Department of Psychiatry, Yale University School of Medicine, One Long Wharf Drive, Box 18, New Haven, CT 06511, USA.
Exp Clin Psychopharmacol. 2013 Feb;21(1):46-54. doi: 10.1037/a0030943. Epub 2012 Dec 17.
Delay discounting is an index of impulsive decision-making and reflects an individual's preference for smaller immediate rewards relative to larger delayed rewards. Multiple studies have indicated comparatively high rates of discounting among tobacco, alcohol, cocaine, and other types of drug users, but few studies have examined discounting among marijuana users. This report is a secondary analysis of data from a clinical trial that randomized adults with marijuana dependence to receive one of four treatments that involved contingency management (CM) and cognitive-behavioral therapy interventions. Delay discounting was assessed with the Experiential Discounting Task (Reynolds & Schiffbauer, 2004) at pretreatment in 93 participants and at 12 weeks posttreatment in 61 participants. Results indicated that higher pretreatment delay discounting (i.e., more impulsive decision-making) significantly correlated with lower readiness to change marijuana use (r = -0.22, p = .03) and greater number of days of cigarette use (r = .21, p = .04). Pretreatment discounting was not associated with any marijuana treatment outcomes. CM treatment significantly interacted with time to predict change in delay discounting from pre- to posttreatment; participants who received CM did not change their discounting over time, whereas those who did not receive CM significantly increased their discounting from pre- to posttreatment. In this sample of court-referred young adults receiving treatment for marijuana dependence, delay discounting was not strongly related to treatment outcomes, but there was some evidence that CM may protect against time-related increases in discounting.
延迟折扣是冲动决策的一个指标，反映了个体对较小即时奖励相对于较大延迟奖励的偏好。多项研究表明，烟草、酒精、可卡因和其他类型的药物使用者的折扣率相对较高，但很少有研究检查大麻使用者的折扣率。本报告是对一项临床试验数据的二次分析，该试验将有大麻依赖的成年人随机分为四组，分别接受包含效价管理（CM）和认知行为疗法干预的四种治疗方法之一。在 93 名参与者的治疗前和 61 名参与者的治疗后 12 周，使用经验折扣任务（Reynolds 和 Schiffbauer，2004）评估了延迟折扣。结果表明，较高的治疗前延迟折扣（即更冲动的决策）与较低的改变大麻使用意愿（r = -0.22，p =.03）和更高的吸烟天数（r =.21，p =.04）显著相关。治疗前的折扣与任何大麻治疗结果均无关。CM 治疗与时间显著交互，预测从治疗前到治疗后的延迟折扣变化；接受 CM 治疗的参与者在治疗期间没有改变他们的折扣率，而没有接受 CM 治疗的参与者则从治疗前到治疗后显著增加了他们的折扣率。在这个接受治疗的法庭转介的年轻成年人样本中，延迟折扣与治疗结果的相关性不强，但有一些证据表明 CM 可能可以防止折扣率随时间的增加。
