Evidence that intergenerational income mobility is the strongest predictor of drug overdose deaths in U. S. Midwest counties.

BACKGROUND: Our goal in this report was to quantify the degree to which opioid prescription rates and socioeconomic correlates of income inequality predicted overdose deaths in the 1055 U.S. Midwest counties. The study follows up a state-level analysis which reported that opioid prescription rates, social capital and unemployment explained much of the variance in opioid overdose death rates (Heyman, McVicar, & Brownell, 2019). METHODS: We created a data set that included drug overdose death rates, opioid prescription rates, and correlates of income inequality. Given that the variables of interest varied at the state and county level, multilevel regression was our statistical approach. RESULTS: From 2006 to 2021, Midwest overdose drug deaths increased according to an exponential equation that closely approximated the equation that describes the increases in overdose deaths for the entire U.S. from 1978 to 2016 (e.g., Jalal et al., 2018). Retail opioid prescription sales increased from 2006 to 2012, but then declined so that by 2017 they were lower than in 2006. The regression analyses revealed that intergenerational income mobility was the strongest predictor of overdose deaths. The other consistently statistically significant predictors were opioid prescription rates, social capital, and unemployment rates. Together these predictors, plus pupil teacher ratios, single parent families, and attending college accounted for approximately 47 % of the variance in overdose death rates each year. In keeping with the decline in opioid prescription rates, the explanatory power of opioid prescription rates weakened over the course of the study. CONCLUSIONS: Overdose deaths increased at a constant exponential rate for the years that it was possible to apply our regression model. This occurred even though access to legal opioids decreased. What remained invariant was the predictive strength of intergenerational income mobility; each year it was the predictor that explained the most variance in overdose deaths.

Overconsumption as a function of how individuals make choices: A paper in honor of Howard Rachlin's contributions to psychology.

Howard Rachlin's widely influential behavioral economic approach to self-control and related issues provides the model for this submission. The topic is overconsumption. Current human consumption levels are unsustainable. Explanations typically focus on societal factors, such as the seductive power of advertising and/or misguided tax policies. However, the effectiveness of these factors depends on the degree to which individuals are susceptible to the message: "consume more." Humans are not blank slates. This paper argues that how individuals frame their choices establishes the susceptibility to overconsume. According to economic theory, consumers frame their options as bundles, composed of different combinations of the available items and activities. This leads to maximizing. In experiments, participants tend to frame their options as "either-or" choices. This leads to the matching law. Mathematical models of concurrent schedule choice procedures show that (1) the matching law implies overconsumption of the most preferred option and (2) that individuals will persist in preferring their favorite option even when doing so reduces overall reward rates. Given that the matching law better describes how individuals choose than does maximizing, the mathematical models of widely used choice procedures help explain why efforts to increase consumption have been more influential than efforts to control consumption.

Personality and Its Partisan Political Correlates Predict U.S. State Differences in Covid-19 Policies and Mask Wearing Percentages.

A central feature of the Covid-19 pandemic is state differences. Some state Governors closed all but essential businesses, others did not. In some states, most of the population wore face coverings when in public; in other states, <50% wore face coverings. According to journalists, these differences were symptomatic of a politically polarized America. The Big 5 personality factors also cluster at the state level. For example, residents of Utah score high on Conscientiousness and low on Neuroticism, whereas residents of Massachusetts and Connecticut show the opposite pattern. In state-level regressions that controlled for partisan political allegiances, Conscientiousness was a significant (negative) predictor of the stringency of state Covid-19 restrictions, whereas Openness was a significant (positive) predictor of mask wearing. A number of the predictors were strongly correlated with each other. For example, the correlation coefficient linking Openness with the percentage of Democratic state legislators was r = 0.53. Commonality regression partitions the explained variance between the amount that is unique to each predictor and the amount that is shared among subsets of correlated predictors. This approach revealed that the common variance shared by Conscientiousness, Openness and partisan politics accounted for 34% of the state differences in Covid-19 policy and 35% of the state differences in mask wearing. The results reflect the importance of personality in how Americans have responded to the Covid-19 pandemic.

Aspiration fuels willpower: Evidence from the addiction literature.

Ainslie identifies two possible motivational sources for resolve: "thinking categorically" and "intertemporal bargaining." Ainslie opts for intertemporal bargaining, adding that thinking categorically has no motivational power. The most researched instance of willpower is remission from addiction. This literature shows that aspirations for a more desirable identity and comfortable lifestyle motivate remission. In other words, "thinking categorically" drives willpower.

How individuals make choices explains addiction's distinctive, non-eliminable features.

In keeping with the goals of this Special Issue, this paper poses the following questions: What are addiction's non-eliminable features and can they be explained by one or more general principles? I have added the qualifier "distinctive" to these goals, as in "distinctive non-eliminable features." The result is a highly heterogeneous list, which includes features of addiction's natural history, such as its high remission rates, its unique idioms (e.g., "kicking the habit"), and its patented interventions, such as Alcoholics Anonymous. I show that each of these distinctive features reflects how individuals make choices. In particular, they reflect the competing claims of two basic choice processes: global maximizing of the sort assumed in introductory economics textbooks and Herrnstein's matching law, which has empirical rather than theoretical roots. These are basic choice processes, which apply to all decision making, not just drugs and not just addicts. Nevertheless, they can result in addiction when one of the options has the capacity to undermine the value of competing interests and undermine global maximizing. Conversely, the analyses also show that the two basic choice processes combine so as to predict that addiction is a semi-stable state that is biased to resolve in favor of remission. These predictions are supported by the high rates of addiction, by the high rates of remission from addiction, and by the fact that remission is often unassisted or "spontaneous." The analyses fail to support the idea that pathological psychological processes lead to addiction. Rather they show that addiction emerges from the interactions of normal choice processes and the behaviorally toxic effects of drugs.

Behavioral psychology's matching law describes the allocation of covert attention: A choice rule for the mind.

The matching law describes the allocation of behavior over a wide range of settings, including laboratory experimental chambers, forest foraging patches, sports arenas, and board games. Interestingly, matching persists in settings in which economic analyses predict quite different distributions of behavior, and it also differs systematically from probability matching. We tested whether the matching law also describes the allocation of covert cognitive processes. Sixty-four participants viewed 2, small, vertically arranged adjacent stimuli that projected an image that fit within the fovea. A trial version of the reward contingencies used in matching law experiments determined which stimulus was the target. For example, in 1 condition, the top stimulus was the target 3 times more frequently than the bottom stimulus. However, the amount of time the stimuli were available was tailored to each participant so that they were not able to make use of the information in both stimuli even though an eye-tracking experiment confirmed that they saw both. The implication of this restriction is that participants had to decide which stimulus to attend to prior to each trial. The only available objective basis for this decision was the relative frequencies that a stimulus was the target. The matching law predicted the correlation between the relative frequency that a stimulus was the target and the proportion of trials that it was attended to. The results support the claim that the matching law is a general choice principle-one that describes the allocation of covert mental processes as well as overt behavioral responses. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evidence that social-economic factors play an important role in drug overdose deaths.

BACKGROUND: Drug overdose deaths in the United States increased from approximately 16,000 per year in 2001 to 41,000 per year in 2014. Although every US state witnessed an increase, the increases were much larger in some states than others. There was also variation as a function of race and ethnicity. Non-Hispanic Whites accounted for more than 80% of the deaths, and in some states their rates were about ten times greater per capita than Hispanic and Non-White rates. State and temporal differences provide an opportunity to evaluate explanations of what is driving drug overdose deaths. In this report, we evaluate the degree to which state level variation in opioid prescription rates and social-economic conditions explain state level variation in overdose death rates. METHODS AND DATA: We used publicly available data from the Center for Disease Control (CDC), Bureau of Labor Statistics (BLS), Drug Enforcement Agency (DEA) and the Opportunity Insights project. RESULTS: Legally prescribed opioids, social capital and work force participation accounted for 53-69% of the between-state variation in overdose deaths in Non-Hispanic Whites. Prescriptions and the two social economic measures accounted for about the same amounts of unique variation, but shared variation among the three independent variables was the strongest predictor of overdose deaths. Panel regression results of the year-to-year changes in overdose deaths were similar. However, the pattern of correlations for Hispanics and Non-Whites was quite different. Neither opioid prescriptions nor social capital were significant predictors of overdose deaths in the between-state and between-year Hispanic and Non-White regression analyses. CONCLUSIONS: Common variation in opioid prescriptions rates, social capital, and work force participation proved the strongest predictor of drug overdose deaths in Non-Hispanic Whites. We discuss reasons why the same did not hold for the Hispanic/Non-White population.

Dissociating Attention and Eye Movements in a Quantitative Analysis of Attention Allocation.

In a recent paper, we introduced a method and equation for inferring the allocation of attention on a continuous scale. The size of the stimuli, the estimated size of the fovea, and the pattern of results implied that the subjects' responses reflected shifts in covert attention rather than shifts in eye movements. This report describes an experiment that tests this implication. We measured eye movements. The monitor briefly displayed (e.g., 130 ms) two small stimuli (≈1.0° × 1.2°), situated one atop another. When the stimuli were close together, as in the previous study, fixations that supported correct responses at one stimulus also supported correct responses at the other stimulus, as measured over the entire session. Yet, on any particular trial, correct responses were limited to just one stimulus. This pattern suggests that the constraints on responding within a trial were due to limits on cognitive processing, whereas the ability to respond correctly to either stimulus on different trials must have entailed shifts in attention (that were not accompanied by eye movements). In contrast, when the stimuli were far apart, fixations that had a high probability of supporting correct responses at one stimulus had a low probability of supporting correct responses at the other stimulus. Thus, conditions could be arranged so that correct responses depended on eye movements, whereas in the "standard" procedure, correct responses were independent of eye movements. The results dissociate covert and overt attention and support the claim that our procedure measures covert attention.

Do addicts have free will? An empirical approach to a vexing question.

INTRODUCTION: This paper addresses two overlapping questions: Do addicts have the capacity to voluntarily quit drugs? And do individuals knowingly pursue courses of action that they realize are bad for them, such as excessive drug use? METHODS: I propose two testable versions of free will. First, the observation that activities differ in the degree to which they are susceptible to the influence of their consequences (e.g., costs and benefits) has proven a useful criterion for classifying behavior as voluntary or involuntary. Thus, we can ask if drug use in addicts is influenced by its consequences. For instance, do laws that promise legal sanctions for drug use reduce drug use in addicts? Second, the philosopher Harry Frankfurt proposed a definition of free will that takes into account desires and self-reflection. I propose that addicts who do not want to desire drugs and successfully stop craving drugs pass his test. RESULTS: Dependence on illicit drugs typically ends after about four to six years. Dependence on cigarettes and alcohol persists for much longer, but most smokers and alcoholics eventually voluntarily quit using. Smokers and heroin addicts can voluntarily regulate their drug cravings as a function of the availability of their drug of choice. They have the capacity to pass Frankfurt's test of free will. CONCLUSIONS: Addicts have free will as defined by the capacity to voluntary quit using drugs and to voluntarily regulate their cravings.

Introducing a Method for Calculating the Allocation of Attention in a Cognitive "Two-Armed Bandit" Procedure: Probability Matching Gives Way to Maximizing.

We tested whether principles that describe the allocation of overt behavior, as in choice experiments, also describe the allocation of cognition, as in attention experiments. Our procedure is a cognitive version of the "two-armed bandit choice procedure." The two-armed bandit procedure has been of interest to psychologistsand economists because it tends to support patterns of responding that are suboptimal. Each of two alternatives provides rewards according to fixed probabilities. The optimal solution is to choose the alternative with the higher probability of reward on each trial. However, subjects often allocate responses so that the probability of a response approximates its probability of reward. Although it is this result which has attracted most interest, probability matching is not always observed. As a function of monetary incentives, practice, and individual differences, subjects tend to deviate from probability matching toward exclusive preference, as predicted by maximizing. In our version of the two-armed bandit procedure, the monitor briefly displayed two, small adjacent stimuli that predicted correct responses according to fixed probabilities, as in a two-armed bandit procedure. We show that in this setting, a simple linear equation describes the relationship between attention and correct responses, and that the equation's solution is the allocation of attention between the two stimuli. The calculations showed that attention allocation varied as a function of the degree to which the stimuli predicted correct responses. Linear regression revealed a strong correlation (r = 0.99) between the predictiveness of a stimulus and the probability of attending to it. Nevertheless there were deviations from probability matching, and although small, they were systematic and statistically significant. As in choice studies, attention allocation deviated toward maximizing as a function of practice, feedback, and incentives. Our approach also predicts the frequency of correct guesses and the relationship between attention allocation and response latencies. The results were consistent with these two predictions, the assumptions of the equations used to calculate attention allocation, and recent studies which show that predictiveness and reward are important determinants of attention.

Disentangling the Correlates of Drug Use in a Clinic and Community Sample: A Regression Analysis of the Associations between Drug Use, Years-of-School, Impulsivity, IQ, Working Memory, and Psychiatric Symptoms.

Years-of-school is negatively correlated with illicit drug use. However, educational attainment is positively correlated with IQ and negatively correlated with impulsivity, two traits that are also correlated with drug use. Thus, the negative correlation between education and drug use may reflect the correlates of schooling, not schooling itself. To help disentangle these relations we obtained measures of working memory, simple memory, IQ, disposition (impulsivity and psychiatric status), years-of-school and frequency of illicit and licit drug use in methadone clinic and community drug users. We found strong zero-order correlations between all measures, including IQ, impulsivity, years-of-school, psychiatric symptoms, and drug use. However, multiple regression analyses revealed a different picture. The significant predictors of illicit drug use were gender, involvement in a methadone clinic, and years-of-school. That is, psychiatric symptoms, impulsivity, cognition, and IQ no longer predicted illicit drug use in the multiple regression analyses. Moreover, high risk subjects (low IQ and/or high impulsivity) who spent 14 or more years in school used stimulants and opiates less than did low risk subjects who had spent <14 years in school. Smoking and drinking had a different correlational structure. IQ and years-of-school predicted whether someone ever became a smoker, whereas impulsivity predicted the frequency of drinking bouts, but years-of-school did not. Many subjects reported no use of one or more drugs, resulting in a large number of "zeroes" in the data sets. Cragg's Double-Hurdle regression method proved the best approach for dealing with this problem. To our knowledge, this is the first report to show that years-of-school predicts lower levels of illicit drug use after controlling for IQ and impulsivity. This paper also highlights the advantages of Double-Hurdle regression methods for analyzing the correlates of drug use in community samples.

Addiction and choice: theory and new data.

Addiction's biological basis has been the focus of much research. The findings have persuaded experts and the public that drug use in addicts is compulsive. But the word "compulsive" identifies patterns of behavior, and all behavior has a biological basis, including voluntary actions. Thus, the question is not whether addiction has a biology, which it must, but whether it is sensible to say that addicts use drugs compulsively. The relevant research shows most of those who meet the American Psychiatric Association's criteria for addiction quit using illegal drugs by about age 30, that they usually quit without professional help, and that the correlates of quitting include legal concerns, economic pressures, and the desire for respect, particularly from family members. That is, the correlates of quitting are the correlates of choice not compulsion. However, addiction is, by definition, a disorder, and thereby not beneficial in the long run. This is precisely the pattern of choices predicted by quantitative choice principles, such as the matching law, melioration, and hyperbolic discounting. Although the brain disease model of addiction is perceived by many as received knowledge it is not supported by research or logic. In contrast, well established, quantitative choice principles predict both the possibility and the details of addiction.

Quitting drugs: quantitative and qualitative features.

According to the idea that addiction is a chronic relapsing disease, remission is at most a temporary state. Either addicts never stop using drugs, or if they do stop, remission is short lived. However, research on remission reveals a more complex picture. In national epidemiological surveys that recruited representative drug users, remission rates varied widely and were markedly different for legal and illegal drugs and for different racial/ethnic groups. For instance, the half-life for cocaine dependence was four years, but for alcohol dependence it was 16 years, and although most dependent cocaine users remitted before age 30, about 5% remained heavy cocaine users well into their forties. Although varied, the remission results were orderly. An exponential growth curve closely approximated the cumulative frequency of remitting for different drugs and different ethnic/racial groups. Thus, each year a constant proportion of those still addicted remitted, independent of the number of years since the onset of dependence.

Received Wisdom Regarding the Roles of Craving and Dopamine in Addiction: A Response to Lewis's Critique of Addiction: A Disorder of Choice.

Lewis's review of my book (2011, this issue) repeats widely shared understandings of the nature of addiction and the role that dopamine plays in the persistence of self-destructive drug use. These accounts depict addiction as a chronic relapsing disease and claim that drug-induced changes in dopamine function explain the transition from drug experimentation to compulsive drug use. In my book, I test the idea that addiction is a chronic, persistent state. Lewis fails to mention the results of the various tests, although they provide a handy test for his account of addiction and are surprising in light of the common verbal formula "addiction is a chronic, relapsing disease." Consequently, I review a few of the key findings in this response. Lewis faults me for not giving enough attention to dopamine. In my book, I conclude that there is more to the biology of addiction than dopamine, and in this response, I describe research that tests the idea that drug-induced increases in dopamine markedly reduce an individual's capacity to choose nondrug reinforcers. In one experiment, rats readily gave up cocaine for saccharin, even when they had been consuming massive amounts of the drug for weeks. Put more generally, well-established research results call for a revision of currently accepted understandings of addiction and the role that dopamine plays in drug use.

Probing reward function in posttraumatic stress disorder: expectancy and satisfaction with monetary gains and losses.

BACKGROUND: Posttraumatic stress disorder (PTSD) may be associated with dysfunctional reward processing. The present study assessed for such dysfunction in both the expectancy and outcome phases of reward processing. METHODS: Male Vietnam veterans with (n=15) and without (n=11) combat-related PTSD were administered a wheel of fortune-type gambling task. Self-reported ratings of expectancy and satisfaction were collected respectively before and after each experience of monetary gain or loss. RESULTS: PTSD participants reported both lower expectancy of reward and lower satisfaction with reward when it was received. The latter result was manifest in a failure of PTSD participants to show the greater satisfaction that normally accompanies rewards received under conditions of low expectancy. CONCLUSION: These results suggest reward function impairment in PTSD related to expectancy, satisfaction, and the expectancy-satisfaction relationship.

Delay discounting in college cigarette chippers.

Individuals who smoke cigarettes regularly but do not become dependent on them provide a unique opportunity for studying the factors that inhibit drug dependence. Previous research on this population, sometimes referred to as 'cigarette chippers', showed that they did not differ from regular smokers in terms of smoking topography (e.g. puff number and duration) and circulating nicotine levels, but that they did show more self-control according to answers on a questionnaire. We evaluated the generality of this finding using a behavioral choice procedure. The participants were undergraduate students (n=71), who were regular smokers, chippers, or nonsmokers. In the choice procedure, one option was a smaller but sooner amount of money, and the other option was a larger but delayed amount of money. Under these conditions, preference for the sooner smaller amount implies that the later larger monetary amounts were discounted. It is widely assumed that the rate of discounting provides an operational definition of impulsivity. In one version of the procedure, the money was hypothetical. In a second version, each choice had a chance of producing an actual monetary outcome. When there was an actual monetary outcome, regular smokers were more likely to choose the sooner but smaller monetary option than chippers and nonsmokers. For all participants, the rate of discounting decreased as the magnitude of the monetary outcomes increased, and for smokers and chippers the differences in discount rates in the two versions of the delayed outcome procedure were the same. These findings are consistent with the view that chippers are less impulsive than smokers. Quantitative aspects of these findings led to the hypothesis that discount rates decrease as a negative power function of the monetary value of the options. This result establishes an analogy between delay discounting experiments and psychophysical experiments. Results from two earlier studies support the analogy.

Decision biases and persistent illicit drug use: an experimental study of distributed choice and addiction.

This experiment tested the hypothesis that differences in drug use are correlated with differences in decision making. The subjects were 22 drug clinic patients who had used either opiates or stimulants for an average of 10 years, and 21 community residents who reported that they had rarely used illicit addictive drugs. The procedure consisted of a series of binary choices with two consequences; they earned money and determined the intervals that separated choice trials. Each choice earned the same amount of money, but one initiated a shorter delay to the next trial, whereas the other initiated a shorter delay as averaged over the next two trials. Shorter delays were advantageous in that they increased the overall rate of earnings and they reduced the time spent waiting for the next trial. Thus, one choice was better from the perspective of the current trial, while the other choice was better from the perspective of two or more consecutive trials. Drug-clinic patients were more likely to favor the one-trial solution compared with control subjects, who were more likely to favor the two-trial solution. There were five different choice games, with different versions varying in the magnitude of the advantage for switching from the two-trial to the one-trial solution. Drug clinic and control subjects differed most in the games in which the immediate advantage of the one-trial solution was larger, and all subjects were more likely to choose the global solution when the incentive for switching to the one-trial solution was lower. The results support the view that individual differences in decision making influence the course of illicit drug use.