One of the main features of impulsivity is dysfunctional decision making. In impulsive dysfunctional decision making, immediate rewards (e.g. satisfying effects of alcohol or drug use, avoiding/escaping emotional or physical suffering/pain, anxiety) are preferred over more substantial but delayed adverse consequences (e.g. relationship damage, health problems). This devaluing of non-immediate (troublesome) outcomes is known as delay discounting and is evident from the established correlations between substance abuse and delay discounting, which is simply the process of devaluing outcomes that happen in the future. Research indicates that non-immediate behavioural consequences, although critical, are devalued due to the delay until experienced.
Several studies claim that delay discounting is strongly associated with dysfunctional health-related decisions. Therefore, interventions that target the reduction in delay discounting and the increase in valuation of delayed outcomes are of critical importance.
Preference for Smaller and Sooner over Larger and Later Outcomes
The model of Mazur (1987) describes the extent to which the worth of an outcome (loss or gain) is subverted with the growing delay of that outcome.
The model forecasts the preference for either smaller and sooner (SS) or larger and later (LL) outcomes. When the outcomes are losses, the option that minimises subjective damage is chosen. Conversely, in the case of rewards as outcomes, the choice is given to the option that maximises subjective gain.
A brilliant example is mentioned by Stein et al. (2022) in their study:
Let’s assume a preference of receiving $450 now versus $900 in 1 year. The smaller and sooner reward is available instantly and, thus, is not discounted. Its subjective value = its nominal value of $450.
On the other hand, the larger and later gain ($900) is discounted: in the Stein et al. (2022) example, the value of the larger and later $900 outcome (gain) is decreased to $429.59 due to the delay.
Here, the choice of the smaller and sooner monetary gain is predicted because it provides a larger gain ($450) than the gain in the later, delayed option ($429.59 initially $900).
Rather, if this same choice were instead between losing either $900 in one year or $450 now, then the choice of the larger and later option is predicted because it minimises subjective loss ($429.59) compared to the smaller and sooner option ($450).
Immediate Rewards of Dysfunctional Impulsive Behaviours can be Devalued by Choice-Bundling Interventions
A study by Stein et al. (2022) was the first to show that a choice-bundling intervention increases the value of delayed gains and losses of smoking cessation, which are disregarded by cigarette smokers. Losses refer to the loss of relationships, health, etc.
Choice-bundling interventions involve deciding on a particular behavioural choice and then facing either smaller-quicker or larger-later gains. These strategies have proven successful in decreasing delay discounting and impulsive dysfunctional behaviours.
Understanding the effect of delay discounting on the intertemporal preference of smaller and sooner outcomes versus larger and later outcomes is critical for developing effective addiction interventions.