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. 2024 Mar 13;2(4):239-249.
doi: 10.1016/j.jaacop.2024.02.003. eCollection 2024 Dec.

Longitudinal Pathways From Maltreatment to Substance Use Through Delay Discounting During Adolescence and Into Young Adulthood

Kristin M Peviani  1 , Claudia Clinchard  1 , Warren K Bickel  1   2 , Brooks Casas  1   2 , Jungmeen Kim-Spoon  1
Affiliations

Longitudinal Pathways From Maltreatment to Substance Use Through Delay Discounting During Adolescence and Into Young Adulthood

Kristin M Peviani et al. JAACAP Open. .

Abstract

Objective: Children and adolescents exposed to maltreatment are at a greater risk for substance use disorders in adulthood. However, developmental processes that explain how maltreatment experiences may influence substance use behaviors remain unclear. We investigated whether delay discounting (ie, the preference for immediate over delayed rewards), a critical indicator of self-regulation, serves as a key mechanism linking maltreatment and substance use. We used a developmental cascade model with a dimensional approach to test the direct and indirect effects of neglect and abuse on substance use during adolescence and across the transition from adolescence to young adulthood.

Method: The present study includes 167 adolescents (53% male; mean age = 14 years at time 1) who provided data on delay discounting and cigarette, alcohol, and cannabis use frequency across 5 time points (ages 14-18, approximately 1 year between assessments). At ages 18 to 19, adolescents provided reports of their exposure to maltreatment during adolescence (across ages 13-17).

Results: Using structural equation modeling, developmental cascade models tested whether the effects of neglect and abuse on cigarette, alcohol, and cannabis use were mediated through delay discounting over time. Our results indicate that adolescents exposed to neglect may be especially vulnerable to cannabis use over time via elevated delay discounting. Neglect experiences predicted greater cigarette use over time.

Conclusion: These findings underscore the critical role of delay discounting in prevention and intervention efforts aimed at mitigating the risks of substance use development among young people who have been exposed to neglect during adolescence.

Keywords: abuse; adolescence; delay discounting; neglect; substance use.

Plain language summary

This study used a developmental cascade model to examine whether delay discounting (ie, choosing smaller, immediate rewards over larger rewards with a delay) may be a mechanism linking maltreatment and substance use (cigarette, alcohol, and cannabis use) during adolescence. One hundred sixty-seven adolescents aged 13-14 were assessed in a computerized delay discounting task across 5 time points over 6 years. Results indicated that adolescent neglect was associated with higher delay discounting, which in turn was associated with increased substance use, especially cannabis use. These findings highlight delay discounting as a potential intervention target to mitigate substance use risk in adolescents who have experienced neglect.

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Figures

Figure 1
Figure 1
A Developmental Cascade Model of Neglect, Abuse, Delay Discounting, and Cigarette Use Note:Significant indirect effects pathway are shown in boldface type. Standardized estimates are reported in the figure. Concurrent correlations were estimated but not reported in the figure for clarity of presentation (r = –0.13 to .33 for abuse↔neglect; r = –0.11 to 0.01 for abuse↔DD; r = –0.22 to 0.03 for abuse↔cigarette use; r = –.01 to 0.20 for neglect↔DD; r = –0.13 to 0.19 for neglect↔cigarette use; r = –0.09 to 0.22 for DD↔cigarette use). Cig = cigarette use; DD = delay discounting; T = time. ∗p < .05
Figure 2
Figure 2
A Developmental Cascade Model of Neglect, Abuse, Delay Discounting, and Alcohol Use Note:Standardized estimates are reported in the figure. Concurrent correlations were estimated but not reported in the figure for clarity of presentation (r = –0.13 to 0.32 for abuse↔neglect; r = –0.11 to 0.03 for abuse↔DD; r = –0.02 to 0.14 for abuse↔alcohol use; r = –0.02 to 0.20 for neglect↔DD; r = –0.17 to 0.14 for neglect↔alcohol use; r = –0.16 to 0.25 for DD↔alcohol use). Alc = alcohol use; DD = delay discounting; T = time. ∗p < .05.
Figure 3
Figure 3
A Developmental Cascade Model of Neglect, Abuse, Delay Discounting, and Cannabis Use Note:Significant indirect effects pathway are shown in boldface type. Standardized estimates are reported in the figure. Concurrent correlations were estimated but not reported in the figure for clarity of presentation (r = –0.13 to 0.32 for abuse↔neglect; r = –0.10 to 0.03 for abuse↔DD; r = –0.18 to 0.02 for abuse↔cannabis use; r = –0.03 to 0.20 for neglect↔DD; r = –0.13 to 0.19 for neglect↔cannabis use; r = –0.10 to 0.08 for DD↔cannabis use). Can = cannabis use; DD = delay discounting; T = time. ∗p < .05.
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