The behavioral- and neuro-economic process of temporal discounting: A candidate behavioral marker of addiction

• A behavioral marker may inform the development, severity, and cause of a disorder.
• Temporal discounting is a potentially useful behavioral marker of addiction.
• Temporal discounting reflects changes across five stages of addiction development.
• Temporal discounting correlates with addiction severity and predicts treatment outcome.
• Temporal discounting and addiction may share some genetic and neurological components.

Addiction science would benefit from the identification of a behavioral marker. A behavioral marker could reflect the projected clinical course of the disorder, function as a surrogate measure of clinical outcome, and/or may be related to biological components that underlie the disorder. In this paper we review relevant literature, made possible with the early and sustained support by NIDA, to determine whether temporal discounting, a neurobehavioral process derived from behavioral economics and further explored through neuroeconomics, may function as a behavioral marker. Our review suggests that temporal discounting 1) identifies individuals who are drug-dependent, 2) identifies those at risk of developing drug dependence, 3) acts as a gauge of addiction severity, 4) correlates with all stages of addiction development, 5) changes with effective treatment, and 6) may be related to the biological and genetic processes that underlie addiction. Thus, initial evidence supports temporal discounting as a candidate behavioral marker. Additional studies will be required in several areas for a more conclusive determination. Confirmation that temporal discounting functions as a behavioral marker for addiction could lead to 1) a screen for new treatments, 2) personalization of prevention and treatment interventions, and 3) the extension of temporal discounting as a behavioral marker for other etiologically similar disorders.This article is part of a Special Issue entitled ‘NIDA 40th Anniversary Issue’.