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Method Article

Errors as a Means of Reducing Impulsive Food Choice

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DOI:

10.3791/53283

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June 5th, 2016

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1Department of Biological Psychology, Justus-Liebig-Universität Giessen, 2Dipartimento di Psicologia, Università di Bologna

In This Article

Summary

Giving in to temptation of tasty food may result in long-term overweight problems. This protocol describes how to reduce imprudent preference for edible commodities during hypothetical intertemporal choices in women by associating them with errors.

Abstract

Nowadays, the increasing incidence of eating disorders due to poor self-control has given rise to increased obesity and other chronic weight problems, and ultimately, to reduced life expectancy. The capacity to refrain from automatic responses is usually high in situations in which making errors is highly likely. The protocol described here aims at reducing imprudent preference in women during hypothetical intertemporal choices about appetitive food by associating it with errors. First, participants undergo an error task where two different edible stimuli are associated with two different error likelihoods (high and low). Second, they make intertemporal choices about the two edible stimuli, separately. As a result, this method decreases the discount rate for future amounts of the edible reward that cued higher error likelihood, selectively. This effect is under the influence of the self-reported hunger level. The present protocol demonstrates that errors, well known as motivationally salient events, can induce the recruitment of cognitive control, thus being ultimately useful in reducing impatient choices for edible commodities.

Introduction

Nowadays, it is crucial to help people face the rise of eating disorders1-4. These disorders reflect an overestimation of the incentive motivation associated with appetitive food, which induces individuals to seek and consume it as soon as possible (this has been shown especially with sweet high-fat foods5-6). This happens at the expense of future benefits that can result from being on a diet for a while, but for which the ability to exert eating control is necessary7-8. Indeed, people showing these abnormal behaviors have increased attentional bias toward edible cues9-10 and experience enhanced incentive value for primary rewards11. Moreover, even just looking at appetizing foodstuffs can cue the desire for consuming the food immediately, both in individuals with eating disorders and in the normal population12-13. In order to refrain from immediate gratification and not forego the long-term outcome (e.g., losing weight after a few months of diet), one must exercise great self-controlled and resist the innate, evolutionarily determined impulse to give into temptation and consume immediately. Exerting self-control, a concept that is interrelated to the notion of cognitive control in the field of the Neuroscience, means that one is capable of overcoming innate impulses for further consideration and, possibly, implementation of other, more appropriate behaviors14.

How do individuals engage in self-control strategies? Research has highlighted over the years that the capacity to refrain from automatic responses is heightened in error-full contexts15. Errors are well considered highly arousing and aversive events that, when encountered, elicit compensatory responses16. Specifically, they cue failure/loss in both performance and utility, thereby signaling that one needs to adjust levels of control over current and future behavior accordingly17. Moreover, errors can cue aversive learning, as a warning way to escape from error-prone, maladaptive behaviors, thus inducing the implementation of optimal choice responses18-21.

The present protocol shows how the association between tasty food items and errors can signal that engaging in a certain behavior would lead to a cost (i.e., reward loss), thus encouraging the implementation of compensatory self-control strategies, and thereby reducing impulsive food choice20,22. In the present protocol adapted from23, participants are preliminarily asked to self-report their hunger level at the time of the experiment and to rate six different food items. Based on the ratings, two foods with equivalent incentive value for each subject are selected for the subsequent task. Then, participants perform an error task (see reference24) in which the two previously selected food items cue different error rates (high and low) associated with performance: The error task is programmed so that in one trial condition, cued by one food, participants make a small number of errors, and in the other trial condition, cued by the other food, they make a much larger number of errors. Afterwards, participants' intertemporal choice for each of the two primary rewards is measured (adapted from reference25). The ability to seek larger but delayed reinforcements instead of sooner gratification, which is crucial when facing tempting foods while being on a diet, is indeed crisply captured by intertemporal choice paradigms26. The longer the time one needs to wait for a good to be received and consumed, the more the subjective evaluation of this potential reward is weakened (i.e., the so-called temporal discounting phenomenon27-34). Poor decisions (i.e., higher propensity to choose close gratifications, namely increased temporal discounting for future gains) are considered as a core feature of impulsivity35 and a landmark of numerous disorders, including drug addiction and obesity36-45. After undergoing the procedure described in this protocol, participants show reduced impatient choice for the stimulus cueing high error rate, selectively. The effect is more evident when the hunger level reported by the subjects is low23. This occurs because hunger affects the immediate evaluation of food items46-49 by heightening the motivational value of primary rewards and, in turn, the discount rate of future amounts of those rewards7,50-52.

The advantage of this method first lies in its easy applicability. The error training preceding the intertemporal decision tasks is almost completely effortless, making it possible to be employed in diverse clinical settings. Second, the method produces the desired effect with hypothetical edible items, without the need to use real food. Third, participants were mainly unaware of the food-error association, making the subsequent effect on food preferences genuine, which might affect food decisions reliably in real life as well. Finally, participants tested in the study23 were all young females, but there is good reason to speculate that the effect of food-error pairing on intertemporal decisions would be the same on young males too, mainly because subjects in the present study were unaware of the intended effect.

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Protocol

Ethics statement: All procedures described in this protocol were developed and tested following ethical approval from the Ethics Committee of the Psychology Department of Bologna University (see also the Declaration of Helsinki23,53).

1. Participants

  1. Select a sample of healthy young adult females.
    1. Recruit participants who are not on a diet, not taking psychoactive drugs, free of current or past psychiatric or neurological illness as determined by history, and naïve as to the purpose of the experiment.
  2. Invite volunteers to sit in a quiet room and collect their demographics, including gender, age, level of education, fasting hours, and height and weight.
  3. Calculate participants' body mass index (BMI)45,54,55.

2. Hunger and Motivation Ratings

  1. Collect subjects' self-ratings about their feeling of hunger at that very moment on an 11-point Likert scale56,57.
  2. Use a similar scale as the one used in the previous step for self-rating the motivation to consume at that very moment six foods, one by one. Choose these foods among those with high appetitive value58-62 in the female population (based on the cultural context).
    1. Display the six foods in pictures, randomly, by using a slide show presentation program, so that their appearance and size match as much as possible those in the real word.

3. Food Stimuli Selection

  1. Select, individually for each participant, the two highest rated food items in the previous step.
    1. Make sure, at the group level, that participants are equally motivated to eat the two foods, namely, that there is no significant difference between the two items in the motivation rating (see steps 2.2 and 2.2.1).

4. Errors as a Way to Enhance Cognitive Control

  1. Use the Error task24 modified as follows to associate the two preselected stimuli with two different error rates.
    1. Program and run the task with an appropriate stimulus delivery software, such as E-Prime. The task should last at least 15 min. See Supplemental Code Files for an example script.
  2. Include two conditions in which one predicts (i.e., it cues) a Low probability of committing an Error (LE), namely, in which participants will make a small number of errors, and one predicts a High probability of committing an Error (HE), namely, in which participants will make a larger number of errors (see steps 4.5.2 and 4.5.3).
    1. Use one of the two preselected food items as the cue for the LE condition (LEFood); use the other food item as the cue for the HE condition (HEFood). Intersperse, randomly, the same number of trials for both conditions.
  3. Set the task so that each trial starts with a grayscale picture of one of the two food items, that, after 1,000 msec, becomes colored (Go signal), thus requiring the subject to respond.
    1. For 33% of the total number of trials, superimpose a red circle on the colored image (Stop signal) after a variable stop-signal delay (SSD) (see section 4.4) relative to the Go signal onset, thus requiring the subject not to respond.
    2. Once the Stop signal appears, leave both Go and Stop signals on the screen for a maximum response time of 1,000 msec after the Go signal onset (time window in which subjects are allowed to respond).
    3. After giving a feedback (see step 4.4.), separate the trials with a blank screen of variable interstimulus interval (500-2,000 msec).
  4. Instruct participants to respond to the Go signal as quickly as possible via button press, and to refrain when a Stop signal occurs. Instruct them about all possible feedback (i.e., ''Correct!'', ''Error!'', ''Too early!'').
  5. Define the error likelihoods for the LE and the HE conditions by changing their SSDs independently, by the means of a staircase algorithm, based on participant's performance. The LE has shorter SSDs, whereas the HE has longer SSDs24.
    1. Start the SSD at 200 msec in both LE and HE after the first Go signal onset.
    2. During the LE, increase the SSD by 5 msec on the subsequent trial if the subject succeeds in avoiding the button press after the Stop signal; decrease the SSD by 50 msec on the subsequent trial if the subject fails.
    3. During the HE, increase the SSD by 50 msec on the next trial if the subject succeeds, otherwise, decrease the SSD by 50 msec on the next trial if the subject fails63.
  6. For the analyses, compare Go and Stop trials and LE and HE conditions for accuracy and response time24. Do not consider missed responses. Use Statistica or any other statistical software to analyze the data.

5. Intertemporal Choice as a Measure of Cognitive Control

  1. Administer participants two Temporal Discounting tasks, separately and in a counterbalanced order, soon after the Error task ends (see below for details). Measure in one Temporal Discounting task the subjective value for the LEFood, and in the other the subjective value for the HEFood. Run the tasks on E-Prime or any other stimulus delivery software. See Supplemental Code Files for an example script.
    1. In each task, present participants, on each trial, a choice between 40 units of fictive food25,64,65 that can be obtained after a variable delay (i.e., 2 days, 2 weeks, 1 month, 3 months, 6 months, and 1 year, for a total of six delay conditions25,66,67) and a smaller amount of the same food available in the immediate present.
    2. Include five choices in each delay condition. Deliver blocks of choices pertaining to the six delay conditions in a random order across subjects.
  2. Instruct participants to make a choice between the two options by imagining to receive the specified amount of reward at the specified time, and to indicate their preference by pressing one of two buttons25,68.
    1. Make clear to participants that they are making choices toward hypothetical foods; there are no correct or incorrect choices but they are free to choose the option they prefer the most; they have no time limit to decide, but they should make their choice as soon as they feel to prefer one reward more than the other.
  3. Program the tasks so that, for each delay condition, the amount of the smaller-immediate option is adjusted, trial by trial, based on participants' previous choice, using a titration procedure that converges on the amount of the immediate reward that has equivalent subjective value as the delayed reward25,67 (see steps 5.3.1 to 5.3.5).
    1. First, always submit participants, for each delay condition, to a choice between 20 units (bites) of food available "now" and 40 units of the same food available at that specific delay67, so that, in the first trial of each delay condition participants always face a choice between these two specific amounts67.
    2. Then, decrease, after the first choice, the amount of the smaller option on the next trial if participant chose the smaller option in the previous trial, otherwise increase the amount of the smaller option on the next trial if the participant chose the larger option in the previous trial.
    3. Reduce the size of the adjustment of the smaller option with successive choices: The first adjustment is half of the difference between the smaller and the larger rewards, whereas for subsequent choices it is half of the previous adjustment23.
    4. Repeat the procedure in the above step until the participant has made five choices at one specific delay condition, after which the participant begins a new series of choices at another delay condition.
    5. For each trial in a block, consider the smaller immediate amount as the best guess as to the subjective value of the larger later reward. Therefore, take the immediate amount that would have been presented on the sixth trial of a delay block as the estimate of the subjective value of the later reward at that delay and use it for the analysis (i.e., the so-called indifference point; see step 5.6)25.
  4. Fit, through nonlinear, least-squares analysis, the hyperbolic equation V = 1/(1 + kT) (i.e., V = subjective value; k = constant of the best fitting; T = time delay in days) to participants' indifference points23, independently for each Temporal Discounting task. Do this in order to calculate the discount rate (k) of the subjective value for each reward under consideration as a function of time69-71. Use Statistica or any other statistical software to perform this non-linear estimation.
  5. Log-transform k values in order to normalize data, and then run parametric analyses23,25.
    Note: A larger k value corresponds to a steeper discounting function, thereby indicating that the subjects are more inclined to choose the smaller-immediate option over the larger later one.
  6. Compare the k values for the LEFood and the HEFood by correcting for hunger rating, self-report questionnaire score of sensitivity to external edible cues (see step 6), and BMI45,54,55. Use Statistica or any other statistical software to analyze the data.

6. External Eating Behavior Subscale of the Dutch Eating Behavior Questionnaire (DEBQEEB)

  1. Use the DEBQEEB72 to measure volunteers' sensitivity to external edible cues, to control for possible confounding during the experiment.

7. Debriefing

  1. Debrief participants as to the purpose of the experiment at the end of the session. Ask them if they were somehow aware of the error manipulation during the Error task and if they think they chose somehow in a different way during the Temporal Discounting tasks according to the two different foods.
    Note: Any impressions or feelings about the entire procedure (e.g., whether they think there was an association between the two main tasks) are welcome.

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Results

Representative results from the application of the protocol described above are reported here.

Error task

The validity of the Error task has been determined by the following results. Concerning the percentage of errors committed by participants, they showed a significantly higher number of errors in the HE than in the LE condition, a significantly higher number of erro...

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Discussion

This article describes in detail a novel protocol aimed at reducing impulsive food choice in healthy young adult women. Critical steps in this protocol include sampling participants from the healthy female population, collecting self-report hunger level at the time of the experiment, selecting two foods with equivalent incentive value for each subject, submitting participants to an error task where each of two different error likelihoods (high and low, randomly interspersed across trials) are associated with one of the t...

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Disclosures

The authors have nothing to disclose.

Acknowledgements

This work was supported by a Programmi di Ricerca Scientifica di Rilevante Interesse Nazionale (PRIN) grant from Ministero Istruzione Università e Ricerca (PRIN 2010, protocol number: 2010XPMFW4_009) awarded to GdP. We are also grateful to Caterina Bertini and Raffaella Marino for proofreading the manuscript and performing in the video.

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Materials

List of materials used in this article
NameCompanyCatalog NumberComments
E-PrimePSTStimulus Delivery Software
StatisticaStatsoftStatistical Software

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Error TaskTemporal DiscountingHunger LevelFood StimuliStop SignalGo SignalSelf ControlCognitive ControlIntertemporal Choice
Errors as a Means of Reducing Impulsive Food Choice
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