Delay discounting predicts adolescent substance abuse treatment outcome.

Abstract

The purpose of the current study was to identify predictors of delay discounting among adolescents receiving treatment for marijuana abuse or dependence, and to test delay discounting as a predictor of treatment outcome. Participants for this study were 165 adolescents (88% male) between the ages of 12 and 18 (M =15.8; SD = 1.3) who enrolled in a clinical trial comparing three behavioral treatments for adolescent marijuana abuse or dependence. Participants completed a delay discounting task at treatment onset for $100 and $1,000 of hypothetical money and marijuana. Overall, smaller magnitude rewards were discounted more than larger magnitude rewards. Delay discounting rates were concurrently related to demographic variables (SES, race). Delay discounting of $1,000 of money predicted during treatment abstinence outcomes among adolescent marijuana abusers, over and above the effects of type of treatment received. Teens who show higher levels of discounting of the future may be an important subgroup to identify at treatment onset. Youth with a greater tendency to discount the future may require different intervention strategies that address their impulsivity (e.g., targeting executive function or inhibitory control) and/or different schedules of reinforcement to address their degree of preference for immediate rewards.

Impulsivity as a vulnerability factor for poor addiction treatment outcomes: A review of neurocognitive findings among individuals with substance use disorders

“…Indeed, a comprehensive assessment including neurocognitive tasks indexing different aspects of impulsivity within the same sample may help to clarify which dimensions are more important to certain outcomes than others. However, the majority of studies selected for this review (n=16) measured only one neurocognitive dimension of impulsivity (Black & Rosen, 2011;Bowden-Jones et al, 2005;Brewer et al, 2008;Carpenter et al, 2006;Cox et al, 2002;Janes et al, 2010;Marissen et al, 2006;Peters et al, 2013;Stanger et al, 2012;Streeter et al, 2008;Washio et al, 2011;Waters et al, 2003;Winhusen et al, 2013;Yoon et al, 2007). In contrast, only six studies assessed two neurocognitive dimensions of impulsivity De Wilde et al, 2013;Mueller et al, 2009;Schmitz et al, 2009; and even a smaller number of studies (n=3) used a test battery indexing three different impulsivity domains Sheffer et al, 2012) (see Table 1).…”

“…A number of studies investigated the effect of impulsivity on abstinence/relapse during treatment Schmitz et al, 2009;Stanger et al, 2012), whereas others looked at the relationship between impulsivity and post-treatment abstinence/relapse (De Marissen et al, 2006). Because the processes controlling the vulnerability to relapse may be different during and after treatment , variability between studies with respect to the time of assessment may have contributed to inconsistent findings.…”

“…Finally, two studies examined the relationship between pretreatment levels of delay discounting and treatment outcomes in marijuana users Stanger et al, 2012). In the first of these studies, steeper levels of delay discounting at treatment onset predicted shorter periods and lower levels of abstinence among adolescents enrolled in a behavioral treatment for marijuana abuse/dependence .…”

“…Six of the 25 selected studies were conducted among primary cocaine users (Black & Rosen, 2011;Brewer, Worhunsky, Carroll, Rounsaville, & Potenza, 2008;Schmitz et al, 2009;Streeter et al, 2008;Washio et al, 2011), three among primary opiate users Passetti et al, 2008Passetti et al, , 2011, three among primary alcohol users Cox et al, 2002;De Wilde et al, 2013), eight among primary nicotine users Janes et al, 2010;Mueller et al, 2009;Sheffer et al, 2012;Waters et al, 2003;Yoon et al, 2007) and two among primary marijuana users (Peters, Petry, Lapaglia, Reynolds, & Carroll, 2013;Stanger et al, 2012). One study examined the relationship between impulsivity and treatment outcomes within a heterogeneous sample of drug users, consisting of cocaine, heroin and marijuana dependent subjects (Carpenter, Schreiber, Church, & McDowell, 2006).…”

Application of environmental sensitivity theories in personalized prevention for youth substance abuse: a transdisciplinary translational perspective

“…The panel of RS variables includes indices of socioeconomic status, preintervention measures of drug use cognitions, and level of drug involvement. Also included is a delay discounting task, a measure of impulsive decision-making and predictor of substance abuse, which has been shown to moderate substance use interventions [61]. Our ES factors include dopaminergic gene variants (combined as a genetic sensitivity score), the Highly Sensitive Child Questionnaire [49], and the post-auricular reflex (PAR, a novel physiological marker of ES).…”