Early life adversity and increased delay discounting: Findings from the Family Health Patterns project

Anhedonia and Delay Discounting: Differing Patterns of Brain-Behavior Relationships in Healthy Control Participants Versus Individuals With Posttraumatic Stress Disorder

BACKGROUND

Anhedonia may contribute to individual differences in delay discounting (DD). In prior work, we found that higher anhedonia was associated with shallower DD in healthy control (HC) participants but steeper DD in individuals with posttraumatic stress disorder (PTSD). In this study, we aimed to directly compare the relationship between anhedonia and DD across groups and to identify functional brain correlates of this interaction.

METHODS

Participants (HC group: n = 23, DSM-5 PTSD group: n = 23) completed a questionnaire assessing anhedonia (Snaith-Hamilton Pleasure Scale [SHAPS]), task-based functional magnetic resonance imaging of decision making including DD, and resting-state functional magnetic resonance imaging. Task-based activity and resting-state functional connectivity were evaluated in reward-related regions that have also been implicated in PTSD (nucleus accumbens [NAcc], right anterior insula).

RESULTS

Higher SHAPS scores were associated with steeper DD in PTSD, but there was no relationship between DD and SHAPS in the HC group. There was a significant group-by-SHAPS interaction for NAcc activity, t31 = 2.92, p = .007: Greater NAcc activity when immediate rewards were chosen was associated with higher SHAPS in the PTSD group but lower SHAPS in the HC group. In resting-state functional connectivity, there was a group-by-SHAPS interaction between the NAcc seed and right parietal and frontal pole clusters.

CONCLUSIONS

These results extend prior findings that anhedonia is associated with steeper DD in PTSD and demonstrate that this behavioral finding occurs in the context of NAcc hyperactivity to immediate rewards and hyperconnectivity in anhedonic individuals with PTSD.

Family history, childhood maltreatment, and adolescent binge drinking exert synergistic effects on delay discounting and future alcohol use

Background: The transition to college is associated with a sharp increase in alcohol binge drinking. Family history (FH) of alcohol use disorder (AUD), childhood maltreatment (CM), and adolescent binge drinking are each associated with heightened impulsivity and greater alcohol misuse.Objectives: We hypothesized that FH, CM, and adolescent binge drinking synergistically increase impulsivity and lead to binge drinking increases over the first year of college.Methods: Overall, 329 first-semester college students (18-19 years old, 70% female) with varying degrees of FH (Family History Assessment Module), CM (Childhood Trauma Questionnaire), and adolescent binge drinking (Carolina Alcohol Use and Patterns Questionnaire) completed an online study that included a computerized delay discounting task and surveys. Binge drinking was surveyed retrospectively to measure adolescent binge drinking, in addition to baseline and one-year follow-up measures. Linear regression analyses tested the interacting effects of FH, CM, and adolescent binge drinking on delay discounting as well as changes in binge drinking severity between baseline and one-year follow-up. A moderated mediation tested whether delay discounting mediated future binge drinking.Results: Greater levels of FH, CM, and adolescent binge drinking interacted to reduce the selection of delayed rewards (β=-0.12, SE = 0.06), indicating increased impulsivity. There was a similar interaction effect on increased binge drinking over the one-year follow-up period (β = 0.37, SE = 0.13). Although FH, CM, and adolescent binge drinking influenced individual paths, the moderated mediation analysis was not significant.Conclusions: Heritable and environmental risk factors for AUD predicted impulsivity and prospectively predicted college binge drinking. Interventions targeting delay discounting processes may represent an effective strategy to reduce harmful drinking specifically for certain high-risk college students.

Childhood adversity and impaired reward processing: A meta-analysis

BACKGROUND

Childhood adversity (CA) is associated with increased risk of psychopathology, and reward processing (RP) may be one of the underlying mechanisms. However, evidence on impaired RP in childhood adversity is theoretically and methodologically heterogeneous.

OBJECTIVE

To provide a quantitative overview of studies on the relation between childhood adversity and RP assessed at the behavioral and subjective levels, and identify differences between studies that influence the effect size.

PARTICIPANTS AND SETTING

Twenty-seven studies (overall N = 6801) were included.

METHODS

Peer-reviewed publications describing empirical studies on the relation between CA and behavioral and self-report measures of RP in humans were identified through systematic searches in six bibliographic databases. Effect sizes (r) were pooled using random-effects models. The potential moderator role of RP dimension, type of RP assessment, type of childhood adversity assessment, and age were examined.

RESULTS

Results indicated a small, but consistent association between CA and impaired RP (r = 0.12; 95% CI: 0.07, 0.16), with medium heterogeneity (I² = 62.43). The effect size was significantly larger (i.e., medium-sized) in studies that focused on reward learning rather than reward valuation and reward responsiveness; used cognitive tasks rather than self-report assessments of RP; and relied on official records rather than subjective reports of CA. There was evidence of publication bias, but overall effect size remained significant after imputation.

CONCLUSIONS

These results suggest that multidimensional RP impairments (e.g., deficits in reward learning, biased reward valuation) are a consistent marker of CA, and may represent mechanisms underlying the increased risk of psychopathology.

Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study

OBJECTIVES

Adverse childhood experiences (ACEs) can affect life-course health and well-being, including risk-taking behaviour and trust. This study explored associations between ACEs and trust in health information on COVID-19, attitudes towards and compliance with COVID-19 restrictions and vaccine hesitancy.

DESIGN

National cross-sectional telephone survey using a sample of landline and mobile numbers stratified by Health Board, deprivation quintile and age group.

SETTING

Households in Wales during national COVID-19 restrictions (December 2020 to March 2021).

PARTICIPANTS

2285 Welsh residents aged ≥18 years.

MEASURES

Nine ACEs; low trust in National Health Service (NHS) COVID-19 information; supporting removal of social distancing and mandatory face coverings; breaking COVID-19 restrictions; and vaccine hesitancy (rejection or uncertainty of vaccination).

RESULTS

Increasing ACE counts were independently related to low trust in NHS COVID-19 information, feeling unfairly restricted by government and ending mandatory face coverings. High ACE counts (4+ vs 0 ACEs) were also associated with supporting removal of social distancing. Breaking COVID-19 restrictions increased with ACE count with likelihood doubling from no ACEs to 4+ ACEs. Vaccine hesitancy was threefold higher with 4+ ACEs (vs 0 ACEs) and higher in younger age groups. Thus, modelled estimates of vaccine hesitancy ranged from 3.42% with no ACEs, aged ≥70 years, to 38.06% with 4+ ACEs, aged 18-29 years.

CONCLUSIONS

ACEs are common across populations of many countries. Understanding how they impact trust in health advice and uptake of medical interventions could play a critical role in the continuing response to COVID-19 and controlling future pandemics. Individuals with ACEs suffer greater health risks throughout life and may also be excluded from interventions that reduce infection risks. While pandemic responses should consider how best to reach those suffering from ACEs, longer term, better compliance with public health advice is another reason to invest in safe and secure childhoods for all children.

Brain responses during delay discounting in youth at high-risk for substance use disorders

Offspring of parents with substance use disorders (SUD) discount future rewards at a steeper rate on the monetary delay discounting task (DD) than typically developing youth. However, brain activation during DD has yet to be studied in drug naïve youth with a family history (FH) of SUD. Here, we investigate brain activation differences in high-risk youth during DD. We recruited substance naïve youth, aged 11-12, into three groups to compare brain activation during DD: (1) High-risk youth (n = 35) with a FH of SUD and externalizing psychiatric disorders, (2) psychiatric controls (n = 25) who had no FH of SUD, but with equivalent externalizing psychiatric disorders as high-risk youth, and (3) a healthy control group (n = 24) with no FH of SUD and minimal psychopathology. A whole-brain voxel wise analysis of the [Delay > Baseline], [Immediate > Baseline], and [Control > Baseline] contrasts identified functional regions of interest, from which extracted parameter estimates were tested for significant group differences. Relative to control youth, high-risk youth showed stronger activation in the left posterior insula and thalamus when making delayed choices, and stronger activation of the parahippocampal gyrus when making both delayed and control choices (ps < 0.05). Activation in the left posterior insula negatively correlated with both subscales of the Emotion Regulation Checklist, and positively correlated with the Stroop interference effect (ps < 0.05). Our findings suggest possible heritable SUD risk neural markers that distinguish drug naïve high-risk youth from psychiatric and healthy controls.

Early life adversity and increased antisocial and depressive tendencies in young adults with family histories of alcohol and other substance use disorders: Findings from the Family Health Patterns project

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Family histories of alcohol/drug use disorders are linked to risk-related traits.

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Early life adversity was linked to additive increases in antisocial tendencies.

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Similar results were seen for depressive tendencies.

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Early life adversity may strongly contribute to family history associated risk.

Background

Individuals with a family history of alcohol and other substance use disorders (FH+) are several times more likely to develop alcohol problems compared to individuals with no such family histories (FH–). Here we sought to evaluate associations of early life adversity (ELA) with two key risk-related FH+ phenotypic characteristics: increased antisocial and depressive tendencies.

Methods

We examined data from 1187 FH+ and FH– young adults (average age 23.6 years old) with and without personal histories of substance use disorders. Antisocial tendencies were evaluated with the Socialization scale of the California Personality Inventory (CPI-So), while depressive tendencies were evaluated with the Beck Depression Inventory II (BDI).

Results

In general, being FH+, having a personal substance use disorder history, and experiencing greater levels of ELA were associated with lower CPI-So scores (indicating more antisocial tendencies) and higher BDI scores (indicating more depressive tendencies).

Conclusions

These results suggest that ELA is linked to increased antisocial and depressive tendencies observed in FH+ persons. Given that FH+ individuals are disproportionately exposed to ELA, this increased exposure may be a major contributor to these and other risk-related characteristics commonly present in FH+ individuals. Additional studies are needed to evaluate the impact of ELA on risk-related phenotypic characteristics, including prospective studies in early childhood and mechanistic studies evaluating pathways by which ELA exerts its effects on FH phenotypic characteristics.

Consistent evidence of indirect effects of impulsive delay discounting and negative urgency between childhood adversity and adult substance use in two samples

RATIONALE

Exposure to adverse life experiences (ACEs) is robustly associated with problematic alcohol and other drug use. In addition, both ACEs and substance use have been independently associated with impulsivity.

OBJECTIVE

To examine whether impulsivity is implicated in the link between ACE and adult substance use in two samples.

METHODS

The primary sample was a cohort of community adults (N = 1431) who completed a one-time in-person assessment. A second sample was crowdsourced using Amazon Mechanical Turk (N = 3021). All participants were assessed for ACEs using the Adverse Childhood Experience Questionnaire and for current alcohol and other drug use. Given its multidimensional nature, impulsivity was assessed using the UPPS-P measure of impulsive personality traits, Go/NoGo (GNG) task (in-person community adult sample only), and delay discounting (Monetary Choice Questionnaire [MCQ] in the community adults and Effective Delay-50 [ED₅₀] in the crowdsourced sample. Structural equation modeling was used to examine the hypothesized indirect effects for the measures of impulsivity between ACEs and substance use.

RESULTS

In the community adults, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β = 0.07, SE = 0.02, 95% CI [0.04, 0.10]), and the MCQ (β = 0.02 SE = .01, 95% CI [0.01, 0.03]). In the crowdsourced sample, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β = 0.05, SE = .01, 95% CI [0.04, 0.07]), UPPS-Premeditation (β = 0.04, SE = .01, 95% CI [0.02, 0.05), and the ED₅₀ (β = 0.02, SE = .01; 95% CI [0.01, 0.03]).

CONCLUSION

These findings provide consistent evidence that decrements in regulation of negative emotions and overvaluation of immediate rewards indirectly link ACE and substance use. These robust cross-sectional findings support the need for elucidating the underlying neural substrates implicated and for longitudinal evaluations.

Delay discounting rate by a surrogate decision maker depends on the smoking status of the recipient

The tendency to devalue future rewards is known as delay discounting. Discounting is measured using a series of intertemporal choices between smaller, sooner outcomes and larger, later outcomes. We used a surrogate delay discounting task to explore whether such choices would differ if a hypothetical recipient was a smoker or was an individual with good health habits. Across three studies, the descriptions of the recipient included only information about smoking status (n = 66), smoking status and equal annual income (n = 47), and smoking status and equal weekly expenditures (n = 42). Higher rates of delay discounting for the smoker recipient compared to the nonsmoker recipient were observed across all three studies. These results parallel previous findings showing group differences in discounting between actual smokers and nonsmokers. We discuss the similarities between the present results and previous studies in light of an extension of Bem's (1967) self-perception theory, which posits that choices in laboratory-based delay discounting tasks are informed by observation of real-world intertemporal choice. The theory asserts that there is no fundamental difference between a first-person account of such knowledge and a third-person account. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Behavioral processes and risk for problem substance use in adolescents

This narrative review examines associations of delay discounting, response inhibition, sensation-seeking, and urgency with adolescent problem substance use. Each of these processes is linked to adult substance use disorders, is associated with conditions linked to increased risk for adolescent problem substance use, and predicts problem substance use. Notably, all processes are linked to early life adversity (ELA) exposure and most appear to help explain links between ELA exposure and problem substance use. These findings are consistent with a growing body of literature indicating ELA interferes with the development of neural circuits crucial to cognitive functioning and emotion regulation. Further, developmental trajectories of these processes generally align with maturational imbalance hypotheses of adolescent risk. Ongoing and pending large longitudinal studies may be essential for better understanding how ELA and other influences shapes these processes and the role of these processes in risk for problem substance use in adolescence and beyond. Finally it is possible that risk-related processes may be useful metrics in the context of implementing and evaluating strategies to prevent problem substance use in adolescence.

Working memory reflects vulnerability to early life adversity as a risk factor for substance use disorder in the FKBP5 cortisol cochaperone polymorphism, rs9296158

Early life adversity (ELA) negatively affects health behaviors in adulthood, but pathways from ELA exposure to behavioral outcomes are poorly understood. ELA in childhood and adolescence may translate into adult outcomes by way of modified glucocorticoid signaling. The cortisol cotransporter, FKBP5 has a G-to-A substitution (rs9296158) that hinders cortisol trafficking within target cells, and this impaired glucocorticoid signaling may shape the long-term response to ELA. We used performance on the Stroop test to assess working memory in 546 healthy young adults who had experienced 0, 1, or > 1 forms of ELA in childhood and adolescence and were genotyped for the FKBP5 rs9296158 G-to-A polymorphism. We observed a robust Gene x Environment interaction (F = 9.49, p < .0001) in which increased ELA exposure led to progressively greater Stroop interference in persons carrying AG and AA genotypes of FKBP5 with no such effect in GG carriers. Further work is needed to explore the modification of cognitive function resulting from ELA. Impairments in working memory illustrate how ELA may use glucocorticoid pathways to influence working memory with potential implications for decision-making and risky behavior including substance use disorders.