Associations of Delay Discounting Rate with Anxiety Disorder Symptomatology and Diagnoses

Abstract

Delay discounting is the tendency for individuals to devalue a reward as time to receipt of the reward increases. Rates of delay discounting describe to what extent one prefers smaller rewards delivered immediately over larger rewards delivered at a delay. Discount rates vary among individuals, and authors have suggested that abnormal discount rate may represent a transdiagnostic process implicated in multiple psychiatric disorders. However, further research is needed on how discount rate may relate to anxiety symptomatology and formally diagnosed anxiety disorders. Thus, the present study, in a sample of individuals with heterogeneous anxiety disorders and healthy controls, examined how monetary discount rate related to dimensional measures of anxiety symptomatology as well as diagnoses of generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD). In addition, we examined how discount rate related to physiological startle response (i.e., fear-potentiated and anxiety-potentiated startle). From 2019 to 2022, adults with a formal diagnosis of GAD, SAD, and/or PD (N = 89) and healthy controls (N = 66) completed dimensional measures of anxiety symptomatology; a hypothetical monetary delay discounting task that followed an adjusting titration procedure; and the neutral, predictable, and unpredictable (NPU) threat test. Correlational analyses revealed that discount rate was not significantly associated with any dimensional measure of anxiety (ps ≥ .31); logistic regressions controlling for appropriate covariates indicated that discount rate was not significantly associated with any anxiety disorder diagnosis (ps ≥ .14). In addition, discount rate was not significantly correlated with any measure of physiological startle (ps ≥ .22). We did find that completion of the delay discounting task during the pandemic was significantly associated with shallower (lower) discount rate. Overall, results suggest that monetary delay discounting paradigms might not represent a highly useful tool within the anxiety disorders field in particular, and the potential transdiagnostic role of abnormal discount rate, at least as measured with monetary discounting paradigms, might not extend to anxiety disorders. However, results should be interpreted cautiously given limitations such as the relatively small sample size, which precluded adequate statistical power to detect effects of small sizes.