Stress and episodic future thinking: Effects on temporal window and alcohol demand

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Abstract
Background: Stress maintains problematic alcohol use, so it is particularly important to identify interventions that effectively reduce the desire for alcohol even in the context of high stress. Reinforcer Pathology Theory suggests that stress increases alcohol demand by inducing short‐term thinking. One intervention that targets this mechanism is episodic future thinking (EFT), which involves vividly imagining personal future events and has been shown to reduce short‐term thinking and accompanying preferences for immediate rewards like alcohol. These shared mechanisms suggest that EFT may be particularly effective at reducing alcohol demand in the context of higher stress. This study first assessed the relationship of stress with preference for immediate rewards and alcohol demand, and the impact of EFT on preference for immediate rewards and alcohol demand. This study then tested whether EFT may be particularly effective in the context of higher stress.Methods: One hundred thirty‐nine adults with problematic alcohol use completed an online survey through Amazon Mechanical Turk (MTurk), including self‐report measures of past month stress and baseline momentary stress, an EFT or episodic recent thinking (ERT) procedure, a delay‐discounting task, and an alcohol purchase task. Univariate correlations assessed the relationship of stress with delay discounting and alcohol demand intensity. Path analyses assessed hypothesized models relating EFT/ERT, stress, delay discounting, and demand intensity.Results: Consistent with Reinforcer Pathology Theory, higher baseline momentary stress was correlated with increased preference for immediate rewards. EFT intervention increased preference for delayed rewards, which contributed to decreased alcohol demand. However, the effect of EFT on delay discounting was not moderated by stress.Conclusions: EFT does not appear uniquely effective at reducing desire for alcohol in the context of higher stress, but equally, EFT's efficacy was not significantly affected by stress level. Findings emphasize the opposing roles of state stress and EFT in the behavioral economics underlying problematic alcohol use.

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