(PS2-B32) Associations of Delay Discounting Rate with Anxiety Disorder Diagnosis and Symptomatology

Background: 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, there is relatively little research on how discount rate may relate to anxiety disorders. Thus, the present study, in a sample of individuals with heterogeneous anxiety disorders and healthy controls, examined how discount rate related to (1) dimensional measures of anxiety symptoms and (2) diagnosis of any anxiety disorder, generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD).

Method: From 2019 to 2022, adults with a primary psychiatric diagnosis of GAD, SAD, or PD (N = 84) and healthy controls (N = 66) completed self-report measures of state anxiety and trait anxiety. Anxiety patients also completed clinician-administered assessments of general anxiety, social anxiety, and panic symptom severity. All participants completed a delay discounting task that presented a series of hypothetical choices between a smaller, sooner monetary reward and a larger, later monetary reward (varying the size of and delay to the rewards). We calculated correlation coefficients between discount rate (log-transformed in all analyses to improve normality) and all dimensional measures, within the full sample and within diagnostic groups. We conducted four separate multiple linear regressions to examine the relationship between discount rate and anxiety disorder diagnosis, considering anxiety disorder diagnosis in four separate ways: all anxiety patients, GAD patients, SAD patients, and PD patients. In all regressions, we controlled for pre- vs. during-COVID-19 time status as this variable differed significantly between the healthy control group and each anxiety disorder group, plus displayed a significant relationship with discount rate.

Results: Discount rate was not significantly associated with any dimensional measure of anxiety, within the full sample or any diagnostic group (ps ≥ .31). Discount rate was not significantly associated with diagnosis of any anxiety disorder (b = .09, 95% CI [-0.54, 0.73], t(152) = 0.28, p = 0.78), though it was significantly associated with pre- vs. during-pandemic time status (b = -.80, 95% CI [-1.42, -0.17], t(152) = -2.50, p = 0.01), such that participants during the pandemic discounted at lower rates. Further, discount rate was not significantly associated with specific diagnosis of GAD, SAD, or PD (ps ≥ .40).

Discussion: Discount rate was not significantly associated with state anxiety, trait anxiety, or general anxiety, social anxiety, or panic symptom severity. Additionally, discount rate was not significantly associated with diagnosis of any anxiety disorder, GAD, SAD, or PD. Broadly, results suggest that monetary delay discounting paradigms may not represent a useful tool within the anxiety disorders field specifically, and the transdiagnostic role of abnormal discount rate may not extend to anxiety disorders.