Psychology of Addictive Behaviors

2015, Vol. 29, No. 4, 1048 1055

2015 American Psychological Association

0893-164X/15/$12.00 http://dx.doi.org/10.1037/adb0000101

Adaptation of the Monetary Choice Questionnaire to Accommodate

Extreme Monetary Discounting in Cocaine Users
Sheri L. Towe and Andra L. Hobkirk

Daniel G. Ye

Duke University School of Medicine

Duke University

Christina S. Meade
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Duke University School of Medicine

Delay discounting, which refers to the phenomenon that rewards decrease in subjective value as the delay
associated with their receipt increases, is a paradigm that has been used extensively in substance abuse
research to understand impulsive decision making. One common measure to assess delay discounting is
the Monetary Choice Questionnaire (MCQ) developed by Kirby, Petry, and Bickel (1999). While the
MCQ has great utility because of its simplicity and brief administration time, it is possible that the MCQ
produces a ceiling effect in estimating delay discounting parameters in highly impulsive individuals. In
the present study, we adapted the MCQ to attempt to address this ceiling effect by extending the original
scale with 9 items, and we then compared scores on the original MCQ with the extended MCQ in a
sample of active cocaine users. The ceiling effect, while observed in the original MCQ scores for over
a quarter of the sample, was largely eliminated with the extended scale. Highly impulsive participants,
whose scores on the extended scale exceeded the highest possible score on the original scale, had higher
levels of sensation seeking compared to other participants, but not trait impulsivity. The extended MCQ
may be useful in populations with high rates of impulsivity, where the original measure may underestimate discounting rates due to a ceiling effect.
Keywords: impulsivity, delay discounting, cocaine dependence, drug abuse

Delay discounting has been utilized extensively as a paradigm for impulsivity in substance users, because increased
delay discounting theoretically reflects a fundamental decision
making process present in substance using populations (Reynolds, 2006). While decision making is a complex process, part
of the phenomenology of substance dependence is that
substance-dependent persons often make choices that contradict
their stated goals. For example, a person may commit to quitting smoking one day, only to buy a pack of cigarettes the
following day. Delay discounting may be a key factor in how
that decision is reached. For those with high rates of delay
discounting, more distal rewards, like achieving 30 days of
sobriety or having funds to pay bills at the end of the month, are
underweighted compared with immediate rewards, such as substance use.
Delay discounting has been shown to correlate with other
measures of impulsivity, including trait impulsivity and sensation seeking (Caswell, Bond, Duka, & Morgan, 2015; Koff &
Lucas, 2011). However, other research has shown weak or
inconsistent associations (Mitchell, 1999; Vuchinich & Simpson, 1998). Research has demonstrated that higher delay discounting rates are associated with addictive behaviors across
many different substances, including nicotine, cocaine, opiates,
and alcohol compared with nondrug using controls (MacKillop
et al., 2011). Cocaine users in particular have demonstrated
greater delay discounting compared with nondrug users
(Garcia-Rodriguez, Secades-Villa, Weidberg, & Yoon, 2013;
Heil, Johnson, Higgins, & Bickel, 2006; Kirby & Petry, 2004).

Delay discounting describes to the phenomenon that rewards

decrease in subjective value as the delay associated with their
receipt increases (Mazur, 1987; Rachlin & Green, 1972).
Highly impulsive individuals exhibit high rates of delay discounting in laboratory tasks, meaning that they show preference
for smaller, immediate rewards over larger, delayed rewards.
Research has demonstrated that higher rates of delay discounting are associated with various health risk behaviors, including
substance use, problematic gambling, and HIV transmission
risk behaviors (Bickel & Marsch, 2001; Chesson et al., 2006;
Odum, Madden, Badger, & Bickel, 2000; Reynolds, 2006).

This article was published Online First July 20, 2015.

Sheri L. Towe and Andra L. Hobkirk, Department of Psychiatry &
Behavioral Sciences and Duke Global Health Institute, Duke University
School of Medicine; Daniel G. Ye, Duke Global Health Institute, Duke
University; Christina S. Meade, Department of Psychiatry & Behavioral
Sciences and Duke Global Health Institute, Duke University School of
Medicine.
This study was funded by Grants K23-DA028660, F32-DA038519, and
T32-AI007392 from the United States National Institutes of Health. We are
grateful to the UNC Center for AIDS Research (P30-AI50410) for its
assistance with patient recruitment. The NIH had no further role in study
design, data collection, analysis and interpretation of data, writing the
report, or in the decision to submit the article for publication. We thank all
the men and women who participated in this study.
Correspondence concerning this article should be addressed to Sheri L.
Towe, Duke University, Box 90519, Durham, NC 27708. E-mail:
sheri.towe@duke.edu
1048

This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

ADAPTATION OF THE MCQ FOR EXTREME DISCOUNTING

One measure that has been successfully used to assess delay

discounting in the laboratory is the Monetary Choice Questionnaire (MCQ; Kirby, Petry, & Bickel, 1999). The MCQ asks
participants to make 27 choices between smaller immediate rewards versus larger delayed rewards (Kirby et al., 1999). By
examining the pattern of responses, one can infer a participants
rate of delay discounting or k value. Kirby, Petry, and Bickel
(1999) found that MCQ scores were correlated with other measures of impulsivity such as the Barratt Impulsiveness Scale, and
mean MCQ scores were higher among the substance-users compared to nondrug using controls. Additionally, research has shown
that the scores from the MCQ correlate highly with scores from
traditional measures of delay discounting, such as adjustingamount procedures (Epstein et al., 2003). Taken together, this
research suggests that the MCQ is a valid means of measuring
delay discounting. Given its simplicity and brevity, the MCQ is an
ideal measure to administer in time-limited research settings where
use of lengthier behavioral tasks to assess delay discounting is not
feasible.
Highly impulsive persons may exhibit an extreme preference for
immediate rewards. On the MCQ, these individuals select the
immediate reward in all 27 items, resulting in a ceiling effect. In
these cases, the 27-item MCQ may underestimate the rate of delay
discounting. This ceiling effect has been observed in prior research
using the MCQ with substance users. For example, in one sample
of alcohol and cocaine users, participants always selected the
immediate reward in approximately 22% of the MCQs administered (Black & Rosen, 2011). In addition, a ceiling effect has been
observed in other measures of delay discounting among highly
impulsive samples and has been cited as a contributing factor to
spurious correlations (Johnson, Bickel, & Baker, 2007; Petry &
Casarella, 1999; Yoon et al., 2007). Thus, this ceiling effect is of
concern when working with populations who exhibit high impulsivity, including stimulant users who engage in high rates of risky
behaviors.
To address this ceiling effect, we adapted the MCQ to accommodate extreme discounting by adding nine items to extend the
scale. The purpose of this article is to describe the adaptation
process and to compare performance on the original versus
adapted versions of the MCQ in a sample of cocaine users.

Method
Participants and Procedures
MCQ data was collected as part of a larger study examining the
neurocognitive effects of HIV and cocaine use (Meade, Towe,
Skalski, & Robertson, 2015). The community-based sample included 101 adult cocaine users who met the following inclusion
criteria: (a) 4 days of cocaine use in the past month or a positive
urine drug screen for cocaine, (b) 1 year of regular cocaine use,
and (c) lifetime cocaine dependence. Alcohol, marijuana, and
nicotine use were permitted, and current alcohol and marijuana
dependence were permitted if cocaine dependence was the principal diagnosis. For other drugs, individuals were excluded for
lifetime abuse or dependence, history of regular use, any use in the
past year, and/or a positive drug screen. Additional exclusion
criteria were: English nonfluency or illiteracy; ninth grade
education; serious neurological disorders (e.g., seizure disorder,

1049

cryptococcal meningitis) or severe head trauma; severe mental

illness; pregnancy; physical disabilities impeding participation
(e.g., blindness); and impaired mental status.
Participants were recruited from the Raleigh-Durham, NC area
between May, 2010 and May, 2015 via advertisements in local
newspapers and websites, flyers, and brochures at communitybased organizations and clinics, and participant referrals. All potential participants completed a structured telephone screen to
assess preliminary eligibility (e.g., HIV infection, drug use history), and interested individuals were then invited for a comprehensive in-person screening.
After providing written informed consent, participants were
given a breathalyzer test to ensure sobriety, and they provided a
urine sample for drug and pregnancy screening. Self-reported
HIV-positive status was verified by medical record review, and
HIV-negative status was confirmed by an OraQuick rapid HIV
test. Participants then completed clinical interviews and questionnaires. Eligible participants returned on another day to complete a
neurocognitive assessment that included the MCQ, additional clinical interviews and questionnaires, and another urine drug test. All
questionnaires were computerized using audio computer-assisted
self-interview (ACASI).
Participants were paid $35 for the screening visit, regardless of
eligibility, and $65 for the neurocognitive assessment. All procedures were approved by the institutional review boards at Duke
University Health System and University of North Carolina at
Chapel Hill.

Measures
Original Monetary Choice Questionnaire (MCQ-27).
Participants are presented with choices between smaller, immediate rewards and larger, delayed rewards (e.g., Would you prefer
$54 today or $80 in 30 days?; Kirby et al., 1999). The MCQ-27
includes a fixed set of 27 items with immediate rewards ranging
from $11$78 and delayed rewards ranging from $25$85 with a
delay of 7186 days. Delayed rewards are grouped into three
categories based on size, with nine items per category: small
($25$35), medium ($50 $60), and large ($75$85).
As described by Kirby et al. (1999), participants hyperbolic
discount parameter (k value) is determined by fitting data to the
following discount function equation: Vimmediate Vdelayed/(1
kD), in which V is the reward value in dollars and D is delay in
days (Mazur, 1984). Values of k range from 0.00016 to 0.25 for the
MCQ-27, with higher values indicating a greater preference for
smaller, immediate rewards over larger, delayed rewards. Each
possible k value increases by an order of approximately 2.5,
resulting in a logarithmic scale. K values are estimated by taking
the geometric midpoint between the discount rates associated with
each item and then examining the participants pattern of responses across trials to determine which k value is most consistent
with the response pattern. By examining the pattern of responses in
this way, one can infer a participants point of indifference between delayed and immediate rewards. To determine the most
consistent value, the proportion of a participants choices that are
consistent with each k value is calculated. The k value that yields
the highest proportion is the value assigned to the participant. If
two or more values have the same proportion, the participants
assigned k value is the geometric mean of those values. Because

TOWE, HOBKIRK, YE, AND MEADE

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1050

raw k values tend to be highly skewed, k values are normalized

using the natural logarithm transformation. K values are also
ranked from 1 to 10. Rank 1 and Rank 10 represent the lowest and
highest possible k values, respectively (e.g., when a participant
selects all delayed rewards or all immediate rewards across trials),
and Ranks 2 through 9 are assigned to the ranges of discount rates
between items (e.g., values between 0.00016 to 0.00040 were
Rank 2).
Extended Monetary Choice Questionnaire (MCQ-36). To
expand the MCQ-27, nine items with higher associated k values were
added. Three new items were added to each category (small, medium,
large), resulting in 12 items per category and a total of 36 items for the
MCQ-36. Additional k values for the extended scale were computed
by continuing the logarithmic scale of the original MCQ-27, resulting
in new k values of 0.625, 1.5625, and 3.90625. The new items
included delay periods lasting 17 days and utilized the same three
delayed rewards as the other items in the category. The immediate
reward for each additional item was calculated based on the standard
discount function equation, resulting in immediate rewards for these
new items ranging from $5$17. Dollar amounts were rounded to the

nearest whole dollar, and then the exact k for that dollar amount was
calculated with the formula. This resulted in k values for the MCQ-36
ranging from 0.00016 to 4.00. K values were also natural log transformed and ranked for the MCQ-36, with ranks ranging from 1 to 13.
Table 1 shows the items included in the MCQ-36 and their calculated
k values.
The MCQ-36 was computerized using ePrime (Psychology
Software Tools, Inc., http://www.pstnet.com). Choices were presented in random order, and participants indicated their response
using a computer mouse. Participants completed the full MCQ-36,
and then scores were generated for the original MCQ-27 and the
extended MCQ-36. Participants were told that all rewards were
hypothetical, and participants did not receive any money based on
their performance on the task.
Barratt Impulsiveness Scaleversion 11 (BIS-11). At the
neurocognitive assessment, participants completed the BIS-11
(Patton, Stanford, & Barratt, 1995), which is one of the oldest and
most widely used self-report measures of trait impulsivity (Stanford et al., 2009). The BIS-11 includes 30 items that describe
common impulsive or nonimpulsive behaviors and preferences.

Table 1
Items in the Extended Monetary Choice Questionnaire (MCQ-36)
Reward size

Amount today

Amount later

Delay in days

Calculated k valuea

Small
Small
Small
Small
Small
Small
Small
Small
Small
Smallb
Smallb
Smallb
Medium
Medium
Medium
Medium
Medium
Medium
Medium
Medium
Medium
Mediumb
Mediumb
Mediumb
Large
Large
Large
Large
Large
Large
Large
Large
Large
Largeb
Largeb
Largeb

34
28
22
25
19
24
14
15
11
6
5
7
54
47
54
49
40
34
27
25
20
12
13
12
78
80
67
69
55
54
41
33
31
17
13
17

35
30
25
30
25
35
25
35
30
25
30
35
55
50
60
60
55
50
50
60
55
50
55
60
80
85
75
85
75
80
75
80
85
80
75
85

186
179
136
80
53
29
19
13
7
5
3
1
117
160
111
89
62
30
21
14
7
5
2
1
162
157
119
91
61
30
20
14
7
6
3
1

0.00016
0.00040
0.00100
0.00250
0.00596
0.01580
0.04135
0.10256
0.24675
0.63333
1.66667
4.00000
0.00016
0.00040
0.00100
0.00252
0.00605
0.01569
0.04056
0.10000
0.25000
0.63333
1.61538
4.00000
0.00016
0.00040
0.00100
0.00255
0.00596
0.01605
0.04146
0.10173
0.24885
0.61765
1.58974
4.00000

Exact values calculated using the standard discount function equation, Vimmediate Vdelayed/(1 kD), in which
k represents the k value, V is the reward value in dollars and D is delay in days. b Item added to the MCQ-36
that was not included in the MCQ-27.

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ADAPTATION OF THE MCQ FOR EXTREME DISCOUNTING

Participants rate each items using a 4-point scale (rarely/never,

occasionally, often, almost always/always), and higher scores indicate greater impulsiveness. All 30 items are summed to yield a
total score, ranging from 30 to 120, and there are six subscales
based on first-order factors determined by a principal component
analysis (Patton et al., 1995). The six subscales are attention,
motor impulsiveness, self-control, cognitive complexity, perseverance, and cognitive instability.
Sensation Seeking Scaleversion V (SSS-V). Participants
also completed the SSS-V (Zuckerman, 1994; Zuckerman, Eysenck,
& Eysenck, 1978). In this 40-item, forced-choice questionnaire, participants choose which of two statements best applies to them. This
inventory was developed to measure individual differences in stimulation and arousal needs and is thought to correlate with impulsivity.
Reliability and construct validity for this instrument has been wellestablished (Zuckerman, 1994; Zuckerman et al., 1978). Each statement is scored as either 0 or 1, and then items are summed to create
a total score, ranging from 0 to 40. In addition to a total score, the
SSS-V produces four subscales that represent different dimensions of
sensation seeking: thrill and adventure seeking, experience seeking,
disinhibition, and boredom susceptibility.
Other measures. Demographic characteristics and detailed assessments of substance use were completed at the screening visit.
Interviews included Module E of the Structured Clinical Interview for
DSMIVTR to assess for lifetime cocaine dependence and other
substance use disorders (First, Spitzer, Gibbon, & Williams, 1996)
and the Addiction Severity Index-Lite to assess lifetime substance use
and associated impairments (McLellan et al., 1992). Frequency of
substance use in the past 30 days was assessed using timeline followback methodology (Robinson, Sobell, Sobell, & Leo, 2014; Sobell &
Sobell, 1996). A urine toxicology screen for cocaine, cannabis, amphetamine, methamphetamine, oxycodone, methadone, other opioids
(including heroin), benzodiazepines, and barbiturates was used to
corroborate self-report. Premorbid verbal IQ was estimated using the
Wechsler Test of Adult Reading (WTAR), in which participants read
50 words aloud that have atypical grapheme to phoneme translations
(Wechsler, 2001). Finally, participants completed a computerized
survey that assessed demographics.
Participants completed the Brief Symptom Inventory 18 (BSI-18)
at the neurocognitive assessment. The BSI-18 is an 18-item questionnaire which assesses psychological distress. Participants rate their
level of distress associated with 18 symptoms over the past week
using a 5-point Likert scale (0 not at all to 4 extremely;
Derogatis, 1993). An overall score is created by calculating the mean
of all 18 items. The HIV Risk Behavior Scale (HRBS), a brief
interview, was also completed at the neurocognitive assessment. The
HRBS, a well-validated measure, assesses frequency of drug risk
behaviors (six items) and sex risk behaviors (six items) in the past 30
days (Darke, Hall, Heather, Ward, & Wodak, 1991). For the HRBS,
items are summed to create a total score.

Quality Assurance Procedures

All MCQ data were evaluated to ensure that participants responded
in a consistent manner and appeared to understand the task. Within
each category of delayed rewards (small, medium, large), consistency
was evaluated by examining the highest proportion of consistent
choices. Cases where ties resulted (e.g., two or more k values have
equally high proportions) were considered indicative of potentially

1051

inconsistent responding because a tie indicates that multiple k values

are equally likely to represent a participants true point of indifference.
While ties are generally handled by taking the geometric mean of the
k values, this method has potential for bias when the pattern of
responding is inconsistent. Therefore, we established more rigorous
standardized criteria to evaluate when ties result in k value estimates
that are potentially not valid. The k value within a category was
excluded if either of the following criteria were met: (a) there was a
tie for the highest proportion between two k values and those k values
were separated by more than one other k value, or (b) there was a tie
between three or more k values for the highest proportion. This first
criterion was selected because the geometric mean of two tied k
values which are separated by only one other k value likely does
closely approximate a participants actual point of indifference, but
the geometric mean of two highly discrepant k values (i.e., separated
by more than one other k value) may not provide as accurate an
approximation. For example, responses in the large category for one
participant resulted in a two-way tie between k values of Rank 6 and
Rank 10, and a geometric mean between these two values would
result in a k value of Rank 8. If one of these responses was an error
or mistake by the participant (due to lack of comprehension or
response imputation error), a Rank of 8 would not be as closely
representative of the participants actual point of indifference. The
second criterion was selected because three- and four-way ties generally result in very low proportions. For example, responses in the
small reward category for one case resulted in a four-way tie, with
each k value having a proportion of 0.58. When no exclusion rule was
met, the k values within each category were considered valid.
Cases were also evaluated for overall consistency. Cases were
marked as overall inconsistent when either: (a) k value proportions
were less than or equal to 0.80 in at least two categories, (b) proportions in all three categories resulted in ties, or (c) k values across two
or more categories were excluded during scoring. These criteria were
selected because they each indicate that inconsistent responding occurred across two or more reward categories. When a case was
marked as overall inconsistent, all k values for that case were excluded.
Using these procedures, two cases (2%) were marked as highly
inconsistent overall and excluded from analysis, resulting in 99 cases
with valid MCQ data. In the individual reward categories for the
remaining 99 cases, no cases were marked as invalid in small, one
case was marked as invalid in medium, and two cases were marked as
invalid in large. For those cases, that category value was considered
invalid, but the other two categories were marked as valid and
therefore the case was retained for analysis.

Data Analysis Plan

Quantitative analysis was conducted using SPSS 21.0.0
(SPSS Inc., Chicago, IL). Descriptive statistics were used to
characterize the sample and determine the geometric mean for
the raw k value, mean ln k value, mean rank value, and the total
number of cases with the maximum score for both the MCQ-27
and MCQ-36. Participants whose k value on the MCQ-36
exceeded the maximum possible k value of 0.25 on the MCQ-27
were classified as extreme responders. Independent sample t
tests and chi-squared tests were conducted to identify differences in demographic and other relevant variables across extreme responders and nonextreme responders. Variables iden-

TOWE, HOBKIRK, YE, AND MEADE

1052

tified as significantly different between groups and relevant

demographic characteristics (age, race, gender, and years of
education) were included as covariates in the remaining analyses. Univariate analyses of covariance (ANCOVAs) were performed to examine differences between extreme versus nonextreme responders on the BIS, SSS, and other relevant variables.

Results

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Participant Characteristics
The majority of participants were male (66%) and African
American (92%). Participants were 46.29 years old on average
(SD 8.46) and 49% of the sample was HIV-positive. Approximately 24% of the sample identified as gay, lesbian, or bisexual. Participants reported 12.24 years of education on average
(SD 2.40) and 84% reported being unemployed. Participants
had used cocaine on average 10.50 of the past 30 days (SD
7.64) and reported a mean of 17.80 years of regular cocaine use
(SD 7.48). The vast majority (88%) reported smoking as their
usual route of cocaine administration, and 85% of the sample
tested positive for cocaine in a urine drug screen completed on
the day the MCQ was administered.

MCQ-27 and MCQ-36 Descriptive Characteristics

Table 2 presents geometric means of raw k values, mean ln k
values, and mean rank values for the MCQ-27 and the MCQ-36
overall and within each reward category. With the extended
scale, the MCQ-36 produced higher k values than the MCQ-27
overall and across each category. Figure 1 shows the number of
participants with each rank value in the MCQ-36. A total of 26
participants (26%) were assigned a k value of 0.25 in either
their overall mean or within at least one individual reward size
category on the MCQ-36. Seventeen participants (17%) were
assigned a k value of 0.25 for their overall mean k value.
Eighteen participants (18%) received a k value of 0.25 in the
small category, 15 (15%) in medium, and 16 (16%) in large. A
total of four participants (4%) were assigned the maximum
possible k value of 4.00 in either their overall mean or within at
least one individual reward size category. Two participants
(2%) were assigned the maximum k value of 4.00 for their
overall mean, with two participants (2%) receiving the maximum value in the small category, two (2%) in the medium
category, and four (4%) in the large category.

Comparison of Extreme Responders to Nonextreme

Responders
We compared the 26 extreme responders to the 73 nonextreme responders on other participant and substance use characteristics (e.g., occupational status, days of cocaine use) to
identify other potential control variables. A significantly higher
proportion of nonextreme responders (89%) were unemployed
compared to extreme responders (69%) for occupational status,
2(1, N 99) 5.55, p .018. There was also a significant
difference between groups on sexual orientation, 2(1, N
99) 3.88, p .049, such that a larger proportion (39%) of
extreme responders identified as gay, lesbian, or bisexual compared to nonextreme responders (19%). There were no other
significant differences between groups. Therefore, in addition
to age, race, gender, and years of education, occupational status
and sexual orientation were included as covariates in the subsequent ANCOVAs.
Table 3 presents the adjusted means and F values for each
ANCOVA. Several group differences were apparent on the
SSS-V, with extreme responders having higher scores overall
and on the experience seeking and disinhibition subscales. On
the BIS-11, groups did not significantly differ across the total or
subscale scores. Groups also did not differ on premorbid verbal
IQ, HRBS score, or BSI total score. To reduce the risk of a Type
I error due to multiple comparisons, we applied a familywise
Bonferroni adjustment to the significance level for these
ANCOVAs so that significance levels were set at p .003. No
results were significant using this adjusted significance level.
Traditional p values (i.e., p .05, 0.01) are noted in Table 3.

Discussion
In this sample of active cocaine users, the modified MCQ-36
appeared to be successful in reducing a ceiling effect on k
scores compared with the MCQ-27. There was a clear ceiling
effect using the original MCQ-27 items, with over a quarter of
participants producing k values that exceeded the maximum
possible k value. This ceiling effect was reduced substantially
with the MCQ-36 to only four participants receiving the maximum possible k value. Based on these results, use of the
extended MCQ-36 may be warranted in populations with high
rates of impulsivity, such as out-of-treatment cocaine users, in
order to get a more accurate estimate of discounting parameters.

Table 2
Average K Values, ln K Values, and Ranks for the Original Monetary Choice Questionnaire (MCQ-27) and Extended Monetary
Choice Questionnaire (MCQ-36)
K value geo. mean (95% CI)a

ln k value M (SD)

Ranked k value M (SD)

Reward size

MCQ-27

MCQ-36

MCQ-27

MCQ-36

MCQ-27

MCQ-36

Small N 99
Medium N 98
Large N 97
Overall mean N 99

0.06 [0.05, 0.08]

0.05 [0.04, 0.06]
0.04 [0.03, 0.05]
0.05 [0.04, 0.06]

0.08 [0.05, 0.10]

0.06 [0.04, 0.08]
0.05 [0.03, 0.07]
0.06 [0.04, 0.08]

2.76 (1.34)
3.00 (1.35)
3.20 (1.38)
2.98 (1.20)

2.57 (1.62)
2.84 (1.61)
2.97 (1.80)
2.78 (1.51)

8.08 (1.58)
7.82 (1.58)
7.59 (1.63)
7.84 (1.43)

8.21 (1.81)
7.93 (1.80)
7.78 (2.02)
7.99 (1.69)

geo. mean geometric mean of raw k values, 95% CI 95% confidence intervals for each geometric mean.

ADAPTATION OF THE MCQ FOR EXTREME DISCOUNTING

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Small

Large

30

30

25

25

20

20

15

15

10

10

1 2

3 4 5 6 7 8 9 10 11 12 13
Ranked k values

1 2

Medium
30

30

25
20

20

15

15

10

10

5
0

3 4 5 6 7 8 9 10 11 12 13
Ranked k values

Overall Mean

35
25

1053

1 2

3 4 5 6 7 8 9 10 11 12 13
Ranked k values

1 2

3 4 5 6 7 8 9 10 11 12 13
Ranked k values

Figure 1. Histograms of ranked k-values across reward categories and by overall mean for the MCQ-36.
Shaded bars represent ranks from the original MCQ-27 items. Additional ranks from the extended k value scale
included in the MCQ-36 are unshaded. MCQ-27 Original Monetary Choice Questionnaire; MCQ-36
Extended Monetary Choice Questionnaire.

There were some notable differences between extreme responders and nonextreme responders on the SSS, though these
were not statistically significant after correcting for multiple
comparisons using the Bonferroni adjustment. Overall, extreme
responders had higher levels of sensation seeking compared
with nonextreme responders, and showed particularly high levels of sensation seeking in disinhibition and experience seeking.
Disinhibition reflects both social and sexual disinhibition that is
expressed in substance-use behaviors and variety in sexual
partners (Zuckerman et al., 1978). Experience seeking represents the pursuit of new sensations and experiences through the
mind and senses, and activities such as travel and a nonconforming lifestyle (Zuckerman et al., 1978).
There were few differences between extreme responders and
nonextreme responders on cocaine use, trait impulsivity, and
many other participant characteristics. The lack of differences
on cocaine use variables is very likely the result of strict
eligibility criteria for the sample related to frequency and
severity of cocaine use. Use of these strict criteria resulted in a

relatively homogeneous sample in terms of substance use characteristics.

The findings from this study have important implications for
measuring delay discounting in highly impulsive populations.
In our results, scores based on the MCQ-27 yielded k values that
underestimated delay discounting due to a ceiling effect for a
large proportion of our participants. Other studies using the
27-item MCQ with substance users reported mean k values
similar to those in the current study sample (Gonzalez et al.,
2012; Kirby & Petry, 2004). Therefore, it is possible that others
have found a similar ceiling effect, although it has not been
reported. The MCQ-36 represents a way to assess a wider range
of delay discounting in highly impulsive individuals that captures variability that would otherwise be missed by the shorter
MCQ-27. Furthermore, while yielding a potentially more accurate estimate of delay discounting, the addition of nine items in
the MCQ-36 did not substantially increase the length of time of
administration. Future research might compare this extended
MCQ against other validated measures of delay discounting.

TOWE, HOBKIRK, YE, AND MEADE

1054

Table 3
Comparison of Extreme Responders to Nonextreme Responders Using ANCOVA
Adjusted means

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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Measure
Barratt Impulsiveness Scale
BIS-11 total score
Self-control
Motor impulsiveness
Attention
Cognitive instability
Cognitive complexity
Perseverance
Sensation Seeking Scale
SSS-V total score
Thrill and adventure seeking
Experience seeking
Disinhibition
Boredom susceptibility
Estimated premorbid verbal IQ
HRBS sex composite
BSI total score

Nonextreme responders
(N 73)

Extreme responders
(N 26)

65.18
14.69
14.51
9.93
4.66
13.16
8.23

65.52
15.60
13.71
10.28
5.04
13.12
7.78

F(1,
F(1,
F(1,
F(1,
F(1,
F(1,
F(1,

91)
91)
91)
91)
91)
91)
91)

.02
1.40
1.40
.29
1.04
.01
.87

14.22
3.23
4.62
4.14
2.23
86.83
3.37
0.49

17.04
3.52
5.56
5.48
2.47
82.71
4.34
0.53

F(1,
F(1,
F(1,
F(1,
F(1,
F(1,
F(1,
F(1,

91)
91)
91)
91)
91)
90)
91)
91)

5.14
.24
4.21
8.27
.37
2.04
1.19
.11

F value

Note. The covariates included were age, race, gender, years of education, sexual orientation, and occupational
status. Means presented represent the adjusted means after controlling for all covariates in the ANCOVA. BIS-11
point scales: total, 30 120; self-control, 6 24; motor impulsiveness, 728; attention, 520; cognitive instability,
312; cognitive complexity, 520; perseverance, 4 16. SSS-V point scales: total, 0 40; all subscales, 0 10.
ANCOVA analysis of covariance; SSS-V Sensation Seeking Scale - version V; HRBS HIV Risk
Behavior Scale; BSI Brief Symptom Inventory.

p .05. p .01.

Additionally, future research could examine whether scores on

the MCQ-36 are more predictive of risk behaviors.

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Received April 8, 2015

Revision received May 8, 2015
Accepted May 9, 2015