systematic review (2019) · cites this paper as MacKillop et al., 2011
Steep discounting of delayed rewards is correlated with most substance-use disorders, their severity, relapse to drug use, and many other maladaptive health-related decisions.
“Steeply discounting delayed rewards is correlated with most substance-use disorders, the severity of these disorders, rates of relapse to drug use, and a host of other maladaptive decisions impacting human health.”
From Changing Delay Discounting and Impulsive Choice: Implications for Addictions, Prevention, and Human Health (2019) · cites this paper as MacKillop et al., 2011
Evidence across studies suggests delay discounting predisposes people to addictions rather than the reverse causal direction.
“evidence across studies suggests that delay discounting predisposes people to addictions rather than the reverse causal direction.190”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [190]
One meta-analysis found an overall medium effect size with acceptable heterogeneity between studies on the relationship between delay discounting and addictive behaviors.
“one meta-analysis on the relationship between delay discounting and addictive behaviors found an overall medium effect size with acceptable heterogeneity between studies.190”
From Early life adversity and health-risk behaviors: Proposed psychological and neural mechanisms (2018) · cites this paper as [190]
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- Authors
- MacKillop, J., Amlung, M. T., Few, L. R., Ray, L. A., Sweet, L. H., & Munafò, M. R.
- Affiliations
- University of Georgia (US)
- University of California, Los Angeles (US)
- Brown University (US)
- Corresponding author
- MacKillop, James
- Venue
- Psychopharmacology
- Published
- 2011-03-04
- Volume
- 216
- Issue
- 3
- Pages
- 305-321
- ISSN
- 0033-3158 (ISSN-L)
- 1432-2072
- PMC
- PMC3201846
- OpenAlex
- W1996296330
- Cited by
- 1,021
- References
- 133
- Citations by year
- 2026: 59 · 2025: 62 · 2024: 65 · 2023: 47 · 2022: 67 · 2021: 79 · 2020: 85 · 2019: 91 · 2018: 87 · 2017: 89 · 2016: 80 · 2015: 72 · 2014: 56 · 2013: 50 · 2012: 25
- FWCI
- 4.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- British Heart Foundation
- Economic and Social Research Council (ES/G007489/1)
- National Institute on Alcohol Abuse and Alcoholism (AA 016936, K23AA016936)
- National Institute on Drug Abuse (P30DA027827)
- Topics
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- delay discounting, addictive behavior, impulsivity, addiction, behavioral economics, impulsivity assessment, publication bias
- MeSH terms
- Alcohol Drinking, Decision Making, Humans, Models, Psychological, Reward, Behavior, Addictive, Substance-Related Disorders
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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