Individual delay-discounting rate in a patients with hypersexual disorder
Smas-Myszczyszyn, M1; Lew-Starowicz, M2
1: Lew-Starowicz Therapy Center, Warsaw, Poland; 2: III Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
Introduction: According to G. Becker and C. Mulligan (1997) people differ in terms of individual delay-discounting rates. This individual rate is connected to impulsivity and self-control trait. The most important indicator of high impulsivity is a preference towards smaller and immediate rewards, while self-control is connected with choosing the bigger and deferred rewards. People with higher impulsivity trait have higher discounting rates for delayed rewards.
Purpose: The aim of this study was to assess differences in discounting rates in 3 groups of patients 1) compulsively masturbating; 2) having uncontrolled sexual relationships with multiple partners; 3) compulsively masturbating and having uncontrolled sexual relationships with many partners.
Methods: 108 patients meeting diagnostic criteria of hypersexual disorder (HD) by Kafka were interviewed and completed the Monetary Choice Questionnaire. Individuals with k (discounting parameter) higher than 0.025 are very impulsive and generally prefer rewards available immediately than rewards deferred in time.
Results: We found differences in the average values of the discounting rate between the three tested groups. The highest discounting rates for each quota range were obtained by the patients from group 3. In addition, subjects in group 3 were more impatient - the average discount function parameters were highest for each quota range compared to the results of the other groups tested.
Conclusions: According to the described effect of withdrawal size - small amounts are discounted more strongly than high amounts in all groups of patients. Patients in group 3 were the most impulsive and preferred immediate rewards. In psychotherapy of those patients small steps strategy with summaries and gratifications after achievement of a single step seems the most appropriate way. Patients with HD respond better to small and quick rewards than to large and deferred in time ones. The ability to postpone gratification is therefore one of very important therapeutic goals. Prizes are more strongly discounted than penalties (Thaler 1991), so therapists should place more emphasis on the potential benefits of cessation of uncontrolled sexual behaviors than the consequences of their continuation.
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