Thinking about the future can take numerous forms, varying from planning actions to foreseeing possible scenarios by means of knowledge and informed guesses, or speculations and intuitions, or imagination and creativity. Different cognitive processes are needed for each of these different types of future thinking. This thesis encompasses a series of experiments both on healthy volunteers and on brain damaged patients, revolving around the issue of "Future Thinking" (FT) that is the cognitive ability, specifically human, of envisaging one's own future. The concept of FT and the relevant literature are presented and discussed in Chapters 2 and 3. The ability to foresee has been normally assumed to rely on the reconstructive nature of episodic memory. This hypothesis is investigated in Chapters 4, 5 and 6. In these chapters data on young adults, who mentally pre-experienced autobiographical episodes, are presented to investigate which type of cue would elicit richer visualizations and to explore possible differences between temporal and a-temporal scene construction. The findings from these experiments on healthy volunteers call for a deeper understanding of the relationship between past experience and FT. Chapter 7 discusses results revealing that aMCI patients produced fewer episodic but more semantic details for both past and future events, as compared to controls, suggesting that reminiscence and FT are the expression of the same neurocognitive system. However, contrary to what was generally thought, data on patients with Parkinson Disease with spared memory performance reported in Chapter 8 and 9 show that FT is not entirely dependent on memory (and the hippocampus), rather the results suggest that poor performance in FT is associated with poor executive control. In Chapter 10 two patients affected by dense amnesia are investigated. Chapter 11 presents a single case exhibiting florid confabulation. The results confirm that although amnesia is associated with poor performance on FT, memory deficits cannot account for the entire picture of FT deficits. Indeed, dysexecutive symptoms play an important role in eliciting FT deficits.

A remarkable feature of the human mind is its capacity to momentarily disengage from the immediate environment in order to contemplate hypothetical future scenarios. This thesis focuses on human prospection, investigating some of the methods used to assess it, its cognitive properties and the functional relevance of this extraordinary ability to anticipate and pre-experience future contingencies. Two experiments carried out with young healthy participants show that the methods used to elicit prospection, the temporal distance and the valence of envisioned events, may affect its content as well as its characteristics. Two studies involving healthy participants of different ages as well as amnesic patients investigate the contribution of long-term memory to scene construction processes. The results provide evidence supporting the hypothesis that a common underlying memory-related factor, the capacity to construct a rich narrative, can influence the descriptions of a-temporal, future and current scenes alike. The third issue concerns the relationship between episodic future simulation and prospective memory. Five experiments with young healthy participants show that mentally pre-experiencing future contingencies associated to an intended action aids prospective remembering, over and above deep encoding processing. Overall, the results of the experiments discussed in the present thesis strengthen the view of prospection as a complex process, which, far from being encapsulated in a single cognitive function, impinges upon a constellation of constituent abilities, which may be adaptively used to anticipate and guide future behaviour.

Humans and other animals discount the value of future rewards, a phenomenon known as delay discounting. Individuals vary widely in the extent to which they discount future rewards, and these tendencies have been associated with important life outcomes. Recent studies have demonstrated that imagining the future reduces subsequent discounting behavior, but no research to date has examined whether a similar principle applies at the trait level, and whether training visualization changes discounting. The current study examined if individual differences in visualization abilities are linked to individual differences in discounting and whether practicing visualization can change discounting behaviors in a lasting way. Participants (n = 48) completed the Vividness of Visual Imagery Questionnaire (VVIQ) and delay discounting task and then underwent a 4-week intervention consisting of visualization training (intervention) or relaxation training (control). Contrary to our hypotheses, participants who reported greater visualization abilities (lower scores) on the VVIQ were higher discounters. To further examine this relationship, an additional 106 participants completed the VVIQ and delay discounting task. In the total sample (n = 154), there was a significant negative correlation between VVIQ scores and discount rates, showing that individuals who are better visualizers are also higher discounters. Consistent with this relationship but again to our surprise, visualization training tended, albeit weakly, to increase discount rates, and those whose VVIQ decreased the most were those whose discount rates increased the most. These results suggest a novel association between visualization abilities and delay discounting.

The capacity to mentally project the self into the future or, what has recently been termed “episodic foresight” is an emerging topic of study in developmental psychology. The aim of this dissertation was to review available research on this topic and explore its development in two groups of children: typically-developing preschoolers and children with autism spectrum disorder (ASD). This dissertation had two main goals. The first goal was to explore whether tasks thought to measure episodic foresight in children are related and whether, as has been hypothesized, they were related to theory of mind (ToM) and executive function (EF). Study 1 showed that after controlling for age and language ability, episodic foresight tasks were not intercorrelated, nor were they individually related to ToM or EF tasks. Importantly, however, an episodic foresight composite score was related to several EF tasks. Specifically, the results suggested a significant relation between episodic foresight and inhibitory control. The second goal of this dissertation was to explore the development of episodic foresight in children with ASD. Specifically, I tested whether children with ASD would perform more poorly on a series of episodic foresight tasks than a mental-age matched group of typically-developing children. Study 2 revealed significant group differences on several episodic foresight tasks, suggesting that children with ASD showed impairments in thinking about themselves in the future. These results are a timely contribution to the research on episodic foresight and will hopefully aid in the further development of tasks that adequately measure this important cognitive ability in children.

The aim of this dissertation was to explore whether preschoolers understand that preferences differ over time and between people. The first goal was to determine if 3-, 4-, and 5-year-olds could appreciate that their future or “grown-up” preferences may differ from their current ones (self-future condition). This understanding was compared to children’s understanding of the preferences of a grown-up (adult-now condition), or the grown-up preferences of a same-aged peer (peer-future condition). Results from 3 experiments (N = 240) suggest that these types of reasoning develop substantially over the preschool years, and that children are generally proficient by 5 years of age. Results also indicate that thinking about one’s own future preferences is more difficult than thinking about the (future) preferences of others. The second goal of this dissertation was to explore the relations between reasoning about preferences and theory of mind (ToM) and executive function (EF) abilities. Correlational analyses revealed that children’s reasoning about their future preferences and those of others was associated with EF skills, but not with ToM. These findings provide a timely contribution to the expanding research on children’s future-oriented cognition. Implications for theories about perspective-taking abilities, more broadly, and future research are also discussed.

The capacity to mentally project the self into the future or, what has recently been termed “episodic foresight” is an emerging topic of study in developmental psychology. The aim of this dissertation was to review available research on this topic and explore its development in two groups of children: typically-developing preschoolers and children with autism spectrum disorder (ASD). This dissertation had two main goals. The first goal was to explore whether tasks thought to measure episodic foresight in children are related and whether, as has been hypothesized, they were related to theory of mind (ToM) and executive function (EF). Study 1 showed that after controlling for age and language ability, episodic foresight tasks were not intercorrelated, nor were they individually related to ToM or EF tasks. Importantly, however, an episodic foresight composite score was related to several EF tasks. Specifically, the results suggested a significant relation between episodic foresight and inhibitory control. The second goal of this dissertation was to explore the development of episodic foresight in children with ASD. Specifically, I tested whether children with ASD would perform more poorly on a series of episodic foresight tasks than a mental-age matched group of typically-developing children. Study 2 revealed significant group differences on several episodic foresight tasks, suggesting that children with ASD showed impairments in thinking about themselves in the future. These results are a timely contribution to the research on episodic foresight and will hopefully aid in the further development of tasks that adequately measure this important cognitive ability in children.

This dissertation addresses three novel aspects of children’s future thinking: First is a study of 3- to 5-year-olds’ capacity to think about the future across two different conceptual domains. Specifically, children had to think ahead to meet either a future physiological need (desire for food) or psychological need (avoiding boredom). Most future thinking tasks only require children to plan in one domain, this despite that future thinking is presumably domain general in humans. Children were better at addressing a future need for food than a future need for toys, with even 3-year-olds succeeding above chance. This study also served as an opportunity to replicate the results of a previous similar task (Atance et al., 2015) and improve the task by removing unnecessary components (social, pretense). Second is a study of 3- to 5-year-olds’ spontaneous talk (as a proxy for spontaneous thought) about the future and past within the context of a behavioural future thinking task. Spontaneous or involuntary thought about the past and future are ubiquitous in adult cognition. Few developmental studies have investigated past spontaneous thought, and none have investigated future spontaneous thought. Children of all ages spontaneously spoke about the future and past and some children even spontaneously solved the future thinking task. Further, children who spontaneously spoke more about the past and future were more likely to correctly answer an explicit test question. Third is an attempt at addressing a limitation in all existing behavioural future thinking tasks: That is, tasks used to assess the development of future thinking do not require children to think ahead about a future state of the world that differs from the present. Children could potentially be solving behavioural future thinking tasks without having to represent the future. However, representing a future that differs from the present is argued to be core to adaptive future thinking in humans. To overcome this limitation, we modified an existing task so that children could not succeed based on their representation of how the world currently is but, rather, how it will be at a future point in time. Four- to 7-year-olds all remembered the information required to solve the modified task; however, only 7-year-olds made a future-oriented decision more often than chance. With the task modification removed (so the correct answer for the present and future matched), even 4-year-olds succeeded above chance. These findings challenge the current accounts that suggest by age 4, children can reliably succeed in future thinking tasks. Taken together, this research program contributes new insights to the development of future thinking in early childhood and suggests directions for novel research.

Rationale: Individuals with addictive disorders commonly exhibit a shortened temporal window, which interferes with treatment focusing on long-term sobriety. Episodic Future Thinking (EFT) involves generating personalized cues related to anticipated, positive events at various future time points. EFT has been shown to reduce the reinforcing value of addictive substances; however, this has only been shown in non-treatment samples. Purpose: To examine the feasibility, cumulative, and sustained effects of implementing EFT in a treatment seeking addiction sample over a 1-week protocol on decision-making and alcohol motivation. Methods: Twenty-eight treatment seeking individuals were randomly assigned to either undergo an EFT intervention or a control Episodic Recent Thinking (ERT) protocol. Assessments were completed at baseline, end of week 1, and a 1-week follow-up. Measures included a delay discounting task, hypothetical alcohol purchase task, clinical outcome measures, and cognitive mechanism measures. Results: There were significant reductions in alcohol demand indices, delay discounting rates, and an increase in mindful attention awareness after both acute and extended exposure to EFT. Furthermore, the EFT group showed greater reductions compared to the ERT group after extended exposure to their cues. Conclusion: The results suggest that early implementation of EFT in a treatment seeking addiction sample is beneficial to counteract motivating factors for relapse. This study lays the foundation for future clinical trials for EFT as a supplemental therapy for addictions treatment. / Thesis / Master of Science (MSc) / People with substance use disorders have a significantly shortened time perspective compared to healthy controls. This means that these individuals struggle with thinking about future events beyond several days to a week. Shortened time perspective can be a significant barrier to addiction treatments that typically focus on long-term positive benefits of sobriety or low-risk use. This study examined whether mindful thinking about future events impacted decision-making and motivation for alcohol and drugs. The study used an experimental protocol known as Episodic Future Thinking (EFT) that involves participants interacting with personalized cues related to positive future events. Prior research using EFT in addiction samples has found that interacting with future cues significantly increases delay of gratification, reduces cigarette use, and decreases reinforcing value of alcohol. In this study, we recruited 28 participants with an alcohol use disorder (AUD). Participants practiced EFT training over a two-week protocol. We tested decision making, alcohol craving, and other variables following a single EFT protocol, and changes in these measures over repeated practice. We found significant changes in alcohol craving, decision making, and mindfulness awareness. The study provides proof-of-concept for using EFT in an AUD treatment population and lays the foundation for future clinical trials of EFT as a complement to existing addiction treatments.

Alcohol use disorder is common, and treatments are currently inadequate. Some of the acute effects of alcohol on the brain, such as altering the decision-making and future thinking capacities, mirror the effects of chronic alcohol use. Therefore, interventions that can address these shortcomings may be useful for reducing the negative effects of alcohol use disorder in combination with other therapies. The signature of those interventions may also be evident in the signature of large-scale, dynamic brain networks, which can show whether an intervention is effective. One such intervention is episodic future thinking, which has been shown to reduce delay discounting and orient people toward pro-social, long-term outcomes. To better understand decision making in high-risk individuals, we examined delay discounting in an adolescent population. When the decision-making faculties were challenged with difficult choices, adolescents made decisions inconsistent with their predicted preference, complemented by increased brain activity in the central executive network and salience network. Using these results and the hypothesis that the default mode network would be implicated in future thinking and intertemporal choice, we examined the neural effects of a brief behavioral intervention, episodic future thinking, that seeks to address these impairments. We showed that episodic future thinking has both acute and longer-lasting effects on consequential brain networks at rest and during delay discounting compared to a control episodic thinking condition in alcohol use disorder. Our failure to show group differences in default mode network prompted us to scrutinize it more carefully, from a position where we could measure the ability to self-regulate the network rather than its resting-state tendency. We implemented a real-time fMRI experiment to test the degree to which people along the alcohol use severity spectrum can self-regulate this network. Our results showed that default mode network suppression is impaired as alcohol use disorder severity increases. In the process, we showed that direct examination of resting-state networks with these methods will provide more information than measuring them at rest alone. We also characterized the default mode network along the real-time fMRI pipeline to show the whole-brain spatial pattern of regions associated and unassociated with the network. Our results indicate that resting-state brain networks are important markers for outcomes in alcohol use disorder and that they can be manipulated under experimental conditions, potentially to the benefit of the afflicted individual. / Doctor of Philosophy / Alcohol is the most widely-used mind-altering substance in the United States. Even though most people do not develop a problem with alcohol use, many people will at some point develop drinking patterns that classify as an alcohol use disorder. Brain damage from drinking can come from the toxicity of alcohol, but also as a result of behaviors associated with drinking too much, including injury, violence, accidents, and other health-related issues. Interventions at the behavioral level can be effective at curbing drinking patterns before damage accrues, and a better understanding of those interventions at the level of the brain may make them more effective. This work investigated the decision-making processes and the ability to think clearly about the future, two faculties that begin to become diminished in alcohol use disorder. In our first set of studies, we tested a brief behavioral intervention called episodic future thinking, which helps people orient themselves away from short-term rewards like alcohol and toward long-term goals that could happen if they stopped drinking as much. We showed that one hour-long, intensive session produced changes in the connectivity between the prefrontal cortex and the lower brain. We also generated data in a long-term experiment suggesting repeated reminders of the episodic future thinking intervention produce changes in large-scale brain networks that are disrupted in substance use disorders. In a separate set of experiments, we showed that people can gain control over one of these networks, called the default mode network, to the point of being able to control a brain-machine interface just by following simple instructions. However, we demonstrated that the degree to which someone can control this brain activity was associated with their drinking severity. In other words, the more people drank, in terms of volume and frequency, the less control they had over their own brain activity. This finding is important because many researchers have shown that activity in this brain region is related to many psychopathologies, including substance use disorders. Other researchers have been developing ways in which the ability to control this brain activity can be trained. While we did not find evidence of a training effect in a small group of healthy people (5), it may be the case that people impaired by alcohol use disorder can improve through practice or through cutting back on drinking. Ultimately, we hope that the research presented here will help to guide the development of treatments for alcohol use disorder to be more effective.

Physical inactivity is a major contributor to increased disease prevalence and reduced quality of life. Measuring behavioral economic demand for exercise may enable more effective physical activity intervention development. In study one, we developed the leisure-time-as-price exercise purchase task (LT-EPT), wherein participants (n = 175) indicate hypothetical likelihood to trade leisure time for access to exercise time. We observed weak to moderate correlations between demand indices (Q1%, α, BP1, and Pmax) generated from the LT-EPT and self-reported leisure and exercise time, demonstrating initial validation of the LT-EPT. In study two, we examine the effect of episodic future thinking (EFT; vivid, personalized prospection of future events) in adults not meeting physical activity guidelines (n = 127) on demand for exercise and delay discounting (sensitivity to delayed rewards). We observed reduced delay discounting in participants randomized to engage in EFT, but no difference between EFT and health information thinking (HIT) controls. In study three, we further examined the effect of EFT on demand for exercise in adults with type 2 diabetes and obesity participating in a 24-week randomized controlled trial (n = 71). All participants engaged in a multicomponent behavioral intervention focused on weight loss and glycemic control; additionally, participants were randomized to engage in EFT or HIT thrice daily beginning in week 3. We measured demand for exercise and delay discounting (among other outcomes) at weeks 0, 8, and 24, observing no differences between EFT or HIT groups in demand indices (Q1%, α) or delay discounting at any time point. In conclusion, early evidence suggests that the LT-EPT may be a valid method to measure behavioral economic demand for exercise; however, EFT may not be an effective intervention to increase demand for exercise. / Doctor of Philosophy / Physical inactivity poses a significant threat to our well-being, contributing to increased disease rates and a diminished quality of life. This dissertation details a novel method to measure how people value exercise and the effect of a behavioral intervention to increase exercise valuation. In the first study, we introduce the leisure-time-as-price exercise purchase task (LT-EPT), a tool designed to gauge individuals' willingness to trade leisure time for exercise time (i.e., exercise demand). Initial results show promising correlations between LT-EPT metrics and self-reported leisure and exercise time, providing a foundation for its potential as a valuable measurement tool. The second study examines the impact of episodic future thinking (EFT), a technique involving vivid and personalized visualization of future events, on exercise demand. While participants engaging in EFT showed increased preference for larger, delayed rewards over smaller, sooner rewards (i.e., reduced delay discounting), no significant difference was found between EFT and the health information thinking (HIT) control in terms of exercise demand. The third study expands our investigation to adults with type 2 diabetes and obesity undergoing a 24-week intervention. All participants engaged in a comprehensive behavioral program, while half were randomized to engage in EFT or HIT three times per day. No discernible differences were observed in exercise demand or delay discounting at any measurement point. In summary, our findings suggest that the LT-EPT may be a valid measure of exercise demand. However, the effectiveness of EFT in increasing demand for exercise remains inconclusive. These insights contribute to the ongoing efforts to develop more targeted and impactful interventions for promoting physical activity and improving overall health.