Monetary Incentive Delay Task for Adolescent Development

(MID Trial)

Overseen By Lu-Ann Kozlowski, BSN

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Stony Brook University

Must not be taking: Stimulants, Antipsychotics

Disqualifiers: Severe illness, Head trauma, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

300 Participants Needed

Trial Summary

What is the purpose of this trial?

150 males and 150 females ages 14-17 years-old will be enrolled in an observational, longitudinal study. There are three planned in-person visits: a baseline assessment, an 18-month follow-up, and a 36-month follow-up. The in-person visits will include assessment of substance use and other individual differences (e.g., reward function, psychiatric history), neuromelanin-sensitive MRI, as well as functional brain activation collected while the participant is at rest (resting-state fMRI) and while the participant completes a Monetary Incentive Delay task. Subjects will also be asked to complete past 90-day substance use assessments remotely every 90 days for 36 months.

Will I have to stop taking my current medications?

The trial requires that you have not used any medication that may affect brain function in the past 6 months and have never used medications that could influence dopamine, like stimulants or antipsychotics.

What data supports the effectiveness of the treatment Monetary Incentive Delay Task for Adolescent Development?

The research suggests that the Monetary Incentive Delay Task, which involves understanding how adolescents respond to rewards, is linked to brain activity related to immediate reward preference. This understanding can help in developing strategies to manage decision-making behaviors in adolescents, potentially reducing unhealthy choices by altering their reward processing. ^{1 2 3 4 5}

Is the Monetary Incentive Delay Task safe for adolescents?

The Monetary Incentive Delay Task has been used in studies with children and adolescents without reported safety concerns, suggesting it is generally safe for these age groups. ^{5 6 7 8 9}

How does the Monetary Incentive Delay Task for Adolescent Development treatment differ from other treatments for impulsivity in adolescents?

The Monetary Incentive Delay Task for Adolescent Development is unique because it focuses on understanding and modifying reward processing in the brain, which is linked to impulsivity. Unlike traditional treatments, this approach uses a task-based method to assess and potentially influence how adolescents respond to immediate versus delayed rewards, targeting the neural mechanisms underlying impulsive behavior. ^{4 5 7 10 11}

Eligibility Criteria

This study is for boys and girls aged 14-17 who are interested in how the brain works during tasks involving money rewards. Participants will be observed over time, but specific eligibility criteria details were not provided.

Inclusion Criteria

I am between 14 and 17 years old.

English-speaking for assent and interview completion

My parents are willing and able to give consent for me.

Exclusion Criteria

Presence of metal in the body

I am currently taking medication that could affect my brain function.

I have had a head injury that made me lose consciousness.

Timeline

Baseline Assessment

Participants undergo baseline assessment including neuromelanin-sensitive MRI, resting-state fMRI, and Monetary Incentive Delay task

1 visit

1 visit (in-person)

Intermediate Follow-up

Participants undergo 18-month follow-up assessment including NM-MRI scan and Monetary Incentive Delay task

18 months

1 visit (in-person)

Final Follow-up

Participants undergo 36-month follow-up assessment including neuromelanin-sensitive MRI, resting-state fMRI, and Monetary Incentive Delay task

36 months

1 visit (in-person)

Remote Substance Use Assessment

Participants complete past 90-day substance use assessments remotely every 90 days for 36 months

36 months

Treatment Details

Interventions

• Monetary Incentive Delay Task

Trial Overview The trial examines adolescent brain function using a Monetary Incentive Delay Task to understand reward-related processes. It involves MRI scans and regular substance use assessments over a period of three years with visits at baseline, 18 months, and 36 months.

Participant Groups

Group I: Whole sample Experimental Treatment 1 Intervention

All enrolled subjects will complete a standard Monetary Incentive Delay Task if able. Inclusion of this task meets criteria for Basic Experimental Studies Involving Humans (BESH)

Who Is Running the Clinical Trial?

Stony Brook University

Lead Sponsor

Trials

225

Recruited

41,700+

Findings from Research

A systematic review of 98 studies involving participants aged 12 and older found that delay discounting (DD), the tendency to prefer smaller immediate rewards over larger delayed ones, can be significantly reduced through various behavioral trainings and manipulations.

The most effective strategies identified include acceptance-based/mindfulness-based trainings and interventions that promote a future-oriented mindset, suggesting that DD is not fixed and can be influenced by context and training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral trainings and manipulations to reduce delay discounting: A systematic review. Scholten, H., Scheres, A., de Water, E., et al.[2023]

The Monetary Choice Questionnaire (MCQ) demonstrated high test-retest reliability (mean rxx = 0.83) over a 2-year period with 680 participants, indicating it is a stable tool for measuring delay discounting of rewards.

The MCQ showed significant associations with health behaviors, such as smoking status and COVID-19 vaccination, suggesting its relevance in clinical contexts for understanding decision-making related to health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Temporal reliability and stability of delay discounting: A 2-year repeated assessments study of the Monetary Choice Questionnaire. Strickland, JC., Gelino, BW., Rabinowitz, JA., et al.[2023]

Delay discounting paradigms are effective tools for linking specific neural systems to behavior, showing promise in understanding decision-making processes across various psychiatric conditions.

Research indicates that abnormalities in delay discounting are associated with different psychopathologies, such as addiction and anorexia nervosa, suggesting that manipulating this behavior in clinical settings could lead to significant health improvements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can delay discounting deliver on the promise of RDoC? Lempert, KM., Steinglass, JE., Pinto, A., et al.[2020]

In a study of 58 early adolescents aged 12-14, increased brain activation in areas related to reward processing was associated with a stronger preference for immediate rewards during a delay discounting task.

This connection between neural activation and immediate reward bias may help explain the significant rise in impulsive decision-making seen in adolescents as they develop.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adolescent Brain Response to Reward Is Associated with a Bias toward Immediate Reward. Hansen, A., Turpyn, CC., Mauro, K., et al.[2020]

The study tested a modified 5-trial adjusting delay task (ADT-5) on 9 children in a psychiatric day treatment program to assess their delay discounting rates for both real and hypothetical monetary rewards.

While the results showed no significant difference in discounting rates between real and hypothetical rewards in initial tasks, they were not statistically equivalent, suggesting that the ADT-5 could be useful for evaluating delay discounting in children, but further research is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing rapid assessments of delay discounting with real and hypothetical rewards in children. Miller, JR.[2020]

The study introduces a user-friendly Excel-based tool that simplifies the scoring of the Monetary Choice Questionnaires, which assess how individuals value immediate versus delayed monetary rewards.

This tool aims to enhance the accessibility and usability of the questionnaires, which are important for predicting behaviors related to delay discounting, a key factor in various societal issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Automating Scoring of Delay Discounting for the 21- and 27-Item Monetary Choice Questionnaires. Kaplan, BA., Amlung, M., Reed, DD., et al.[2020]

The newly modified Child Incentive Delay (CID) task successfully elicited significant brain activity related to reward anticipation in both healthy young adults and children, indicating its effectiveness for studying reward processing.

The CID showed comparable results to the traditional Monetary Incentive Delay (MID) task without differences in reaction times or accuracy, supporting its validity for use in future research involving children and adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

CID: a valid incentive delay paradigm for children. Kappel, V., Koch, A., Lorenz, RC., et al.[2021]

High school students who opted for an immediate monetary reward displayed more self-regulatory issues, including higher involvement with substances like cigarettes, alcohol, and marijuana, as well as poorer academic performance.

A similar pattern was observed in middle-school students, suggesting that the tendency to choose immediate rewards over delayed ones is linked to negative behaviors and self-concept across different age groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Delay of gratification: impulsive choices and problem behaviors in early and late adolescence. Wulfert, E., Block, JA., Santa Ana, E., et al.[2022]

In a study involving 49 children with ADHD, stimulant medication (methylphenidate) significantly reduced impulsivity related to real-world rewards, indicating its efficacy in addressing delay discounting.

The medication did not have the same effect on hypothetical rewards, suggesting that the type of reward may influence how ADHD treatments work, highlighting the need for careful consideration of task design in future studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of methylphenidate on discounting of delayed rewards in attention deficit/hyperactivity disorder. Shiels, K., Hawk, LW., Reynolds, B., et al.[2021]

In a study involving 19 healthy youth aged 10-14, researchers found that activation in the left ventromedial caudate during the anticipation of potential rewards was negatively correlated with delay discounting behavior, suggesting that brain activity can indicate how willing a person is to wait for larger rewards.

This suggests that individual differences in the ability to delay gratification may be linked to specific neural responses to anticipated rewards, providing insights into the neurobiological factors that could influence risk for developing issues like substance abuse.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Caudate responses to reward anticipation associated with delay discounting behavior in healthy youth. Benningfield, MM., Blackford, JU., Ellsworth, ME., et al.[2021]

In a study involving 36 participants (18 adolescents and 18 adults), adults showed greater brain activity in response to relative rewards, indicating they process the value of rewards differently than adolescents.

The research found that adults had a more consistent increase in brain activity with larger rewards, while adolescents showed less sensitivity to reward magnitude, which was associated with higher impulsivity traits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neural sensitivity to absolute and relative anticipated reward in adolescents. Vaidya, JG., Knutson, B., O'Leary, DS., et al.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Behavioral trainings and manipulations to reduce delay discounting: A systematic review. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Temporal reliability and stability of delay discounting: A 2-year repeated assessments study of the Monetary Choice Questionnaire. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Can delay discounting deliver on the promise of RDoC? [2020]

4. England pubmed.ncbi.nlm.nih.gov

Adolescent Brain Response to Reward Is Associated with a Bias toward Immediate Reward. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Comparing rapid assessments of delay discounting with real and hypothetical rewards in children. [2020]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Automating Scoring of Delay Discounting for the 21- and 27-Item Monetary Choice Questionnaires. [2020]

7. Austria pubmed.ncbi.nlm.nih.gov

CID: a valid incentive delay paradigm for children. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Delay of gratification: impulsive choices and problem behaviors in early and late adolescence. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Effects of methylphenidate on discounting of delayed rewards in attention deficit/hyperactivity disorder. [2021]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Caudate responses to reward anticipation associated with delay discounting behavior in healthy youth. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Neural sensitivity to absolute and relative anticipated reward in adolescents. [2021]