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    Delay Discounting as a Transdiagnostic Process in Psychiatric Disorders: A Meta-analysis

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    Issue Date
    2019-08-28
    Author
    Amlung, Michael
    Marsden, Emma
    Holshausen, Katherine
    Morris, Vanessa
    Patel, Herry
    Vedelago, Lana
    Naish, Katherine R.
    Reed, Derek D.
    McCabe, Randi E.
    Publisher
    American Medical Association
    Type
    Article
    Article Version
    Scholarly/refereed, publisher version
    Rights
    © 2019 American Medical Association. All rights reserved.
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    Abstract
    Importance Delay discounting is a behavioral economic index of impulsive preferences for smaller-immediate or larger-delayed rewards that is argued to be a transdiagnostic process across health conditions. Studies suggest some psychiatric disorders are associated with differences in discounting compared with controls, but null findings have also been reported.

    Objective To conduct a meta-analysis of the published literature on delay discounting in people with psychiatric disorders.

    Data Sources PubMed, MEDLINE, PsycInfo, Embase, and Web of Science databases were searched through December 10, 2018. The psychiatric keywords used were based on DSM-IV or DSM-5 diagnostic categories. Collected data were analyzed from December 10, 2018, through June 1, 2019.

    Study Selection Following a preregistered Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol, 2 independent raters reviewed titles, abstracts, and full-text articles. English-language articles comparing monetary delay discounting between participants with psychiatric disorders and controls were included.

    Data Extraction and Synthesis Hedges g effect sizes were computed and random-effects models were used for all analyses. Heterogeneity statistics, one-study-removed analyses, and publication bias indices were also examined.

    Main Outcomes and Measures Categorical comparisons of delay discounting between a psychiatric group and a control group.

    Results The sample included 57 effect sizes from 43 studies across 8 diagnostic categories. Significantly steeper discounting for individuals with a psychiatric disorder compared with controls was observed for major depressive disorder (Hedges g = 0.37; P = .002; k = 7), schizophrenia (Hedges g = 0.46; P = .004; k = 12), borderline personality disorder (Hedges g = 0.60; P < .001; k = 8), bipolar disorder (Hedges g = 0.68; P < .001; k = 4), bulimia nervosa (Hedges g = 0.41; P = .001; k = 4), and binge-eating disorder (Hedges g = 0.34; P = .001; k = 7). In contrast, anorexia nervosa exhibited statistically significantly shallower discounting (Hedges g = –0.30; P < .001; k = 10). Modest evidence of publication bias was indicated by a statistically significant Egger test for schizophrenia and at the aggregate level across studies.

    Conclusions and Relevance Results of this study appear to provide empirical support for delay discounting as a transdiagnostic process across most of the psychiatric disorders examined; the literature search also revealed limited studies in some disorders, notably posttraumatic stress disorder, which is a priority area for research.
    URI
    http://hdl.handle.net/1808/31440
    DOI
    https://doi.org/10.1001/jamapsychiatry.2019.2102
    Collections
    • Applied Behavioral Science Scholarly Works [115]
    Citation
    Amlung M, Marsden E, Holshausen K, et al. Delay Discounting as a Transdiagnostic Process in Psychiatric Disorders: A Meta-analysis. JAMA Psychiatry. 2019;76(11):1176–1186. doi:10.1001/jamapsychiatry.2019.2102

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    785-864-8983

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    Contact KU ScholarWorks
    785-864-8983
    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    785-864-8983

    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    Image Credits
     

     

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