How People in Recovery from Alcohol Use Disorder Think About the Future May Help Predict Their Risk of Relapse

Newswise — A new study suggests that interventions modifying the time perspective of people with alcohol use disorder (AUD) may improve their recovery outcomes. Although more than 50 million adults in the US are in remission from AUD, our understanding of recovery is limited. The life-history theory emphasizes humans’ adaptation to environmental factors, predicting how we allocate energy and resources to different goals. Stable environments motivate longer-term goals and delayed investments. Such “slower” life-history strategies include education, self-care, and saving money, reflecting decision-making based on valuing future rewards. Unpredictable environments, in contrast, position us to favor short-term goals. “Faster” life-history strategies include brief relationships, early reproduction, reduced self-care, and substance use. In these scenarios, decision-making is influenced by the temporal window (i.e., how far in the future one can imagine and integrate into present decisions; as measured by delay discounting), a psychological trait that determines the valuation of long-term reward and is associated with impulsivity and risky behaviors. Early life experiences may determine life-history strategy into adulthood. Faster life-history factors are associated with substance use, and discounting of future rewards may be a marker of addiction. For the study in Alcoholism: Clinical & Experimental Research, researchers at Virginia Tech, examined the relationships between life-history strategies, the discounting of delayed reward, and health and financial behaviors among people in recovery from AUD.

The study involved 110 participants aged 18 or above (mean age 49, 90% white) who had met the criteria for alcohol abuse and dependence. They were recruited through an international online registry of people recovering from substance misuse. The researchers evaluated participants’ delay discounting rates with a task that asked them to choose between lower amounts of money in the short term or larger amounts in the longer term. Surveys assessed participants’ life-history strategies (such as experiences in close relationships, insight, planning, and control), health-related behaviors (for example, drug use, physical activity, saving money, and safe driving), past and current AUD status, substance use, and demographics. The researchers used statistical analysis to explore links between these factors at the same point in time.

The study revealed associations between life-history strategies, discounting of delayed monetary rewards, and various health and financial behaviors among people recovering from AUD. Slower life-history strategies were linked to lower discount rates, and to positive economic, health, and personal development behaviors. People in remission from AUD — who had not experienced AUD symptoms (except craving) in the past three months — exhibited slower life-history strategies, lower discounting of future reward, and beneficial behaviors, including less drug use and safer driving. Faster life-history strategies were linked to higher discount rates.

The study bolsters research suggesting that life-history strategy is directly related to substance use frequency and severity, including remission status. People with substance use disorder who exhibit faster life-history strategies may face greater challenges to recovery. The study implies that delay discounting may predict individuals’ experience of recovery and remission — a critical insight, since AUD recovery typically involves relapses. The researchers concluded that people in recovery from AUD with higher measures of delay discounting and faster life-history strategies may benefit from interventions that expand their future perspective.

The Phenotype of Recovery VI: The association between life-history strategies, delay discounting, and maladaptive health and financial behaviors among individuals recovering from alcohol use disorders. L. Athamneh, R. Freitas-Lemos, J. Basso, D. Keith, M. King, W. Bickel. (pp xxx)

ACER-21-4930.R1