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Johansen AN, Acuff SF, Strickland JC. Human laboratory models of reward in substance use disorder. Pharmacol Biochem Behav 2024; 241:173803. [PMID: 38843997 PMCID: PMC11223959 DOI: 10.1016/j.pbb.2024.173803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/30/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024]
Abstract
Human laboratory models in substance use disorder provide a key intermediary step between highly controlled and mechanistically informative non-human preclinical methods and clinical trials conducted in human populations. Much like preclinical models, the variety of human laboratory methods provide insights into specific features of substance use disorder rather than modelling the diverse causes and consequences simultaneously in a single model. This narrative review provides a discussion of popular models of reward used in human laboratory research on substance use disorder with a focus on the specific contributions that each model has towards informing clinical outcomes (forward translation) and analogs within preclinical models (backward translation). Four core areas of human laboratory research are discussed: drug self-administration, subjective effects, behavioral economics, and cognitive and executive function. Discussion of common measures and models used, the features of substance use disorder that these methods are purported to evaluate, unique issues for measure validity and application, and translational links to preclinical models and special considerations for studies wishing to evaluate homology across species is provided.
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Affiliation(s)
| | - Samuel F Acuff
- Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA.
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Bado PP, Salum GA, Rohde LA, Gadelha A, Pan PM, Miguel EC, Tripp G, Furukawa E. Is waiting for rewards good for you? No association between impulsive choice, psychopathology, and functional outcomes in a large cohort sample. JCPP ADVANCES 2024; 4:e12231. [PMID: 38827985 PMCID: PMC11143955 DOI: 10.1002/jcv2.12231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/19/2024] [Indexed: 06/05/2024] Open
Abstract
Background A stronger preference for immediate rewards has been reported in individuals with ADHD and other disorders. However, the consistency of the associations between this preference and psychiatric conditions as well as functional outcomes have been questioned. Research on its association with longitudinal outcomes is scarce. Methods The current study used data on a choice delay task (CDT) from a school-based cohort of Brazilian children with those at higher risk for psychiatric disorders over-sampled (n = 1917). The sample included typically developing children (n = 1379), those with ADHD (n = 213), and other disorders. The frequency of the trials where children chose a larger later reward versus a smaller sooner reward was compared for those with ADHD and typically developing children. Cross-sectionally and longitudinally, the study also evaluated whether children's preference for larger delayed rewards at baseline predicted the presence of psychiatric disorders and functional life outcomes (academic performance, alcohol use, early pregnancy, criminal conviction, BMI). Results Children with ADHD and their typically developing peers performed similarly on the CDT. Their baseline task performance was not related to psychiatric conditions or life outcomes. Conclusions The current results raise questions regarding the use of the CDT with diverse populations and whether a preference for larger delayed rewards is predictive of positive long-term outcomes as widely assumed.
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Affiliation(s)
- Patricia P. Bado
- Hospital de Clínicas de Porto Alegre (HCPA)Universidade Federal Do Rio Grande Do Sul (UFRGS)Porto AlegreBrazil
- Pontifícia Universidade Católica do Rio de Janeiro (PUC‐Rio)Rio de JaneiroBrazil
| | - Giovanni A. Salum
- Hospital de Clínicas de Porto Alegre (HCPA)Universidade Federal Do Rio Grande Do Sul (UFRGS)Porto AlegreBrazil
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Innovation and Research in Mental HealthSão PauloBrazil
| | - Luis A. Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Innovation and Research in Mental HealthSão PauloBrazil
- ADHD Outpatient Program & Developmental Psychiatry ProgramHospital de Clínicas de Porto AlegreFederal University of Rio Grande Do SulPorto AlegreBrazil
- Medical Council UniEduKSão PauloBrazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Innovation and Research in Mental HealthSão PauloBrazil
- Universidade Federal de São Paulo (UNIFESP)São PauloBrazil
- Laboratório de Neurociências Integrativas (Linc)Universidade Federal de São Paulo (UNIFESP)São PauloBrazil
| | - Pedro M. Pan
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Innovation and Research in Mental HealthSão PauloBrazil
- Laboratório de Neurociências Integrativas (Linc)Universidade Federal de São Paulo (UNIFESP)São PauloBrazil
| | - Eurípedes C. Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents & National Center for Innovation and Research in Mental HealthSão PauloBrazil
- Universidade de São Paulo (USP)São PauloBrazil
| | - Gail Tripp
- Okinawa Institute of Science and Technology (OIST) Graduate UniversityOnna‐sonOkinawaJapan
| | - Emi Furukawa
- Okinawa Institute of Science and Technology (OIST) Graduate UniversityOnna‐sonOkinawaJapan
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Gebru NM, Wongsomboon V. Sexual Arousal-Delay Discounting: When Condoms Delay Arousal. JOURNAL OF SEX RESEARCH 2024; 61:727-741. [PMID: 37506314 PMCID: PMC10822021 DOI: 10.1080/00224499.2023.2239216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Sexual arousal plays an important role in condom use decisions. However, combined effects of reduced sexual arousal and delay to achieving arousal on condom use decisions remain understudied. This study used a novel sexual arousal-delay discounting (SADD) task to measure individuals' willingness to use a condom in situations where condom use would (1) delay time to arousal and (2) reduce the level of arousal one could achieve even after the delay (e.g., 5 minutes to reach 50% arousal). In Study 1, U.S. college students (N = 115; Mage = 18.6) reported their willingness to have sex with a condom in hypothetical scenarios where the condom delayed and reduced their partner's sexual arousal. In Study 2, U.S. college students (N = 208; Mage = 19.6; 99% ≤ 24 years old) completed the same task for two partners-partner perceived as most desirable and partner perceived as least likely to have an STI. In this study, a condom would affect either participants' own or partner's arousal. Study 3 replicated Study 2 using a non-college sample in the U.S. (N = 227; Mage = 30.5; 84% ≥ 25 years old). Across studies, willingness to use a condom decreased as the delay to reduced arousal increased. This effect of SADD was stronger when condoms reduced participants' own (vs. partner's) arousal, whereas comparisons between most desirable and least likely-to-have-STI partners provided mixed findings. Men had higher discounting rates than women across conditions. Greater SADD was associated with lower condom use self-efficacy, providing initial evidence for the task's validity. The role of delayed arousal in condom use and implications are discussed.
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Affiliation(s)
- Nioud Mulugeta Gebru
- Center for Alcohol and Addictions Studies; Department of Behavioral and Social Sciences; Brown University School of Public Health, Providence, RI USA
| | - Val Wongsomboon
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA
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Gelino BW, Schlitzer RD, Reed DD, Strickland JC. A systematic review and meta-analysis of test-retest reliability and stability of delay and probability discounting. J Exp Anal Behav 2024; 121:358-372. [PMID: 38499476 PMCID: PMC11078611 DOI: 10.1002/jeab.910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024]
Abstract
In this meta-analysis, we describe a benchmark value of delay and probability discounting reliability and stability that might be used to (a) evaluate the meaningfulness of clinically achieved changes in discounting and (b) support the role of discounting as a valid and enduring measure of intertemporal choice. We examined test-retest reliability, stability effect sizes (dz; Cohen, 1992), and relevant moderators across 30 publications comprising 39 independent samples and 262 measures of discounting, identified via a systematic review of PsychInfo, PubMed, and Google Scholar databases. We calculated omnibus effect-size estimates and evaluated the role of proposed moderators using a robust variance estimation meta-regression method. The meta-regression output reflected modest test-retest reliability, r = .670, p < .001, 95% CI [.618, .716]. Discounting was most reliable when measured in the context of temporal constraints, in adult respondents, when using money as a medium, and when reassessed within 1 month. Testing also suggested acceptable stability via nonsignificant and small changes in effect magnitude over time, dz = 0.048, p = .31, 95% CI [-0.051, 0.146]. Clinicians and researchers seeking to measure discounting can consider the contexts when reliability is maximized for specific cases.
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Affiliation(s)
- Brett W. Gelino
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Rebekah D. Schlitzer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
| | - Derek D. Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, US
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Meshes E, Tarbox J, Meshes JA, Odum AL. An apparatus and procedure for studying discounting of real outcomes of money and aversive sound. J Exp Anal Behav 2024; 121:389-398. [PMID: 38561597 DOI: 10.1002/jeab.912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
We developed and examined a laboratory preparation with adult humans that pits shorter term avoidance over longer term positive reinforcement and may serve as a useful laboratory functional analogue of problematic behavior. Participants were exposed to choices between (1) avoiding an aversive sound and acquiring no money or (2) listening to an aversive sound for a set duration and then receiving money. The first choice, avoiding an aversive sound and acquiring no money, was conceptualized as immediate negative reinforcement and no positive reinforcement, whereas the latter choice, listening to an aversive sound for a set duration and then receiving money, was conceptualized as a potential positive punisher paired with a larger later positive reinforcer. We manipulated the duration of the sound and the magnitude of money to identify the point at which individual participants' choices changed from avoiding the sound to choosing the sound plus money. As the sound duration increased, the choice of listening to the sound and receiving money decreased. Similar functions were observed with two different monetary magnitudes. The model has potential applicability to real-world problems such as smoking, addiction, gambling, anxiety disorders, and other impulse control disorders.
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Affiliation(s)
- Elizabeth Meshes
- Department of Applied Behavior Analysis, The Chicago School, Los Angeles, CA, USA
| | - Jonathan Tarbox
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | | | - Amy L Odum
- Department of Psychology, Utah State University, Logan, UT, USA
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Keidel K, Lu X, Suzuki S, Murawski C, Ettinger U. Association of temporal discounting with transdiagnostic symptom dimensions. NPJ MENTAL HEALTH RESEARCH 2024; 3:13. [PMID: 38627606 PMCID: PMC11021403 DOI: 10.1038/s44184-024-00060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/15/2024] [Indexed: 04/19/2024]
Abstract
Temporal discounting (TD), the tendency to devalue future rewards as a function of delay until receipt, is aberrant in many mental disorders. Identifying symptom patterns and transdiagnostic dimensions associated with TD could elucidate mechanisms responsible for clinically impaired decision-making and facilitate identifying intervention targets. Here, we tested in a general population sample (N = 731) the extent to which TD was related to different symptom patterns and whether effects of time framing (dates/delay units) and monetary magnitude (large/small) had particularly strong effects in people scoring higher on specific symptom patterns. Analyses revealed that TD was related to symptom patterns loading on anxious-depression and inattention-impulsivity-overactivity dimensions. Moreover, TD was lower in the date than the delay version and with higher magnitudes, especially in people scoring higher on the inattention-impulsivity-overactivity dimension. Overall, this study provides evidence for TD as a transdiagnostic process across affective and impulsivity-related dimensions. Future studies should test framing interventions in clinical populations characterized by impulsivity.Preregistration: This research was preregistered at https://osf.io/fg9sc .
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Affiliation(s)
- Kristof Keidel
- Department of Psychology, University of Bonn, Bonn, Germany
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Xiaping Lu
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Shinsuke Suzuki
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
- Faculty of Social Data Science, Hitotsubashi University, Tokyo, Japan
- HIAS Brain Research Center, Hitotsubashi University, Tokyo, Japan
| | - Carsten Murawski
- Centre for Brain, Mind and Markets, Department of Finance, The University of Melbourne, Carlton, Vic, Australia
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Bonn, Germany.
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Luken A, Rabinowitz JA, Wells JL, Sosnowski DW, Strickland JC, Thrul J, Kirk GD, Maher BS. Designing and Validating a Novel Method for Assessing Delay Discounting Associated With Health Behaviors: Ecological Momentary Assessment Study. JMIR Form Res 2024; 8:e48954. [PMID: 38412027 PMCID: PMC10933719 DOI: 10.2196/48954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Delay discounting quantifies an individual's preference for smaller, short-term rewards over larger, long-term rewards and represents a transdiagnostic factor associated with numerous adverse health outcomes. Rather than a fixed trait, delay discounting may vary over time and place, influenced by individual and contextual factors. Continuous, real-time measurement could inform adaptive interventions for various health conditions. OBJECTIVE The goals of this paper are 2-fold. First, we present and validate a novel, short, ecological momentary assessment (EMA)-based delay discounting scale we developed. Second, we assess this tool's ability to reproduce known associations between delay discounting and health behaviors (ie, substance use and craving) using a convenience-based sample. METHODS Participants (N=97) were adults (age range 18-71 years), recruited on social media. In phase 1, data were collected on participant sociodemographic characteristics, and delay discounting was evaluated via the traditional Monetary Choice Questionnaire (MCQ) and our novel method (ie, 7-item time-selection and 7-item monetary-selection scales). During phase 2 (approximately 6 months later), participants completed the MCQ, our novel delay discounting measures, and health outcomes questions. The correlations between our method and the traditional MCQ within and across phases were examined. For scale reduction, a random number of items were iteratively selected, and the correlation between the full and random scales was assessed. We then examined the association between our time- and monetary-selection scales assessed during phase 2 and the percentage of assessments that participants endorsed using or craving alcohol, tobacco, or cannabis. RESULTS In total, 6 of the 7 individual time-selection items were highly correlated with the full scale (r>0.89). Both time-selection (r=0.71; P<.001) and monetary-selection (r=0.66; P<.001) delay discounting rates had high test-retest reliability across phases 1 and 2. Phase 1 MCQ delay discounting function highly correlated with phase 1 (r=0.76; P<.001) and phase 2 (r=0.45; P<.001) time-selection delay discounting scales. One or more randomly chosen time-selection items were highly correlated with the full scale (r>0.94). Greater delay discounting measured via the time-selection measure (adjusted mean difference=5.89, 95% CI 1.99-9.79), but not the monetary-selection scale (adjusted mean difference=-0.62, 95% CI -3.57 to 2.32), was associated with more past-hour tobacco use endorsement in follow-up surveys. CONCLUSIONS This study evaluated a novel EMA-based scale's ability to validly and reliably assess delay discounting. By measuring delay discounting with fewer items and in situ via EMA in natural environments, researchers may be better able to identify individuals at risk for poor health outcomes.
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Affiliation(s)
- Amanda Luken
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jill A Rabinowitz
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jonathan L Wells
- Department of Epidemiology, School of Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - David W Sosnowski
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, United States
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Gregory D Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Dwyer CL, Tegge AN, Craft WH, Tomlinson DC, Athamneh LN, Bickel WK. The Phenotype of Recovery X: Associations between delay discounting, regulatory flexibility, and remission from substance use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 155:209122. [PMID: 37451516 PMCID: PMC10787043 DOI: 10.1016/j.josat.2023.209122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/09/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Delay discounting (DD) and self-regulation are important predictors of substance use disorder (SUD) outcomes. Further, regulatory flexibility (RF; i.e., selecting, monitoring, and adapting coping techniques based on contextual demands) is related to psychological resilience. However, studies have yet to examine associations among DD, RF, and remission from SUDs among individuals in recovery. METHODS Individuals (N = 148) in SUD recovery completed the Context Sensitivity Index (CSI), the Flexible Regulation of Emotional Expression (FREE) Scale, and the Perceived Ability to Cope with Trauma (PACT) Scale to assess RF and, an $1000 hypothetical reward Adjusting Amount Delay Discounting Task. The study considered individuals to be in remission from SUD if they did not endorse any SUD DSM-5 symptom other than craving (except tobacco use disorder) in the past three months. The study team used t-tests to examine differences in RF and DD by remission status. Univariate linear regressions were used to examine the relationship between RF and DD. Finally, mediation models examined the dynamic relationship among DD, RF, and remission status. RESULTS Remitted individuals (n = 82) had significantly lower DD (i.e., greater preference for larger, later rewards) rates (p < .001) and higher context sensitivity (p < .001) and coping flexibility (p < .001). The study found significant negative associations between DD and context sensitivity (p = .008), coping flexibility (p = .002), and emotion regulation flexibility (p < .001). Finally, context sensitivity (p = .023) and coping flexibility (p = .009) mediated the relationship between DD and SUD remission. CONCLUSIONS Results suggest that individuals in recovery with broader temporal windows can better identify contextual demands and flexibly cope, contributing to improved SUD recovery outcomes.
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Affiliation(s)
- Candice L Dwyer
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - Allison N Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - William H Craft
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, USA
| | - Devin C Tomlinson
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, USA
| | - Liqa N Athamneh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA.
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al'Absi M, DeAngelis B, Borodovsky J, Sofis MJ, Fiecas M, Budney A. Early life adversity and substance use: The mediating role of mood and the moderating role of impulsivity. J Psychiatr Res 2023; 168:38-44. [PMID: 37883864 PMCID: PMC10872790 DOI: 10.1016/j.jpsychires.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 08/13/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Early life adversity (ELA) is a risk factor for substance use and misuse, and multiple factors mediate and moderate this association. We examined whether moods mediate the relationships between ELA and nicotine use, cannabis use, and co-use, and whether these mediation effects varied as a function of delay discounting. METHODS A total of 2555 adults completed a delay discounting task and responded to questions related to demographics, ELA, mood, and substance use. Data were analyzed using Pearson correlations and moderated mediation using Hayes' PROCESS macro (V3.4, Model 15). RESULTS ELA was positively associated with cannabis use, nicotine use, co-use of both substances, depressed and stressed moods, and it was negatively associated with positive mood. While cannabis use was associated negatively with stressed and depressed moods and positively with positive mood, nicotine use was associated negatively with positive mood. Moderated mediation analyses indicated that positive mood mediated the relationship between ELA and cannabis use for those with average and above average delay discounting. Positive mood also mediated the relationship between ELA and co-use among those with above average delay discounting. CONCLUSION The results suggest that ELA's associations with cannabis use and cannabis-nicotine co-use may be partially attributable to ELA's effects on positive mood among those who are predisposed to moderately to highly impulsive decision making.
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Affiliation(s)
| | | | | | | | - Mark Fiecas
- University of Minnesota School of Public Health, Minneapolis, MN, USA
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Dwyer CL, Craft WH, Tegge AN, Yu-Hua Y, Bickel WK. Utility of the 5-trial adjusting delay task in screening for high delay discounting rates: A cohort study of individuals reporting harmful alcohol and tobacco use. Exp Clin Psychopharmacol 2023; 31:786-792. [PMID: 36701520 PMCID: PMC10368788 DOI: 10.1037/pha0000623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
High delay discounting (DD) rates are associated with several health conditions, including addiction. Investigators interested in the modulation of DD rates may be interested in screening for individuals with high DD rates within substance-using samples. The adjusting delay discounting task (ADT) is a brief DD rate measure suitable for screening purposes, but how performance on this task is related to more granular DD measures (e.g., adjusting amount task; AAT) in individuals who use substances is unknown. This study investigated the relationship between DD rates measured by the ADT and AAT to assess the utility of the ADT in screening for high discounting rates in individuals who use tobacco and alcohol. Participants (N = 488) were screened for high discounting rates, ln(k) ≥ -4.3118, using the ADT. Subsequently, participants completed the AAT. Linear regressions were conducted to understand the relationship between the ADT and AAT DD rates. Separate analyses between the total, high-quality and low-quality samples were conducted. Significant relationships between the ADT and AAT were found for the total (p < .001), high-quality (p < .001), and low-quality samples (p < .001). Although the ADT overestimated DD rates on the AAT by 2.49, 2.29, and 2.97 units in the total, high-quality, and low-quality samples, the ADT accurately identified individuals with high discounting rates. Specifically, 71% of the total sample, 80% of the high-quality sample, and 66% of the low-quality sample maintained a high DD rate on the AAT. These results demonstrate that ADT can be used as a quick, accurate screening tool to identify high discounting rates in individuals who use substances. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Candice L. Dwyer
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
| | - William H. Craft
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, USA
| | - Allison N. Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - Yeh Yu-Hua
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Warren K. Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
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Martínez-Loredo V. Critical appraisal of the discussion on delay discounting by Bailey et al. and Stein et al.: A scientific proposal for a reinforcer pathology theory 3.0. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2022.101006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Levitt EE, Oshri A, Amlung M, Ray LA, Sanchez-Roige S, Palmer AA, MacKillop J. Evaluation of delay discounting as a transdiagnostic research domain criteria indicator in 1388 general community adults. Psychol Med 2023; 53:1649-1657. [PMID: 35080193 PMCID: PMC10009385 DOI: 10.1017/s0033291721005110] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/08/2021] [Accepted: 11/24/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The Research Domain Criteria (RDoC) approach proposes a novel psychiatric nosology using transdiagnostic dimensional mechanistic constructs. One candidate RDoC indicator is delay discounting (DD), a behavioral economic measure of impulsivity, based predominantly on studies examining DD and individual conditions. The current study sought to evaluate the transdiagnostic significance of DD in relation to several psychiatric conditions concurrently. METHODS Participants were 1388 community adults (18-65) who completed an in-person assessment, including measures of DD, substance use, depression, anxiety, posttraumatic stress disorder, and attention-deficit hyperactivity disorder (ADHD). Relations between DD and psychopathology were examined with three strategies: first, examining differences by individual condition using clinical cut-offs; second, examining DD in relation to latent psychopathology variables via principal components analysis (PCA); and third, examining DD and all psychopathology simultaneously via structural equation modeling (SEM). RESULTS Individual analyses revealed elevations in DD were present in participants screening positive for multiple substance use disorders (tobacco, cannabis, and drug use disorder), ADHD, major depressive disorder (MDD), and an anxiety disorder (ps < 0.05-0.001). The PCA produced two latent components (substance involvement v. the other mental health indicators) and DD was significantly associated with both (ps < 0.001). In the SEM, unique significant positive associations were observed between the DD latent variable and tobacco, cannabis, and MDD (ps < 0.05-0.001). CONCLUSIONS These results provide some support for DD as a transdiagnostic indicator, but also suggest that studies of individual syndromes may include confounding via comorbidities. Further systematic investigation of DD as an RDoC indicator is warranted.
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Affiliation(s)
- E. E. Levitt
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | - A. Oshri
- Department of Human Development and Family Science, Athens, Georgia, United States
| | - M. Amlung
- Department of Applied Behavioral Science, Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, United States
| | - L. A. Ray
- Department of Psychology, University of California, Los Angeles, California, United States
| | - S. Sanchez-Roige
- Department of Psychiatry, University of California San Diego, San Diego, California, United States
| | - A. A. Palmer
- Department of Psychiatry, University of California San Diego, San Diego, California, United States
- Institute for Genomic Medicine, University of California San Diego, San Diego, California, United States
| | - J. MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
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13
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Sadeh N, Miglin R, Bounoua N, Sheehan A, Spielberg JM. Development of a cortical delay discounting assay: a potential biomarker of externalizing disorders. Psychol Med 2023; 53:1143-1150. [PMID: 34167611 PMCID: PMC10625335 DOI: 10.1017/s003329172100252x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND People who tend to impulsively choose smaller, sooner rewards over larger, later rewards are at increased risk for addiction and psychiatric disorders. A neurobiological measure of the tendency to overvalue immediate gratification could facilitate the study of individuals who are susceptible to these mental disorders. The objective of this research was to develop a cortical assay of impulsive choice for immediate rewards. METHODS A cortex-based assay of impulsive choice was developed using 1105 healthy adults from the Human Connectome Project, and then cross-validated in two independent samples of adults with elevated rates of psychiatric disorders. RESULTS Study 1: Cortical delay discounting (C-DD) was developed using a multivariate additive model of gray matter thickness across both hemispheres. Higher C-DD corresponded to thinner cortex and greater impulsive choice for immediate rewards. It also predicted cannabis use beyond established risk factors for drug use, including familial substance use, childhood conduct problems, personality traits, and cognitive functioning. Study 2: C-DD replicated the association with delay discounting performance from study 1. Structural equation modeling showed C-DD covaried with symptoms of externalizing, but not internalizing disorders. Study 3: C-DD positively predicted future delay discounting behavior (6-34 months later). CONCLUSIONS Across three studies, a cortical assay of impulsive choice evidenced consistent associations with drug use and delay discounting task performance. It was also uniquely associated with psychiatric disorders that share impulsivity as a core feature. Together, findings support the utility of C-DD as a neurobiological assay of impulsive decision-making and a possible biomarker of externalizing disorders.
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Affiliation(s)
- Naomi Sadeh
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA
| | - Rickie Miglin
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA
| | - Nadia Bounoua
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA
| | - Ana Sheehan
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA
| | - Jeffrey M Spielberg
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA
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Abstract
Cannabis exerts an indirect effect on dopamine (DA) output in the mesolimbic projection, a circuit implicated in reward processing and effort expenditure, and thus may be associated with aberrant effort-based decision making. The "amotivation syndrome" hypothesis suggests that regular cannabis use results in impaired capacity for goal-directed behavior. However, investigations of this hypothesis have used divergent methodology and have not controlled for key confounding variables. The present study extends these findings by examining the relation between cannabis use and effort-related decision making in a sample of college students. Cannabis using (n = 25; 68% meeting criteria for Cannabis Use Disorder) and noncannabis using (n = 22) students completed the Effort Expenditure for Rewards Task (EEfRT). In generalized estimating equation models, reward magnitude, reward probability, and expected value predicted greater likelihood of selecting a high-effort trial. Furthermore, past-month cannabis days and cannabis use disorder symptoms predicted the likelihood of selecting a high-effort trial, such that greater levels of both cannabis use days and symptoms were associated with an increased likelihood after controlling for Attention Deficit/Hyperactivity Disorder (ADHD) symptoms, distress tolerance, income, and delay discounting. The results provide preliminary evidence suggesting that college students who use cannabis are more likely to expend effort to obtain reward, even after controlling for the magnitude of the reward and the probability of reward receipt. Thus, these results do not support the amotivational syndrome hypothesis. Future research with a larger sample is required to evaluate possible associations between cannabis use and patterns of real-world effortful behavior over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Sofis MJ, Lemley SM, Jacobson NC, Budney AJ. Initial evaluation of domain-specific episodic future thinking on delay discounting and cannabis use. Exp Clin Psychopharmacol 2022; 30:918-927. [PMID: 34096759 PMCID: PMC9214768 DOI: 10.1037/pha0000501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Episodic Future Thinking (EFT), mental simulation of personally relevant and positive future events, may modulate delay discounting (DD) in cannabis users. Whether EFT impacts cannabis use, whether DD mediates this effect, and whether EFT can be enhanced by prompting future events across specific life domains is unknown. Active, adult cannabis users (n = 90) recruited from Amazon mTurk and Qualtrics Panels were administered an Episodic Specificity Induction (ESI) to enhance quality of imagined events before being randomized to EFT, domain-specific-EFT (DS-EFT), or Episodic Recent Thinking (ERT). All participants created four, positive life events; DS-EFT participants imagined social, leisure, health, and financial events. Event-quality ratings were assessed (e.g., enjoyment). DD was assessed at baseline (Day 1), post-intervention (Days 2-4), and follow-up (Days 9-12). Cannabis use was assessed at baseline and follow-up. Differences in change in days and grams of cannabis use between conditions and mediation of changes in use by DD were examined. No differences in DD were observed between conditions. DS-EFT, but not EFT, showed significantly greater reductions in grams (d = .54) and days of cannabis use (d = .50) than ERT. DS-EFT and EFT demonstrated significantly greater event-quality ratings than ERT (ds > .55). EFT-based interventions showed potential for reducing cannabis use. Unexpectedly, effects on DD did not mediate this effect. Further testing with larger samples of cannabis users is needed to better understand EFT's mechanisms of action and determine optimal implementation strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Michael J Sofis
- Geisel School of Medicine, Dartmouth College, Center for Technology and Behavioral Health
| | - Shea M Lemley
- Geisel School of Medicine, Dartmouth College, Center for Technology and Behavioral Health
| | - Nicholas C Jacobson
- Geisel School of Medicine, Dartmouth College, Center for Technology and Behavioral Health
| | - Alan J Budney
- Geisel School of Medicine, Dartmouth College, Center for Technology and Behavioral Health
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16
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Naudé GP, Strickland JC, Reed DD, Amlung M. Delay discounting and neurocognitive performance in young adults with differential patterns of substance use: Findings from the Human Connectome Project. Exp Clin Psychopharmacol 2022; 30:682-691. [PMID: 34081511 PMCID: PMC9710271 DOI: 10.1037/pha0000469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A large proportion of individuals who use psychoactive substances regularly use more than one substance. This pattern of behavior, termed polysubstance use, is associated with greater risks than when consuming only a single substance. The present study examined delay discounting, neurocognitive functioning, and demographic indicators among a large, racially and socioeconomically diverse sample of young adults drawn from the Human Connectome Project who reported either non, mono, or dual use of alcohol, tobacco, and/or cannabis. Univariate and multivariate tests suggested individuals who reported using multiple substances were more likely to be male, experienced higher rates of alcohol use disorder, and, when reporting both alcohol use and cannabis involvement, scored lower on a measure of inhibitory control relative to those who reported mono or dual use of alcohol and/or cigarettes. Individuals who reported currently smoking cigarettes exhibited the steepest discounting irrespective of other substances used; however, we observed additive effects for alcohol use and, to a lesser extent, cannabis involvement. Specifically, steeper discounting occurred when individuals who reported either regular alcohol use or > 100 lifetime instances of cannabis use also reported smoking cigarettes. We discuss several hypotheses for this finding related to the diversity of the sample and substances assessed as well as directions for future programmatic lines of research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Gideon P. Naudé
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Derek D. Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Michael Amlung
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
- Peter Boris Centre for Addictions Research, McMaster University, Hamilton, ON, Canada
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17
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Niklason GR, Rawls E, Ma S, Kummerfeld E, Maxwell AM, Brucar LR, Drossel G, Zilverstand A. Explainable machine learning analysis reveals sex and gender differences in the phenotypic and neurobiological markers of Cannabis Use Disorder. Sci Rep 2022; 12:15624. [PMID: 36115920 PMCID: PMC9482622 DOI: 10.1038/s41598-022-19804-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Cannabis Use Disorder (CUD) has been linked to a complex set of neuro-behavioral risk factors. While many studies have revealed sex and gender differences, the relative importance of these risk factors by sex and gender has not been described. We used an “explainable” machine learning approach that combined decision trees [gradient tree boosting, XGBoost] with factor ranking tools [SHapley’s Additive exPlanations (SHAP)] to investigate sex and gender differences in CUD. We confirmed that previously identified environmental, personality, mental health, neurocognitive, and brain factors highly contributed to the classification of cannabis use levels and diagnostic status. Risk factors with larger effect sizes in men included personality (high openness), mental health (high externalizing, high childhood conduct disorder, high fear somaticism), neurocognitive (impulsive delay discounting, slow working memory performance) and brain (low hippocampal volume) factors. Conversely, risk factors with larger effect sizes in women included environmental (low education level, low instrumental support) factors. In summary, environmental factors contributed more strongly to CUD in women, whereas individual factors had a larger importance in men.
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18
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Gold AK, Otto MW. Impaired risk avoidance in bipolar disorder and substance use disorders. J Psychiatr Res 2022; 152:335-342. [PMID: 35785576 PMCID: PMC9308707 DOI: 10.1016/j.jpsychires.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 12/01/2022]
Abstract
Comorbid substance use disorders are highly prevalent in bipolar disorder, and research suggests that individuals with the comorbid presentation typically have worse outcomes than individuals with bipolar disorder without this comorbidity. However, psychosocial treatments for the comorbid presentation have not demonstrated effectiveness for both mood and substance use symptom domains, suggesting novel treatments are needed. An alternative path to treatment development is to identify mechanisms that underlie comorbid bipolar disorder and substance use disorders that can subsequently be targeted in treatment. We evaluated neurocognitive markers for impairments in risk avoidance (the tendency to engage in a persistent pattern of problematic behaviors despite negative outcomes resulting from such behaviors) as potential mechanistic variables underlying negative illness outcomes in the comorbid population. Participants with bipolar disorder (n = 45) or comorbid bipolar disorder and substance use disorders (n = 31) in a relatively euthymic mood state completed clinical risk behavior assessments, task-based risk avoidance assessments, and neurocognitive assessments. Results indicated a lack of notable between-group differences in the clinical risk composite score, task-based risk avoidance assessments, and neurocognitive assessments, with the exception of self-reported executive dysfunction which was elevated among the comorbid sample. Collapsing across group, we found that increased discounting of delayed rewards, older age, and an earlier age of (hypo)mania onset predicted an increased clinical risk composite score. These findings underscore the potential importance of delay discounting as a novel mechanistic target for reducing clinical risk behaviors among individuals with bipolar disorder both with and without comorbid substance use disorders.
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Affiliation(s)
- Alexandra K. Gold
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
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19
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Nieto SJ, Venegas A, Burnette EM, MacKillop J, Ray LA. Additive roles of tobacco and cannabis co-use in relation to delay discounting in a sample of heavy drinkers. Psychopharmacology (Berl) 2022; 239:1387-1395. [PMID: 34652499 PMCID: PMC9059652 DOI: 10.1007/s00213-021-05993-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 09/20/2021] [Indexed: 11/28/2022]
Abstract
RATIONALE Alcohol use disorder (AUD) is associated with steeper delay discounting rates; however, it is unknown whether substance co-use, particularly cannabis use, has an additive effect on discounting rates among heavy drinkers. Furthermore, it is unclear whether substance co-use and delay discounting are independently associated with AUD severity. OBJECTIVES The purpose of this study was to determine whether alcohol, tobacco, and cannabis co-use impacts delay discounting rates. We also sought to determine whether substance co-use and delay discounting were associated with AUD symptom counts. METHODS The study sample was culled from several human laboratory studies and consisted of 483 heavy drinking individuals who completed a baseline visit (prior to experimental procedures). Participants were divided into groups based on self-reported alcohol, tobacco, and cannabis use during the past 30 days: alcohol only (n = 184), alcohol + cigarettes (n = 89), alcohol + cannabis (n = 82), and tri-use (n = 128). We examined discounting rates across the 4 groups and used multiple linear regression to test whether co-use and delay discounting were associated with AUD symptoms. RESULTS After adjusting for covariates, individuals in the alcohol + cannabis group and the tri-use group had steeper discounting rates relative to the alcohol-only group. In addition, tri-use and delay discounting rates were independently correlated with a greater number of AUD symptoms. CONCLUSIONS Delay discounting rates were significantly greater among subgroups reporting cannabis use providing partial support for an additive effect, while also highlighting the importance of co-use substance type. Both tri-use and delay discounting were associated with greater AUD severity, which may provide relevant intervention targets.
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Affiliation(s)
- Steven J Nieto
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Alexandra Venegas
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Elizabeth M Burnette
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
- Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - James MacKillop
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Lara A Ray
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
- Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
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20
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Naudé GP, Reed DD, Jarmolowicz DP, Martin LE, Fox AT, Strickland JC, Johnson MW. Single- and cross-commodity discounting among adults who use alcohol and cannabis: Associations with tobacco use and clinical indicators. Drug Alcohol Depend 2021; 229:109082. [PMID: 34634563 DOI: 10.1016/j.drugalcdep.2021.109082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/28/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Delay discounting assessments typically involve choices between an immediate outcome and a larger amount of the same outcome after a delay. Real-world choices, however, more often involve qualitatively different alternatives. The primary aim of this study was to examine single- and cross-commodity discounting of money, alcohol, and cannabis, along with clinical measures of alcohol and cannabis use among people who use both alcohol and cannabis, yet differ in tobacco cigarette smoking status (i.e., dual- versus tri-use). METHODS An online crowdsourced sample (N = 318) of people who reported using alcohol and cannabis in the past week completed single- and cross-commodity discounting assessments across each combination of money, alcohol, and cannabis. We recruited a balanced number of people who did and did not also use tobacco cigarettes and examined associations between discounting, tobacco use, and clinical indicators. RESULTS People who reported using tobacco cigarettes in addition to alcohol and cannabis tended to engage in significantly higher rates of harmful alcohol and cannabis use than those who reported using only alcohol and cannabis. Cross-commodity discounting was significantly associated with patterns of harmful alcohol and cannabis use while no associations emerged for single-commodity discounting. CONCLUSIONS Cross-commodity discounting provides a nuanced account of intertemporal choice by incorporating relative commodity valuation and appears to characterize harmful alcohol and cannabis use more clearly than single-commodity arrangements. Further cross-commodity research is needed to better understand the interplay between temporal location and relative commodity value among people who use multiple substances.
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Affiliation(s)
- Gideon P Naudé
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA.
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - David P Jarmolowicz
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Laura E Martin
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA; Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Andrew T Fox
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA; Division of Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, KS, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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21
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Cannabis Use, Age of Initiation, and Neurocognitive Performance: Findings from a Large Sample of Heavy Drinking Emerging Adults. J Int Neuropsychol Soc 2021; 27:533-545. [PMID: 34261551 DOI: 10.1017/s1355617721000618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the associations between cannabis use and neurocognitive functioning, including self-reported attention deficit hyperactivity disorder (ADHD) symptoms, in a large sample of emerging adults (ages 21-25) using a cross-sectional design. A secondary objective was to examine age of cannabis initiation as a moderator. METHODS Participants were high-risk drinking emerging adults (n = 598) reporting past-month cannabis use in the following categories: 1) non-users (i.e., never or not in the past month; n = 276), 2) occasional users (i.e., monthly or weekly users; n = 201), and 3) daily users (n = 121). Categorical comparisons were conducted on working memory, attention, behavioral inhibition, delay and probability discounting, verbal intelligence, and ADHD symptoms. Complementary dimensional analyses examined cannabis severity in relation to neurocognition using regressions. Covariates were age, race, sex, income, years of education, tobacco use, and alcohol use. RESULTS Frequency of cannabis use was significantly associated with poorer working memory performance, more impulsive delay discounting, and greater endorsement of ADHD symptoms, but not other domains. Effect sizes were small and poorer performance was selectively present among daily, not occasional, cannabis users. Earlier age of initiation was not independently or interactively associated with neurocognitive performance. CONCLUSIONS Daily cannabis use was selectively adversely associated with aspects of memory, impulsivity, and subjective attentional functioning, but most cognitive indicators were not implicated, and evidence of amplification by earlier age of initiation was not observed. Ascertaining causal versus consequential roles of cannabis in neurocognitive functioning is an important priority.
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22
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Sobolev M, Vitale R, Wen H, Kizer J, Leeman R, Pollak JP, Baumel A, Vadhan NP, Estrin D, Muench F. The Digital Marshmallow Test (DMT) Diagnostic and Monitoring Mobile Health App for Impulsive Behavior: Development and Validation Study. JMIR Mhealth Uhealth 2021; 9:e25018. [PMID: 33480854 PMCID: PMC7837672 DOI: 10.2196/25018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/29/2020] [Accepted: 12/07/2020] [Indexed: 12/26/2022] Open
Abstract
Background The classic Marshmallow Test, where children were offered a choice between one small but immediate reward (eg, one marshmallow) or a larger reward (eg, two marshmallows) if they waited for a period of time, instigated a wealth of research on the relationships among impulsive responding, self-regulation, and clinical and life outcomes. Impulsivity is a hallmark feature of self-regulation failures that lead to poor health decisions and outcomes, making understanding and treating impulsivity one of the most important constructs to tackle in building a culture of health. Despite a large literature base, impulsivity measurement remains difficult due to the multidimensional nature of the construct and limited methods of assessment in daily life. Mobile devices and the rise of mobile health (mHealth) have changed our ability to assess and intervene with individuals remotely, providing an avenue for ambulatory diagnostic testing and interventions. Longitudinal studies with mobile devices can further help to understand impulsive behaviors and variation in state impulsivity in daily life. Objective The aim of this study was to develop and validate an impulsivity mHealth diagnostics and monitoring app called Digital Marshmallow Test (DMT) using both the Apple and Android platforms for widespread dissemination to researchers, clinicians, and the general public. Methods The DMT app was developed using Apple’s ResearchKit (iOS) and Android’s ResearchStack open source frameworks for developing health research study apps. The DMT app consists of three main modules: self-report, ecological momentary assessment, and active behavioral and cognitive tasks. We conducted a study with a 21-day assessment period (N=116 participants) to validate the novel measures of the DMT app. Results We used a semantic differential scale to develop self-report trait and momentary state measures of impulsivity as part of the DMT app. We identified three state factors (inefficient, thrill seeking, and intentional) that correlated highly with established measures of impulsivity. We further leveraged momentary semantic differential questions to examine intraindividual variability, the effect of daily life, and the contextual effect of mood on state impulsivity and daily impulsive behaviors. Our results indicated validation of the self-report sematic differential and related results, and of the mobile behavioral tasks, including the Balloon Analogue Risk Task and Go-No-Go task, with relatively low validity of the mobile Delay Discounting task. We discuss the design implications of these results to mHealth research. Conclusions This study demonstrates the potential for assessing different facets of trait and state impulsivity during everyday life and in clinical settings using the DMT mobile app. The DMT app can be further used to enhance our understanding of the individual facets that underlie impulsive behaviors, as well as providing a promising avenue for digital interventions. Trial Registration ClinicalTrials.gov NCT03006653; https://www.clinicaltrials.gov/ct2/show/NCT03006653
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Affiliation(s)
- Michael Sobolev
- Cornell Tech, Cornell University, New York City, NY, United States.,Feinstein Institute for Medical Research, Northwell Health, Great Neck, NY, United States
| | - Rachel Vitale
- The Partnership to End Addiction, New York, NY, United States
| | - Hongyi Wen
- Cornell Tech, Cornell University, New York City, NY, United States
| | - James Kizer
- Cornell Tech, Cornell University, New York City, NY, United States
| | - Robert Leeman
- College of Health and Human Performance, Department of Health Education and Behavior, University of Florida, Gainsville, FL, United States
| | - J P Pollak
- Cornell Tech, Cornell University, New York City, NY, United States
| | | | - Nehal P Vadhan
- Feinstein Institute for Medical Research, Northwell Health, Great Neck, NY, United States
| | - Deborah Estrin
- Cornell Tech, Cornell University, New York City, NY, United States
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23
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Sofis MJ, Borodovsky JT, Pike CK, Liu L, Jacobson NC, Budney AJ. Sifting through the weeds: Relationships between cannabis use frequency measures and delay discounting. Addict Behav 2021; 112:106573. [PMID: 32805539 DOI: 10.1016/j.addbeh.2020.106573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/27/2020] [Accepted: 07/21/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Delay Discounting (DD) relates to more frequent cannabis use, but results are variable, potentially because of variations in whether integrated or single-item measures are used, and whether the timeframe of measures is narrow or broad. Explicating the relationship between DD and cannabis use may result from comparing use indices that vary on these characteristics. METHODS This online study of current cannabis users (n = 1,800) assessed DD and three cannabis use frequency items: number of days of use in the past month, times used per day, and weekly-monthly use. A fourth index derived with Latent Class Analysis (LCA) integrated days per month and times per day to try to better characterize frequency patterns. Effect sizes reflecting relations between cannabis use frequency indices and DD were compared. RESULTS Three frequency classes emerged from the LCA (Low-Moderate-High). DD was significantly associated with times per day (r = 0.11, d = 0.21), days of use (r = 0.09, d = 0.18), and the LCA index (r = 0.06, d = 0.13), but not weekly-monthly use (r = 0.04, d = 0.09). Times per day was more strongly related to DD than LCA classes (p < 0.01) and weekly-monthly use (p < 0.05), but not days of use (p = 0.66). Days of use exhibited a stronger relationship with DD than weekly-monthly use (p < 0.001), but not LCA classes (p = 0.06). CONCLUSIONS Cannabis use frequency measures with narrower timeframes may demonstrate stronger positive relationships to DD. The LCA index did not improve the relationship between frequency and DD, potentially because of shared variance between use days and times per day. Specific characteristics of cannabis use frequency may be particularly indicative of excessive DD.
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24
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Assari S. Social Determinants of Delayed Gratification among American Children. CASPIAN JOURNAL OF NEUROLOGICAL SCIENCES 2020; 6:181-189. [PMID: 33215045 DOI: 10.32598/cjns.6.22.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A wide array of socioeconomic status (SES) indicators tend to show differential effects for members of diverse social groups. Limited knowledge exists on ethnic variation in the effects of family income on delay discounting which is predictor of risk behaviors. OBJECTIVES This study tested whether the effect of family income on delayed gratification differs between Latino and non-Latino children. METHODS AND MATERIALS In this cross-sectional analytical study, data came from wave one of the Adolescent Brain Cognitive Development (ABCD) study which included 3903 non-Latino or Latino Black or White American children between ages 9 and 10 years old. The predictor was family income. Data were collected in 21 sits in the US in 2018. The outcome was children's delay discounting. We measured delay discounting, which reflected individuals' tendency to assign less value to remote outcomes and rewards (inversely correlated with delayed gratification). Using SPSS 22.0, linear regression was used for data analysis. RESULTS According to our pooled sample regression, higher family income was associated with lower children delay discounting (Beta= -0.05, p = .021). We found a significant interaction between family income and ethnicity, suggesting that the association between family income and delay discounting is stronger for Latino than non-Latino children (Beta= -0.09, p = .043). CONCLUSIONS Not all ethnic disparities are due to SES gaps; differential returns of socioeconomic status indicators, such as family income, across diverse social groups also contribute to ethnic disparities in health.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University, Los Angeles, CA 90059, USA
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