# Electrophysiological Predictors and Indicators of Contingency Management Treatment Response

> **NIH VA IK2** · VETERANS HEALTH ADMINISTRATION · 2022 · —

## Abstract

Electrophysiological methods, including event-related potential and functional connectivity approaches,
have strong potential to clarify mechanisms of substance use treatment response and characterize individual
differences therein. Veterans are disproportionately affected by disorders of addiction, of which cocaine use
disorder (CUD) is particularly problematic due to high relapse rates and the absence of approved pharmaco-
therapy treatment options. Behavioral interventions for CUD, have therefore become an important focus of
research and Contingency Management (CM) has emerged as the best-supported and most widely used
approach. CM involves reinforcing cocaine abstinence (established through objective testing) with reliable,
short-term reward, such as chances to win prizes (i.e., Prize-Based CM or PBCM). In response to substantial
empirical support, national dissemination of PBCM has been supported by a VHA initiative since 2011.
However, PBCM response rates are variable and long-term benefits are limited – problems magnified by the
cost of implementation with respect to staffing and prizes. Measurement-based approaches to PBCM
implementation have strong promise to improve the effectiveness and efficiency of CM programming but have
not yet been investigated within the VA or considered in relation to promising neuromarkers. Importantly, two
versions of PBCM are already utilized at VA sites and may differentially benefit individuals with distinct
neurocognitive profiles. Specifically, VA PBCM programs employ either abstract (voucher prize) or concrete
(tangible prize) incentives, the latter of which may more effectively incentivize abstinence in Veterans with
poor future-oriented thinking and planning ability. While selection between existing PBCM variants is
currently driven by practical considerations (e.g., provider convenience), measurement of pretreatment
neurocognitive functioning could meaningfully and realistically inform clinical decision-making in this regard.
 This CDA aims to advance measurement-based implementation of CM by testing a novel neurocognitive
model of CM with immediate implications for the use of abstract versus concrete PBCM incentives within the
VA. Specifically, the future-minded decision-making (FMDM) model posits that CM scaffolds future-oriented
goal representation and self-control to support abstinence during in the moment use-related decision-making.
For individuals with greater FMDM impairment, concrete, readily-accessible incentives may be more effective
than abstract monetary rewards (e.g., vouchers) which require future-oriented thinking and planning to inherit
value. To test this model, neurocognitive substrates of FMDM will be examined as predictors of differential
treatment response in voucher (VoucherPBCM) versus tangible prize (TangiblePBCM) versions of the
intervention used within the VA. Treatment-related change in neural and cognitive-behavioral correlates of
FMDM will also be evaluated in PBCM relati...

## Key facts

- **NIH application ID:** 10417037
- **Project number:** 5IK2CX001807-04
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** SARAH E FORSTER
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10417037

## Citation

> US National Institutes of Health, RePORTER application 10417037, Electrophysiological Predictors and Indicators of Contingency Management Treatment Response (5IK2CX001807-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10417037. Licensed CC0.

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