Applying Behavioral Theories of Choice to Substance Use in a Sample of Psychiatric Outpatients

The current study tests the utility of the contextual view of reinforcement in predicting substance use among a sample of 34 psychiatric outpatients enrolled at a public psychiatric facility. Participants reported substance use, as well as the frequency and enjoyability of a variety of potential reinforcers, for the previous 30 days. A series of regression analyses revealed that a ratio of reinforcement from substance use relative to total reinforcement was more predictive of substance use days than was reinforcement for substance use taken alone. The results demonstrate importance of viewing behaviors within their broader environmental context and support predictions derived from the behavioral choice perspective.