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Comment & Response
December 18, 2019

The Elusive Nature of Delay Discounting as a Transdiagnostic Process in Psychiatric Disorders—The Devil Is in the Detail

Author Affiliations
  • 1Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
JAMA Psychiatry. 2020;77(3):325. doi:10.1001/jamapsychiatry.2019.4121

To the Editor Amlung and colleagues1 published a meta-analysis of delay discounting (DD), a behavioral measure of impulsivity and self-control, including 57 effect sizes from 43 studies across 8 psychiatric diagnostic categories. Results indicated a greater preference for smaller immediate monetary rewards (ie, more impulsive decision-making) in 6 conditions (major depression, schizophrenia, bipolar disorder, borderline personality disorder, bulimia nervosa, and binge-eating disorder) compared with controls but greater preference for larger delayed rewards (ie, more self-controlled choice) in anorexia nervosa. The findings have important implications for the National Institute of Mental Health’s Research Domain Criteria initiative, which seeks to elucidate neurocognitive mechanisms that transcend categorical diagnoses.

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