Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA.
Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Biomedical Statistics, University of Vermont, Burlington, VT, USA.
Prev Med. 2024 Nov;188:108093. doi: 10.1016/j.ypmed.2024.108093. Epub 2024 Aug 22.
Low loss aversion (LA) and high delay discounting (DD) are behavioral-economic decision-making biases that independently predict cigarette smoking and other risky substance use. Here we examine (1) whether low-LA and high-DD co-occur, (2) does co-occurrence increase the odds of current smoking and other substance use compared to only low-LA, high-DD, or neither; and (3) potential gender differences in these associations.
Data are from five studies with U.S. adults who currently smoked or never-smoked cigarettes recruited using online convenience sampling matching on gender and education. Participants completed identical sociodemographic, substance use (cigarette, other drugs, alcohol), and LA (hypothetical 50-50 gambles) and DD (monetary-choice questionnaire) measures. LA and DD scores were dichotomized as low and high using Receiver-Operating-Characteristic Curve logistic regression.
LA and DD each independently predicted substance use and with few exceptions were not influenced by gender. Low-LA compared to high-LA predicted two-fold greater odds of co-occurring high-DD (AOR = 2.120, 95%CI:1.749-2.571, p < .0001). Similarly, high-DD compared to low DD predicted two-fold greater odds of low-LA (AOR = 2.118, 95%CI:1.747-2.568, p < .0001). Among those with co-occurring low-LA and high-DD, odds of substance use were 5-10 times greater than those exhibiting neither, and 2-3 times greater than those exhibiting only low-LA or high-DD.
Low-LA and high-DD cluster in women and men such that exhibiting one of these decision-making biases doubles the odds of exhibiting the other. These results demonstrate reliable clustering of low-LA and high-DD and a striking increase in risk for substance use relative to having only one or neither decision-making bias.
低损失厌恶（LA）和高延迟折扣（DD）是行为经济学决策偏差，它们独立预测吸烟和其他危险物质的使用。在这里，我们研究了（1）低 LA 和高 DD 是否同时发生，（2）与仅低 LA、高 DD 或两者都没有相比，同时发生是否会增加当前吸烟和其他物质使用的几率；（3）这些关联在性别上的潜在差异。
数据来自五项研究，这些研究在美国成年人群中进行，他们通过在线便利抽样，按照性别和教育程度进行匹配，招募了当前吸烟或从不吸烟的成年人。参与者完成了相同的社会人口统计学、物质使用（香烟、其他毒品、酒精）、LA（假设的 50-50 赌博）和 DD（货币选择问卷）测量。使用接收器操作特征曲线逻辑回归将 LA 和 DD 评分分为低和高两类。
LA 和 DD 各自独立预测物质使用，除了少数例外，不受性别影响。与高 LA 相比，低 LA 预测同时存在高 DD 的几率增加一倍（AOR=2.120，95%CI：1.749-2.571，p<0.0001）。同样，与低 DD 相比，高 DD 预测低 LA 的几率增加一倍（AOR=2.118，95%CI：1.747-2.568，p<0.0001）。在同时存在低 LA 和高 DD 的人群中，物质使用的几率是既不表现出这两种决策偏差的几率的 5-10 倍，是仅表现出低 LA 或高 DD 的几率的 2-3 倍。
低 LA 和高 DD 在女性和男性中聚集，表现出其中一种决策偏差的几率增加一倍，表现出另一种决策偏差的几率增加一倍。这些结果表明，低 LA 和高 DD 确实存在聚类，并且与仅有一种或两种决策偏差相比，物质使用的风险显著增加。
