Insights from behavioral economics to characterize substance use involvement in adolescentsa cluster analysis

  1. Alba González-Roz 1
  2. Itziar Suárez-Martínez 1
  3. Gema Aonso-Diego 1
  4. Víctor Martínez-Loredo 1
  5. Roberto Secades-Villa 1
  1. 1 Universidad de Oviedo
    info

    Universidad de Oviedo

    Oviedo, España

    ROR https://ror.org/006gksa02

Revista:
Revista de Psicología Clínica con Niños y Adolescentes

ISSN: 2340-8340

Año de publicación: 2021

Volumen: 8

Número: 2

Páginas: 37-43

Tipo: Artículo

Otras publicaciones en: Revista de Psicología Clínica con Niños y Adolescentes

Resumen

La economía conductual para caracterizar el uso de drogas en adolescentes: análisis de cluster. La patología del refuerzo (PR), basada en la economía conductual, ha contribuido al avance de la etiología y el tratamiento de drogas. La demanda y el descuento por demora (DD) informan sobre el incremento en el consumo y los objetivos de tratamiento. Ningún estudio realizado en España ha examinado la interacción entre ambas variables en adolescentes. Los objetivos fueron: 1) identificar si el DD y la demanda de alcohol pueden identificar distintos subgrupos y, 2) examinar sus diferencias en el consumo de sustancias. La muestra incluyó 107 (% mujeres = 54,2) adolescentes (M =15,46, DT =1,25) de enseñanza obligatoria en Asturias (España). Se evaluó el consumo de drogas en los últimos 30 días y el último año. El poder reforzante del alcohol se evaluó mediante una tarea de compra de 20 ítems (APT). La toma de decisiones impulsiva se evaluó mediante el Cuestionario de Elección Monetaria. Se identificaron dos subgrupos: Grupo 1 (n = 72) y Grupo 2 (n = 35). El Grupo 2 mostró una demanda e impulsividad más elevada, indicando menor sensibilidad a incrementos en el precio. Comparado con el Grupo 1, el 2 obtuvo una prevalencia más elevada de consumo en el último mes [G1: 26/72 (36,1%) vs. G2: 33/35 (94,3%), p <,001], mayor frecuencia de borracheras (p <,001) y episodios de consumo intensivo de alcohol (p <,001). La PR permite caracterizar e identificar grupos con distintos patrones de consumo de sustancias. La existencia de distintos perfiles debería ser considerada a la hora de desarrollar políticas preventivas.

Referencias bibliográficas

  • Acuff, S. F., Amlung, M., Dennhardt, A. A., MacKillop, J., & Murphy, J. G. (2020). Experimental manipulations of behavioral economic demand for addictive commodities: a meta-analysis. Addiction, 115(5), 817-831. https://doi.org/10.1111/add.14865
  • Acuff, S. F., Soltis, K. E., Dennhardt, A. A., Berlin, K. S., & Murphy, J. G. (2018). Evaluating behavioral economic models of heavy drinking among college students. Alcoholism, Clinical and Experimental Research, 42(7), 1304–1314. doi: https://doi.org/10.1111/acer.13774
  • Amlung, M., MacKillop, J., Monti, P. M., & Miranda, R. (2017). Elevated behavioral economic demand for alcohol in a community sample of heavy drinking smokers. Journal of Studies on Alcohol and Drugs, 78(4), 623–628. https://doi.org/10.15288/jsad.2017.78.623
  • Audrain-McGovern, J., Rodriguez, D., Epstein, L. H., Cuevas, J., Rodgers, K., & Wileyto, E. P. (2009). Does delay discounting play an etiological role in smoking or is it a consequence of smoking? Drug and Alcohol Dependence, 103(3), 99–106. https://doi.org/10.1016/j.drugalcdep.2008.12.019
  • Bandara, N., Wanniarachchi, S., & Mehrnoush, V. (2020). Evidence-based tobacco-control legislation on e-cigarettes is urgently needed. Canadian Medical Association Journal, 192(3), E74. https://doi.org/10.1503/cmaj.73819
  • Bickel, W. K., Jarmolowicz, D. P., Mueller, E. T., & Gatchalian, K. M. (2011). The behavioral economics and neuroeconomics of reinforcer pathologies: implications for etiology and treatment of addiction. Current Psychiatry Reports, 13(5), 406–415. https://doi.org/10.1007/s11920-011-0215-1
  • Bickel, W. K., Johnson, M. W., Koffarnus, M. N., MacKillop, J., & Murphy, J. G. (2014). The behavioral economics of substance use disorders: reinforcement pathologies and their repair. Annual Review of Clinical Psychology, 10(1), 641–677. https://doi.org/10.1146/annurev-clinpsy-032813-153724
  • Buscemi, J., Acuff, S. F., Minhas, M., MacKillop, J., & Murphy, J. G. (2021). Identifying patterns of alcohol use and obesity related factors among emerging adults: a behavioral economic analysis. Alcoholism: Clinical and Experimental Research. Advance online publication. https://doi. org/10.1111/acer.14569
  • Cassidy, R. N., Aston, E. R., Tidey, J. W., & Colby, S. M. (2020). Behavioral economic demand and delay discounting are differentially associated with cigarette dependence and use in adolescents. Addictive Behaviors, 103,106225. https://doi.org/10.1016/j.addbeh.2019.106225
  • Cassidy, R. N., Bernstein, M. H., Magill, M., MacKillop, J., Murphy, J. G., & Colby, S. M. (2019). Alcohol demand moderates brief motivational intervention outcomes in underage young adult drinkers. Addictive Behaviors, 98, 106044. https://doi.org/10.1016/j.addbeh.2019.106044
  • Donoghue, K., Rose, H., Boniface, S., Deluca, P., Coulton, S., Alam, M. F., Gilvarry, E., Kaner, E., Lynch, E., Maconochie, I., McArdle, P., McGovern, R., Newbury-Birch, D., Patton, R., Phillips, C. J., Phillips, T., Russell, I., Strang, J., & Drummond, C. (2017). Alcohol consumption, early-onset drinking, and health-related consequences in adolescents presenting at emergency departments in England. Journal of Adolescent Health, 60(4), 438–446. https://doi.org/10.1016/j.jadohealth.2016.11.017
  • Daugherty, J. R., & Brase, G. L. (2010). Taking time to be healthy: Predicting health behaviors with delay discounting and time perspective. Personality and Individual Differences, 48, 202–207. https://doi.org/10.1016/j. paid.2009.10.007
  • Dougherty, D., Charles, N., Mathias, C., Ryan, S., Olvera, R., Lian, Y., & Acheson, A. (2014). Delay discounting differentiates pre-adolescents at high and low risk for substance use disorders based on family history. Drug and Alcohol Dependence, 143, 105–111. https://doi.org/10.1016/j. drugalcdep.2014.07.012
  • Fernie, G., Peeters, M., Gullo, M. J., Christiansen, P., Cole, J. C., Sumnall, H., & Field, M. (2013). Multiple behavioural impulsivity tasks predict prospective alcohol involvement in adolescents. Addiction, 108(11), 1916–1923. https://doi.org/10.1111/add.12283
  • Field, M., Heather, N., Murphy, J. G, Stafford, T., Tucker, J., & Witkiewitz, K. (2020). Recovery from addiction: behavioral economics and value-based decision-making. Psychology of Addictive Behaviors, 34(1), 182-193. doi: https://doi.org/10.31234/OSF.IO/RFJWU
  • González-Roz, A., García-Pérez, Á., Weidberg, S., Aonso-Diego, G., & Secades-Villa, R. (2019). Reinforcer pathology and response to contingency management for smoking cessation. Psychology of Addictive Behaviors, 34(1), 156-163. https://doi.org/10.1037/adb0000500
  • González-Roz, A., Jackson, J., Murphy, C., Rohsenow, D. J., & MacKillop, J. (2019). Behavioral economic tobacco demand in relation to cigarette consumption and nicotine dependence: a meta-analysis of cross-sectional relationships. Addiction 114(11), 1926-1940. https://doi.org/10.1111/add.14736
  • González-Roz, A., Secades-Villa, R., Martínez-Loredo, V., & Fernández-Hermida, J. R (2020). Aportaciones de la economía conductual a la evaluación, la prevención y el tratamiento psicológico en adicciones. Papeles del Psicólogo, 41(2), 91-98. https://doi.org/10.23923/pap.psicol2020.2922
  • Joyner, K. J., Meshesha, L. Z., Dennhardt, A. A., Borsari, B., Martens, M. P., & Murphy, J. G. (2019). High opportunity cost demand as an indicator of weekday drinking and distinctly severe alcohol problems: a behavioral economic analysis. Alcoholism, Clinical and Experimental Research, 43(12), 2607–2619. https://doi.org/10.1111/acer.14206
  • Kaplan, B. A., Amlung, M., Reed, D. D., Jarmolowicz, D. P., McKerchar, T. L., & Lemley, S. M. (2016). Automating scoring of delay discounting for the 21- and 27-item monetary choice questionnaires. Behavior Analyst, 39(2), 293–304. https://doi.org/10.1007/s40614-016-0070-9
  • Keyes, K. M., Rutherford, C., & Miech, R. (2020). Historical trends in the grade of onset and sequence of cigarette, alcohol, and marijuana use among adolescents from 1976-2016: implications for “Gateway” patterns in adolescence. Drug and Alcohol Dependence, 194, 51–58. https://doi. org/10.1016/j.drugalcdep.2018.09.015
  • Khurana, A., Romer, D., Betancourt, L. M., Brodsky, N. L., Giannetta, J. M., & Hurt, H. (2015). Experimentation versus progression in adolescent drug use: a test of an emerging neurobehavioral imbalance model. Development and Psychopathology, 27(3), 901–913. https://doi.org/10.1017/ S0954579414000765
  • Kirby, K. N., & Herrnstein, R. J. (1995). Preference reversals due to myopic discounting of delayed reward. Psychological Science, 6, 83–89. https://doi. org/ 10.2307/40062992
  • Kiselica, A., Webber, T., & Bornovalova, M. (2016). Validity of the alcohol purchase task: a meta-analysis. Addiction, 111(5), 806–816. https://doi. org/10.1111/add.13254
  • Koffarnus, M. N., Franck, C. T., Stein, J. S., & Bickel, W. K. (2015). A modified exponential behavioral economic demand model to better describe consumption data. Experimental and Clinical Psychopharmacology, 23(6), 504-512. https://doi.org/10.1037/pha0000045
  • Krishnan-Sarin, S., Reynolds, B., Duhig, A. M., Smith, A., Liss, T., McFetridge, A., Cavallo, D. A., Carroll, K. M., & Potenza, M. N. (2007). Behavioral impulsivity predicts treatment outcome in a smoking cessation program for adolescent smokers.  Drug and alcohol dependence,  88(1), 79–82. https://doi.org/10.1016/j.drugalcdep.2006.09.006
  • Lemley, S. M., Kaplan, B. A., Reed, D. D., Darden, A. C., & Jarmolowicz, D. P. (2016). Reinforcer pathologies: predicting alcohol related problems in college drinking men and women. Drug and Alcohol Dependence, 167, 57–66. https://doi.org/10.1016/j.drugalcdep.2016.07.025
  • Mackillop, J. (2016). The behavioral economics and neuroeconomics of alcohol use disorders. Alcoholism: Clinical and Experimental Research, 40(4), 672–685. https://doi.org/10.1111/acer.13004
  • Martínez-Loredo, V., González-Roz, A., Secades-Villa, R., Fernández-Hermida, J. R., & MacKillop, J. (2020). Concurrent validity of the Alcohol Purchase Task for measuring the reinforcing efficacy of alcohol: an updated systematic review and meta-analysis. Addiction. Advance online publication. https://doi.org/10.1111/add.15379
  • Martínez-Loredo, V., & Fernández-Hermida, J. R. (2019). Impulsivity-targeted selective preventive interventions and treatments in addictive behaviors. Revista de Psicología Clínica con Niños y Adolescentes, 6(3), 1-7. https:// doi.org/10.21134/rpcna.2019.06.2.4
  • Martínez-Loredo, V., Fernández-Hermida, J. R., De La Torre-Luque, A., & Fernández-Artamendi, S. (2018a). Trajectories of impulsivity by sex predict substance use and heavy drinking. Addictive Behaviors, 85, 164–172. https://doi.org/10.1016/j.addbeh.2018.06.011
  • Martínez-Loredo, V., Fernández-Hermida, J. R., De La Torre-Luque, A., & Fernández-Artamendi, S. (2018b). Polydrug use trajectories and differences in impulsivity among adolescents. International Journal of Clinical and Health Psychology, 18(3), 235–244. https://doi.org/10.1016/j. ijchp.2018.07.003
  • Merrill, J. E., & Aston, E. R. (2020). Alcohol demand assessed daily: Validity, variability, and the influence of drinking-related consequences. Drug and Alcohol Dependence, 208, 107838. https://doi.org/10.1016/j.drugalcdep.2020.107838
  • Minhas, M., Oshri, A., Amlung, M., Dennhardt, A., Ferro, M., Halladay, J., Munn, C., Tucker, J., Murphy, J., & MacKillop, J. (2020). Latent profile analysis of heavy episodic drinking in emerging adults: a reinforcer pathology approach.  Alcoholism, Clinical and Experimental Research,  44(10), 2130–2140. https://doi.org/10.1111/acer.14438
  • Morris, V., Patel, H., Vedelago, L., Reed, D. D., Metrik, J., Aston, E., MacKillop, J., & Amlung, M. (2018). Elevated behavioral economic demand for alcohol in co-users of alcohol and cannabis. Journal of Studies on Alcohol and Drugs, 79(6), 929–934. https://doi.org/10.15288/jsad.2018.79.929
  • Murphy, J. G., Dennhardt, A. A., Yurasek, A. M., Skidmore, J. R., Martens, M. P., MacKillop, J., & McDevitt-Murphy, M. E. (2015). Behavioral economic predictors of brief alcohol intervention outcomes. Journal of Consulting and Clinical Psychology, 83(6), 1033–1043. https://doi.org/10.1037/ccp0000032
  • Murphy, J. G., & MacKillop, J. (2006). Relative reinforcing efficacy of alcohol among college student drinkers. Experimental and Clinical Psychopharmacology, 14(2), 219–227. https://doi.org/10.1037/1064-1297.14.2.219
  • Nighbor, T. D., Zvorsky, I., Kurti, A. N., Skelly, J. M., Bickel, W. K., Reed, D. D., Naudé, G. P., & Higgins, S. T. (2019). Examining interrelationships between the Cigarette Purchase Task and delay discounting among pregnant women. Journal of the Experimental Analysis of Behavior, 111(3), 405–415. https://doi.org/10.1002/jeab.499
  • Phung, Q. H., Snider, S. E., Tegge, A. N., & Bickel, W. K. (2019). Willing to work but not to wait: individuals with greater alcohol use disorder show increased delay discounting across commodities and less effort discounting for alcohol. Alcoholism, Clinical and Experimental Research, 43(5), 927–936. https://doi.org/10.1111/acer.13996
  • Ramirez, J. J., Cadigan, J. M., & Lee, C. M. (2020). Behavioral economic demand for alcohol among young adults who engage in simultaneous alcohol and marijuana use. Substance Abuse, 41(2), 203-207. https://doi. org/10.1080/08897077.2019.1671939
  • Reed, D., Niileksela, C., & Kaplan, B. (2013). Behavioral Economics: a tutorial for behavior analysts in practice. Behavior Analysis in Practice, 6(1), 34–54. https://doi.org/10.1007/BF03391790
  • Reynolds, B. (2006). A review of delay-discounting research with humans: Relations to drug use and gambling. Behavioural Pharmacology, 17, 651–667. https://doi.org/ 10.1097/FBP.0b013e3280115f99
  • Rial, A., Golpe, S., Barreiro, C., Gómez, P., & Isorna, M. (2020). The age of onset for alcohol consumption among adolescents: implications and related variables. Adicciones, 32, 52-62. https://doi.org/10.20882/adicciones.1266 
  • Richardson, C. G., & Edalati, H. (2016). Application of a brief measure of delay discounting to examine the relationship between delay discounting and the initiation of substance use among adolescents. Substance Use and Misuse, 51(4), 540–544. https://doi.org/10.3109/10826084.2015.1126740
  • Roma, P. G., Reed, D. D., DiGennaro Reed, F. D., & Hursh, S. R. (2017). Progress of and prospects for hypothetical purchase task questionnaires in consumer behavior analysis and public policy. Behavior Analyst, 40(2), 329–342. https://doi.org/ 10.1007/s40614-017-0100-2
  • Rung, J. M., & Madden, G. J. (2018). Experimental reductions of delay discounting and impulsive choice: A systematic review and meta-analysis. Journal of Experimental Psychology. General, 147(9), 1349–1381. https:// doi.org/10.1037/xge0000462
  • Scholten, H., Scheres, A., de Water, E., Graf, U., Granic, I., & Luijten, M. (2019). Behavioral trainings and manipulations to reduce delay discounting: a systematic review. Psychonomic Bulletin & Review, 26(6), 1803-1849. https://doi.org/10.3758/s13423-019-01629-2
  • Sheffer, C. E., Christensen, D. R., Landes, R., Carter, L. P., Jackson, L., & Bickel, W. K. (2014). Delay discounting rates: a strong prognostic indicator of smoking relapse. Addictive Behaviors, 39(11), 1682–1689. https://doi. org/10.1016/j.addbeh.2014.04.019
  • Snider, S. E., DeHart, W. B., Epstein, L. H., & Bickel, W. K. (2019). Does delay discounting predict maladaptive health and financial behaviors in smokers? Health Psychology, 38(1), 21–28. https://doi.org/10.1037/hea0000695
  • Sofis, M. J., Budney, A. J., Stanger, C., Knapp, A. A., & Borodovsky, J. T. (2020). Greater delay discounting and cannabis coping motives are associated with more frequent cannabis use in a large sample of adult cannabis users. Drug and Alcohol Dependence, 207, 107820. https://doi.org/10.1016/j. drugalcdep.2019.107820
  • Soneji, S., Barrington-Trimis, J. L., Wills, T. A., Leventhal, A. M., Unger, J. B., Gibson, L. A., Yang, J., Primack, B. A., Andrews, J. A., Miech, R. A., Spindle, T. R., Dick, D. M., Eissenberg, T., Hornik, R. C., Dang, R., & Sargent, J. D. (2017). Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: a systematic review and meta-analysis. JAMA Pediatrics, 171(8), 788–797. https://doi. org/10.1001/jamapediatrics.2017.1488
  • Spear, L. P. (2018). Effects of adolescent alcohol consumption on the brain and behaviour. Nature Reviews Neuroscience, 19(4), 197–214. https://doi. org/10.1038/nrn.2018.10
  • Stein, J. S., Koffarnus, M. N., Snider, S. E., Quisenberry, A. J., & Bickel, W. K. (2015). Identification and management of nonsystematic purchase task data: toward best practice. Experimental and Clinical Psychopharmacology, 23(5), 377-386. https://doi.org/10.1037/pha0000020
  • Strickland, J. C, Alcorn, J. L., & Stoops, W. W. (2019). Using behavioral economic variables to predict future alcohol use in a crowdsourced sample. Journal of Psychopharmacology, 33(7), 779–790. https://doi. org/10.1177/0269881119827800
  • Strickland, J. C., Campbell, E. M., Lile, J. A., & Stoops, W. W. (2019). Utilizing the commodity purchase task to evaluate behavioral economic demand for illicit substances: a review and meta-analysis. Addiction, 115, 393-406. https://doi.org/10.1111/add.14792
  • Tabachnick, B. G., & Fidell, L. S. (2000). Using multivariate statistics. Boston, US: Allyn and Bacon.
  • Verdejo-García, A., Lawrence, A. J., & Clark, L. (2008). Impulsivity as a vulnerability marker for substance-use disorders: review of findings from high-risk research, problem gamblers and genetic association studies. Neuroscience and Biobehavioral Reviews, 32, 777–810. https://doi. org/10.1016/j.neubiorev.2007.11.003
  • Weidberg, S., Landes, R. D., López-Núñez, C., Pericot-Valverde, I., GonzálezRoz, A., Yoon, J. H., & Secades-Villa, R. (2015). Efectos del manejo de contingencias sobre el descuento por demora en pacientes que reciben tratamiento para dejar de fumar. Psicothema, 27(4), 309–316. https://doi. org/10.7334/psicothema2015.184
  • Weidberg, S., Secades-Villa, R., García-Pérez, Á., González-Roz, A., & Fernández-Hermida, J. R. (2019). The synergistic effect of cigarette demand and delay discounting on nicotine dependence among treatment-seeking smokers. Experimental and Clinical Psychopharmacology, 27(2), 146–152. https://doi.org/10.1037/pha0000248
  • Weidberg, S., Vallejo-Seco, G., González-Roz, A., García-Pérez, & Secades-Villa, R. (2018). In-treatment cigarette demand among treatment-seeking smokers with depressive symptoms. Addictive Behaviors, 82, 35–43. https://doi.org/ 10.1016/j.addbeh.2018.02.022
  • White, A., & Hingson, R. (2014). The burden of alcohol use: excessive alcohol consumption and related consequences among college students. Alcohol Research: Current Reviews, 35(2), 201–218.
  • Yuresak, A. M., Murphy, J. G., Clawson, A. H., Dennhardt, A. A., & MacKillop, J. (2013). Smokers report greater demand for alcohol on a behavioral economic purchase task. Journal of Studies on Alcohol and Drugs, 74(4), 626–634. https://doi.org/10.15288/jsad.2013.74.626
  • Zvorsky, I., Nighbor, T. D., Kurti, A. N., DeSarno, M., Naude, G., Reed, D. D., & Higgins, S. T. (2019). Sensitivity of hypothetical purchase task indices when studying substance use: a systematic literature review. Preventive Medicine, 128, 105789. https://doi.org/10.1016/j.ypmed.2019.105789