Consistent evidence of indirect effects of impulsive delay discounting and negative urgency between childhood adversity and adult substance use in two samples.

Abstract

RATIONALE\nExposure to adverse life experiences (ACEs) is robustly associated with problematic alcohol and other drug use. In addition, both ACEs and substance use have been independently associated with impulsivity.\n\n\nOBJECTIVE\nTo examine whether impulsivity is implicated in the link between ACE and adult substance use in two samples.\n\n\nMETHODS\nThe primary sample was a cohort of community adults (N\xa0=\u20091431) who completed a one-time in-person assessment. A second sample was crowdsourced using Amazon Mechanical Turk (N\xa0=\u20093021). All participants were assessed for ACEs using the Adverse Childhood Experience Questionnaire and for current alcohol and other drug use. Given its multidimensional nature, impulsivity was assessed using the UPPS-P measure of impulsive personality traits, Go/NoGo (GNG) task (in-person community adult sample only), and delay discounting (Monetary Choice Questionnaire [MCQ] in the community adults and Effective Delay-50 [ED50] in the crowdsourced sample. Structural equation modeling was used\xa0to examine the hypothesized indirect effects for the measures of impulsivity between ACEs and substance use.\n\n\nRESULTS\nIn the community adults, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β\u2009=\u20090.07, SE\u2009=\u20090.02, 95% CI [0.04, 0.10]), and the MCQ (β\u2009=\u20090.02 SE\u2009=\u2009.01, 95% CI [0.01, 0.03]). In the crowdsourced sample, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β\u2009=\u20090.05, SE\u2009=\u2009.01, 95% CI [0.04, 0.07]), UPPS-Premeditation (β\u2009=\u20090.04, SE\u2009=\u2009.01, 95% CI [0.02, 0.05), and the ED50 (β\u2009=\u20090.02, SE\u2009=\u2009.01; 95% CI [0.01, 0.03]).\n\n\nCONCLUSION\nThese findings provide consistent evidence that decrements in regulation of negative emotions and overvaluation of immediate rewards indirectly link ACE and substance use. These robust cross-sectional findings support the need for elucidating the underlying neural substrates implicated and for longitudinal evaluations.