Health behaviors, positive and negative, can support or reduce risk for multiple chronic diseases, such as substance use disorder and obesity. These diseases are marked by overconsuming commodities that offer predictable short-term benefits, and neglecting other behaviors with variable long-term benefits (e.g., fast food is enjoyable in the moment; exercise may have delayed benefits, but moment-to-moment may not be as reinforcing as fast food). An individual's valuation of these fast food or exercise may depend on how far out into the future these benefits are considered, their temporal window. The first study shows that the temporal window is constricted among high-risk substance users than people who do not have substance problems, especially when considering higher-value choices. The second study shows that the temporal window can change depending on the environment. Specifically, engaging with stories of job loss can constrict the temporal window. The third study shows that engaging with job loss can specifically constrict the temporal window and increase the value of fast food among obese individuals. The final study shows that a similar hardship scenario, natural disasters, can constrict the temporal window, increase demand for alcohol and cigarettes, and decrease the valuation of more temporally extended reinforcers (e.g., employment, savings, and seatbelt wearing) among smoking drinkers. Together, these studies support a model, reinforcer pathology; wherein the temporal window, which can differ both between individuals and environments, drives valuation of reinforcers that impact health. / Doctor of Philosophy / Health behaviors, positive and negative, can support or reduce risk for multiple chronic diseases, such as substance use disorder and obesity. These diseases are marked by overconsuming commodities that offer predictable short-term benefits, and neglecting other behaviors with variable long-term benefits (e.g., fast food is enjoyable in the moment; exercise may have delayed benefits, but moment-to-moment may not be as reinforcing as fast food). An individual’s valuation of these fast food or exercise may depend on how far out into the future these benefits are considered, their temporal window. The first study shows that the temporal window is constricted among high-risk substance users than people who do not have substance problems, especially when considering higher-value choices. The second study shows that the temporal window can change depending on the environment. Specifically, engaging with stories of job loss can constrict the temporal window. The third study shows that engaging with job loss can specifically constrict the temporal window and increase the value of fast food among obese individuals. The final study shows that a similar hardship scenario, natural disasters, can constrict the temporal window, increase demand for alcohol and cigarettes, and decrease the valuation of more temporally extended reinforcers (e.g., employment, savings, and seatbelt wearing) among smoking drinkers. Together, these studies support a model, reinforcer pathology; wherein the temporal window, which can differ both between individuals and environments, drives valuation of reinforcers that impact health.

Despite decades of effort in developing evidence-based treatments, drug addiction remains one of the most problematic and enduring public health crises. Developing a new generation of theoretically-derived interventions constitutes an important clinical and scientific gap that, if addressed, may open innovative treatment opportunities. Based on the Reinforcer Pathology theory, altering the temporal window over which reinforcers are integrated (i.e., measured by delay discounting) would alter drug valuation and consumption. The first investigation—in 2 separate studies— test the Reinforcer Pathology theory by examining the effect of expanding and constricting the temporal window of integration using two mating narratives (long-term and short-term relationships, respectively) on cigarette valuation among cigarette smokers. The second investigation, test the Reinforcer Pathology theory by assessing the effect of remotely delivered Episodic Future Thinking (EFT) narratives (expands the temporal window) on real-world alcohol consumption among individuals with alcohol use disorder (AUD). Together, these investigations supported the Reinforcer Pathology theory and demonstrated its relevance for understanding and intervening in addiction. The current findings provide scientific justification to further investigate Reinforcer Pathology based interventions that expand the temporal window to change drug valuation and consumption. The construction of multi-component treatments that incorporate Reinforcer Pathology based interventions to systematically alter the temporal window may provide a novel intervention to reduce alcohol consumption. / Doctor of Philosophy / The following studies provide evidence that altering the temporal widow (how far in the future one can imagine and integrate into the present) would alter drug valuation. In the following studies, we used narratives describing long-term or short-term mating relationships (Study 1) and Episodic Future Thinking (EFT; represents one's capability to pre-experience the future; Study 2) to alter the valuation of cigarettes and alcohol, respectively. In the first study, cigarette smokers who read and vividly imagined long-term romance relationship narrative (expands the temporal window) valued cigarettes less than control (imagined looking for a lost key). In contrast, those who read and vividly imagined a short-term sexual encounter (shortens the temporal window) valued cigarettes more than controls. The second study employed EFT (expands the temporal window) as a strategy to reduce alcohol consumption, in real-world settings, over two weeks in individuals with alcohol use disorder. The study found that expanding the temporal window using EFT reduced alcohol consumption. Together, these two studies provide support to employing interventions that extend the temporal window to change drug valuation and consumption. The construction of multi-component treatments that incorporate interventions expanding the temporal window may reduce drug consumption.