2026 ECNP Congress

PS04-4003

Comparison of episodic future thinking and scene construction abilities in patients with alcohol use disorder and healthy controls

Koray Hamza Cihan — K. Yarız, A. Aktakke, K.H. Cihan1,, İ. İlhan · Ankara University School of Medicine, Department of Psychiatry, Ankara, Türkiye

2026 ECNP Congress

Introduction: Alcohol use disorder (AUD) is associated with prominent deficits in episodic memory, linked to structural and functional alterations in the hippocampus and prefrontal cortex. Episodic future thinking (EFT) — the capacity to mentally simulate personally relevant future events — critically depends on the same neural architecture and plays a central role in motivation, goal-directed behavior, and self-regulation [1, 2]. Scene construction paradigms offer a process-oriented method for dissociating temporally indeterminate imagery from future-oriented, self-referential episodic simulation [3]. Although scene construction has been investigated in neurodegenerative and other psychiatric conditions, no study to date has applied this paradigm in AUD. This study aimed to characterize scene construction performance in AUD, with the hypothesis that future-oriented episodic construction would be selectively impaired relative to atemporal fictional scene generation.

Methods: Thirty individuals with AUD (DSM-5 criteria; mean abstinence: 3 months; 60% severe dependence by SADQ) and 20 age-, sex-, and education-matched healthy controls were recruited from a university psychiatry clinic. Participants completed a culturally adapted ten-scene construction task [3], comprising three subscales: Imagined Experiences (six atemporal fictional scenes), Future Construction (three future-oriented self-referential scenes), and Narrative (one self-referential scene). Performance was quantified using the Experiential Index (EI) scores. Neuropsychological assessment included the MoCA, WMS-III Logical Memory subtests, and BDI. Interrater reliability was excellent (ICC = .95 for total EI). Between-group differences were examined using independent samples t-tests and ANCOVA, controlling for education, depressive symptoms, and delayed recall.

Results: Groups did not differ in age, sex, or years of education. The AUD group demonstrated significantly lower MoCA scores, poorer immediate and delayed episodic recall, and higher BDI scores. For scene construction, no significant between-group difference was found in Imagined Experiences EI scores, whereas Future Construction EI scores were significantly lower in the AUD group (22.50 ± 4.88 vs. 26.68 ± 6.49; p = .012, d = .75). Group differences in Future Construction persisted after controlling for education, depressive symptoms, and delayed recall (ANCOVA: F(4,45) = 3.874, p = .009; group effect: p = .042, η² = .089). Years of education was the only significant covariate (β = .632, p = .008). SADQ severity and depressive symptoms were not associated with Future Construction performance.

Discussion: The dissociation between intact Imagined Experiences and impaired Future Construction indicates a selective vulnerability in future-oriented, self-referential episodic simulation in AUD, rather than a global imagery deficit. The persistence of this impairment after statistical control for memory and affective variables suggests contributions from executive, motivational, and reward-valuation processes — consistent with constructive episodic simulation frameworks [2, 4].

Conclusion: This study provides the first evidence that individuals with AUD exhibit a selective impairment in future-oriented episodic construction, independent of episodic memory deficits and affective state. Impaired capacity to vividly simulate personally relevant future scenarios may represent a core cognitive mechanism underlying diminished treatment motivation and relapse vulnerability in AUD. Future-oriented scene construction constitutes a potential cognitive target for EFT-based motivational interventions.

References

  1. Atance, C. M., & O’Neill, D. K., 2001. Episodic future thinking. Trends in Cognitive Sciences 5(12), 533–539.
  2. Schacter, D. L., Benoit, R. G., & Szpunar, K. K., 2017. Episodic future thinking: Mechanisms and functions. Current Opinion in Behavioral Sciences 17, 41–50.
  3. Hassabis, D., & Maguire, E. A., 2007. Deconstructing episodic memory with construction. Trends in Cognitive Sciences 11(7), 299–306.
  4. Peters, J., & Büchel, C., 2010. Episodic future thinking reduces reward delay discounting through an enhancement of prefrontal–mediotemporal interactions. Neuron 66(1), 138–148.