Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


41st Annual Convention; San Antonio, TX; 2015

Event Details

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Symposium #309
CE Offered: BACB
Behavioral Economics of Chronic Disease: The Role of Discounting Process in Health Decisions
Monday, May 25, 2015
9:00 AM–10:50 AM
Texas Ballroom Salon B (Grand Hyatt)
Area: CBM/EAB; Domain: Applied Research
Chair: Derek D. Reed (The University of Kansas)
Discussant: Suzanne H. Mitchell (Oregon Health & Science University)
CE Instructor: Derek D. Reed, Ph.D.

Since the inception of behavioral economics in the early 1980s, the intersection of behavioral science and microeconomic principles has yielded novel insights into health-related behaviors and their promotion. Early applications primarily explore the abuse liability of pharmacological agents in nonhumans. However, as behavioral scientists began translating behavioral economics outside the operant chamber, researchers and policymakers soon discovered that behavioral economic principles and applications could be taken to scale to inform public health policies and preventative healthcare. This symposium highlights cutting-edge applications of behavioral economic principles and procedures to health decision making. The presentations featured in this symposium range from basic decision making studies on episodic future thinking regarding cancer to applications of mindfulness to alter delay discounting of food. Despite the novel applications across each of the four presentations, a common thread unifying these studies is the reliance on discounting processes and assays to evaluate health decision making under uncertainty or in the face of intertemporal tradeoffs common attributes in most real-world health decisions. These use-inspired studies underscore the translational utility of behavioral economics for health promotion and advancing the fields understand of healthy decision making.

Keyword(s): behavioral economics, discounting, health, mindfulness
The Effects of Modified Episodic Future Thinking on Risky Long-Term Health Decisions
BRENT KAPLAN (The University of Kansas), Derek D. Reed (The University of Kansas), David P. Jarmolowicz (The University of Kansas)
Abstract: Many of our everyday choices are associated with outcomes that are both delayed and probabilistic. The temporal attention hypothesis suggests that individuals’ decision making can be improved by focusing attention to temporally distal events and reducing the desire for proximate outcomes. Viewing discounting this framework implies that environmental manipulations that expand the limits of an individual’s temporal perspective by bringing focus on temporally distal outcomes, and thereby reducing present bias, may alter his/her degree of discounting. One such manipulation, episodic future thinking, has shown to successfully lower discount rates. Several questions remain as to the applicability of episodic future thinking to domains other than temporal discounting. The present experiments examine the effects of a modified episodic future thinking procedure on probability discounting in the context of both a delayed health gain and loss. Eleven college-aged participants responded on a probabilistic discounting task when the outcome was either a health gain or loss. Results indicate the modified episodic future thinking procedure effectively altered 9 out of the 11 participants’ degree of discounting in the predicted directions and lend further support to the temporal attention hypothesis.
Measurement and Validation of a Novel Delay Discounting Measure for Hypothetical Food: The Food Kirby
ERIN B. RASMUSSEN (Idaho State University), Kelsie Hendrickson (Idaho State University), Steven R. Lawyer (Idaho State University)
Abstract: This study established a brief measure of delay discounting for food, the Food Choice Questionnaire (FCQ), and compared it to other established measures of food and money discounting. Over 140 participants completed either two hypothetical money discounting measures [a computerized monetary adjusting amount (AA) procedure or the Monetary Choice questionnaire (MCQ)] or two hypothetical food discounting (a computerized food AA procedure or the FCQ) measures. Monetary discounting measures highly correlated, replicating previous work. The novel FCQ yielded highly consistent data that strongly correlated with the AA food discounting task. There were also significant magnitude effects across the FCQ and the MCQ. Finally, individuals with higher PBF discounted food more steeply than individuals with lower PBF in the FCQ and AA food discounting procedure. This study is the first to show that the Food Kirby (FCQ) yielded consistent data that strongly correlated to an established measure of food discounting and is sensitive to PBF.

Costs, Benefits, and the Propensity to Take Pills: On the Behavioral Economics of Medication Adherence in Multiple Sclerosis Patients

DAVID P. JARMOLOWICZ (The University of Kansas), Jared M. Bruce (University of Missouri-Kansas City), Amanda S. Bruce (University of Missouri-Kansas City), Derek D. Reed (The University of Kansas)

Discounting analyses have robustly contributed to our understanding of clinical disorders such as addiction, problematic gambling, and obesity. Importantly, individuals rates of discounting predict the progression of addiction and the success of addiction treatments. That success suggests that discounting analyses may help predict health behavior in other clinical populations. For example, individuals with Multiple Sclerosis (MS) frequently have low levels of medication adherence. Predicting which individuals will have adherence difficulties may help direct treatment resources to those that need it the most. The current study developed a novel probability discounting paradigm which assessed the effects of differing probabilities of medication efficacy and side effects in a sample of MS patients whom typically were (n=35) or where not (n=35) adherent with their treatments. Discounting was both different across groups and was predictive of group membership, even when accounting for other MS related variables (fatigue, depression, etc.).

Mindful Eating Training Reduces Food Discounting Rates in Adolescents and Adults
KELSIE HENDRICKSON (Idaho State University), Erin B. Rasmussen (Idaho State University)
Abstract: The present study examined the effects of a brief mindful eating training on temporal discounting rates (preferences between smaller sooner and larger later outcomes) for hypothetical food and money. In Session 1, 348 participants (176 adults and 174 adolescents) completed a variety a modified Food Choice Questionnaire (FCQ) and Monetary Choice Questionnaire (MCQ) as baseline measures of food and money discounting, respectively. In Session 2, participants were randomly assigned to one of three conditions: a 50-min mindful eating workshop, a 50-min clip of a DVD on nutrition, or an unstructured activity. All participants completed the discounting tasks for food and money again as a post-manipulation measure. Individuals in the mindful eating group evidenced lower rates of food, but not money, discounting after the training, compared to baseline. Participants in the two control conditions did not exhibit changes in their discounting patterns. This study replicates our research with mindful eating and discounting with adults and extends our findings to adolescents.



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