The Phenotype of Recovery II: The Association Between Delay Discounting, Self-Reported Quality of Life, and Remission Status Among Individuals in Recovery From Substance Use Disorders

Quality of life (QOL) and delay discounting (preference for smaller, immediate rewards) are significantly associated with substance use status, severity, and treatment outcomes. Associations between delay discounting and QOL among individuals in recovery from substance use have not been investigated. In this 2-study investigation, using data collected from The International Quit & Recovery Registry, we examined the association between QOL, discounting rates, and remission status among individuals in recovery from SUD. Study 1 (N = 166) investigated the relationship between delay discounting and QOL among individuals in recovery from SUD. Study 2 (N = 282) aimed to validate and extend the results of Study 1 by assessing the association between the remission status, delay discounting, and QOL among individuals in recovery from alcohol use disorder (AUD). In both studies, delay discounting was a significant predictor of QOL domains of physical health, psychological, and environment even after controlling for age, gender, race, ethnicity, education, and days since last use. In Study 2, a mediation analysis using Hayes's methods revealed that the association between the remission status and QOL domains of physical health, psychological and environment were partially mediated by the discounting rates. The current study expands the generality of delay discounting and indicates that discounting rates predict QOL and remission status among individuals in recovery from substance use disorders. This finding corroborates the recent characterizations of delay discounting as a candidate behavioral marker of addiction and may help identify subgroups that require special treatment or unique interventions to overcome their addiction. Public Health Significance In this investigation, delay discounting, which assesses the extent to which an individual chooses smaller, sooner rewards over larger, delayed ones, was significantly associated with quality of life domains of physical health, psychological, and environment among individuals in recovery from substance use. In addition, delay discounting was significantly associated with the remission status among those in recovery from alcohol. That is, those in remission (had no signs or symptoms, other than craving, of active addiction in the last 3 months) had lower rates of discounting (higher valuation of larger delayed rewards) compared to those not in remission. This information may serve as a base to better identify and targ