Differences in Sexual Delay Discounting Among In-Treatment Adults with Opioid Use Disorder

Previous research has found impulsive decision-making to be a core component of addiction (Moody, Franck, Hatz, & Bickel, 2016). One way to measure impulsive choice is through the use of a delay discounting task. The delay discounting task provides a way to measure choice of immediate, smaller rewards compared to delayed, larger rewards (Odum, 2011b). An emerging area of research in addiction science is the intersection of addiction and sexual health. Previous sexual delay discounting research has focused on whether attractiveness or STD risk can shift the likelihood of waiting until a condom was available (Johnson & Bruner, 2012). This study is among the first to include a pregnancy-risk condition, utilize shorter delays, and include individual difference variables such as gender, future time perspective, condom attitudes, and sexual arousal. The final analysis included 113 adults in treatment for Opioid Use Disorder. Two monetary discounting conditions ($10, $100) and three sexual discounting conditions (attraction, STD risk, pregnancy risk) were used to test differences in choice between and within condition. Results indicated significant differences between and within monetary and sexual domains. Next, magnitude differences were observed within each monetary and sexual condition. Lastly, individual differences indicated participants with higher views of the Future as Limited and Future as Ambiguous were less likely to wait for a delayed condom in the Low Pregnancy Risk condition. Higher condom pleasure was associated with a greater likelihood of waiting until a delayed condom was available in the High Attraction, Low STD Risk, and Low Pregnancy Risk conditions. This study advances our understanding of impulsive decision-making and addiction. First, between condition differences were observed indicating that monetary and sexual decision making are distinct concepts that can yield distinct patterns of behavior. The High Attraction condition and the Low STD Risk condition had the least likelihood of waiting until a condom was available. Interestingly, the Low Pregnancy Risk condition elicited a greater likelihood of waiting until a condom was available. This suggests that STD Risk and Pregnancy Risk are evaluated differently and could motivate decision-making. Second, within condition differences were observed indicating that magnitude or level of risk can shift responding, even with the use of hypothetical constructs. Third, individual differences variables such as future time perspective and condom attitudes are associated with delayed condom choice