Lee Dustin C, Stanger Catherine, Budney Alan J
Department of Psychiatry, Geisel School of Medicine at Dartmouth.
Exp Clin Psychopharmacol. 2015 Apr;23(2):130-7. doi: 10.1037/a0038792. Epub 2015 Feb 2.
Delay discounting is associated with problematic substance use and poorer treatment outcomes in adolescents and adults with substance use disorders. Although some research has addressed delay discounting among individuals with cannabis use disorders (CUDs), results have been equivocal, and no study has examined whether discounting rates differ between adolescent and adult cannabis users. The aim of this study was to compare discounting rates between adolescents and adults in treatment for CUD to determine whether discounting at intake or changes in discounting across treatment differed between age groups. Participants were 165 adolescents and 104 adults enrolled in treatment for CUD. Participants completed a delay discounting task at intake and end of treatment for 2 commodities (money and cannabis) at 2 different magnitudes ($100 and $1,000). Repeated measures mixed models examined differences in discounting rates by commodity and magnitude across age groups at intake and changes in discounting across treatment. At intake, adolescents discounted money more than adults whereas adults showed greater discounting at $100 magnitude than $1,000. In addition, adults had greater decreases in discounting of cannabis over the course of treatment. Overall, adolescents appeared less sensitive to changes in magnitude of rewards, discounted money at higher rates, and showed less improvement in discounting over the course of treatment compared to adults. Comparing delay discounting in adolescents and adults with CUD can contribute to a better understanding of how development influences the effect of discounting on substance use to better inform treatment for substance use disorders.
延迟折扣与患有物质使用障碍的青少年和成年人的问题性物质使用及较差的治疗结果相关。尽管一些研究探讨了患有大麻使用障碍(CUD)的个体中的延迟折扣问题,但结果并不明确,且尚无研究考察青少年和成年大麻使用者的折扣率是否存在差异。本研究的目的是比较接受CUD治疗的青少年和成年人的折扣率,以确定入组时的折扣率或整个治疗过程中折扣率的变化在不同年龄组之间是否存在差异。参与者为165名青少年和104名接受CUD治疗的成年人。参与者在入组时和治疗结束时针对两种商品(金钱和大麻)、两种不同金额(100美元和1000美元)完成了一项延迟折扣任务。重复测量混合模型考察了入组时不同年龄组按商品和金额划分的折扣率差异以及整个治疗过程中折扣率的变化。入组时,青少年对金钱的折扣高于成年人,而成年人在100美元金额时的折扣高于1000美元时。此外,成年人在治疗过程中大麻折扣的下降幅度更大。总体而言,与成年人相比,青少年似乎对奖励金额变化的敏感度较低,对金钱的折扣率较高,且在治疗过程中折扣率的改善较小。比较患有CUD的青少年和成年人的延迟折扣有助于更好地理解发育如何影响折扣对物质使用的作用,从而为物质使用障碍的治疗提供更充分的信息。