Impulsivity and polysubstance use: A systematic comparison of delay discounting in mono-, dual-, and trisubstance use.
Impulsivity and polysubstance use: A systematic comparison of delay discounting in mono-, dual-, and trisubstance use.
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DOI：
10.1037/pha0000059
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发表时间：
2016-02
影响因子：
2.3
通讯作者：
Bickel WK
中科院分区：
文献类型：
--
作者：
Moody L;Franck C;Hatz L;Bickel WK
了解多物质使用和冲动之间的关联与治疗计划和疗效有关。延迟贴现是一种衡量冲动性的方法，它提供了随着接收时间延迟的增加，一个购买者失去价值的比率。过度延迟折扣已被广泛观察到在使用药物的个人;虽然，使用一种以上的物质的影响，只有很少的研究。在这里，在控制人口统计学变量后，我们系统地比较了社区控制、重度吸烟者、酒精依赖者和可卡因依赖者的延迟折扣，以评估非、单、双和三种物质使用的影响。所有物质使用组的折扣显著高于社区对照组（p < 0.05）。此外，吸烟和另一种物质依赖的组比单独吸烟的组显著降低（p < 0.05）。三种物质使用者中，酒精依赖者、可卡因依赖者和重度吸烟者的折扣显著高于重度吸烟者（p < 0.01）。然而，三物质使用者的折扣并不比任何双重物质组多。三种物质的使用与更大的冲动性比单一物质吸烟，但没有更大的冲动性比双物质的用户，这表明一个上限效应折扣时，两种以上的物质在使用中。目前的研究表明，吸烟者谁从事额外的物质使用可能会遇到更糟糕的治疗结果，因为过度折扣是预测不良的治疗结果在几项研究。
Understanding the association between polysubstance use and impulsivity is pertinent to treatment planning and efficacy. Delay discounting, a measure of impulsivity, supplies the rate at which a reinforcer loses value as the temporal delay to its receipt increases. Excessive delay discounting has been widely observed among drug using individuals; though, the impact of using more than one substance has been only minimally studied. Here, after controlling for demographic variables, we systematically compare delay discounting in community controls, heavy smokers, alcohol-dependent, and cocaine-dependent individuals to assess the impact of non-, mono-, dual-, and tri-substance use. All substance-using groups discount significantly more than community controls (p < 0.05). Additionally, groups that smoke cigarettes in addition to another substance dependency discount significantly more than cigarette smoking alone (p < 0.05). Lastly, tri-substance users who were alcohol-dependent, cocaine-dependent and heavy cigarette smokers discount significantly more than heavy smokers (p < 0.01). However, tri-substance users do not discount significantly more than any dual-substance group. Tri-substance use is associated with greater impulsivity than mono-substance smoking, but no greater impulsivity than dual-substance users, suggesting a ceiling effect on discounting when more than two substances are in use. The present study suggests that smokers who engage in additional substance use may experience worse treatment outcomes given that excessive discounting is predictive of poor therapeutic outcomes in several studies.