PROJECT SUMMARY
Anhedonia, or loss of pleasure from nondrug rewards, is clinically significant for up to half of patients with an
opioid use disorder (OUD) and is a strong predictor of poor outcome. Anhedonia is complex, however,
because patients who report anhedonia in clinical settings may also report frequent, enjoyable nondrug
rewards in daily life. Nondrug reward in people with OUD may be driven by dynamic personal, social, and built-
environmental (i.e. socio-spatial) factors. It is critical that researchers understand the role of each factor in
anhedonia, in order to build effective nondrug-reward interventions. The proposed studies will examine
nondrug-reward heterogeneity in real time and socio-spatial context among OUD outpatients in Franklin
County, Ohio. This proposal addresses the NIDA research priority of identifying the environmental, behavioral,
and social consequences of addiction and is well positioned to translate findings into actionable interventions
for OUD—a primary goal of the applicant’s career. In Aim 1 we will gain insight into experiences of drug and
nondrug reward through a cross-sectional survey (n=200), geotagging to identify local contexts of typical
nondrug reward experiences, and exploratory open-ended questions. In Aim 2 we will examine day-to-day
experiences of nondrug reward (14 days, 2 assessments per day; n=50 recruited from Study 1) in socio-spatial
contexts via ecological momentary assessments (EMAs) and passively collected GPS location data. We will
also test which aspects of nondrug reward predict OUD recovery outcomes. In Aim 3 we will characterize
heterogeneity in experiences of reward and their socio-spatial contexts. To achieve these aims, the analytical
approach will include regression (Aim 1), multilevel modeling integrating EMA and socio-spatial data (Aim 2),
and multilevel latent class analysis (Aim 3). Findings will clarify heterogeneity and environmental contexts of
nondrug reward experiences and inform development of nondrug reward interventions that are personally and
contextually adapted to support individuals’ recovery from OUD. The applicant’s exceptional mentor team has
expertise in intensive longitudinal methods and modeling heterogeneity (Stephanie Lanza), health geography
and geospatial methods (Louisa Holmes), OUD treatment (David Epstein), and substance use and geospatial
analysis in Ohio (Bridget Freisthler); this team will provide outstanding support as the applicant becomes an
independent investigator. The mentorship team will support training in the following areas: the role of nondrug
reward in addiction, socio-spatial determinants of health, methods for geospatial analysis and characterizing
heterogeneity, partnering with addiction treatment centers to collect data from diverse populations, and the
responsible conduct of research. The proposed work will position the applicant to generate new knowledge on
the role of nondrug reward in OUD and to advance the science of OUD treatment throughout his career.