Improving Delay Discounting to Decrease Harsh Parenting Among Parents Receiving Substance Use Treatment

NCT ID: NCT05229120

Last Updated: 2025-03-14

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-07

Study Completion Date

2023-03-31

Brief Summary

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Parents with substance use disorders are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including child maltreatment and the intergenerational transmission of addictive disorders. One mechanism linking substance use and maladaptive parenting strategies is parental delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical punishment) relative to larger, but delayed rewards (like shaping adaptive child behaviors over time). This study will examine the efficacy of implementing a low-cost, brief intervention targeting the reduction of parental delay discounting to inform broader public health efforts aimed at reducing child maltreatment and interrupting intergenerational cycles of substance abuse in traditionally underserved communities.

Detailed Description

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Parents with substance use disorders (SUD) are significantly more likely to engage in harsh parenting practices, including spanking, hitting, and belittling their children, than parents without SUD. Punitive physical and emotional discipline is, in turn, associated with increased rates of child maltreatment and the subsequent intergenerational transmission of substance use disorders. Parents in residential substance use treatment facilities are among those at highest risk for perpetrating harsh and abusive parenting; yet most behaviorally based parenting interventions available within inpatient settings do not take into account the unique mechanisms linking parental substance use to harsh parenting. Specifically, parents with SUD may be at heightened risk for engaging in maladaptive parenting approaches given a tendency to prioritize immediate rewards (such as stopping a child's misbehavior using physical punishment) relative to larger, but delayed rewards (including shaping positive child behavior over a longer term). This behavioral tendency is known as delay discounting and recent findings suggest that rates of delay discounting predict parents' use of harsh physical discipline. Existing research also indicates a strong link between steeper (more problematic) rates of delay discounting and the severity of alcohol and illicit drug use across the lifespan. Thus, delay discounting may represent a specific vulnerability underlying both harsh parenting and disordered substance use. The current project proposes to pilot and feasibility test an adapted episodic future thinking (EFT) intervention to target the reduction of parenting-related delay discounting and examine its effects on parenting practices among families in a residential substance use treatment setting. The intervention will be delivered by peer recovery coaches who are already employed in the center.

Conditions

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Behavioral Health

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Episodic Future Thinking

Parents who are receiving residential substance use disorder (SUD) treatment will receive an adapted episodic future thinking focused condition. Parents will meet with peer recovery coaches (PRCs) who will administer the intervention, focused on generating future, pleasant events with their children. After the intervention session, parents will receive a daily postcard over the course of two weeks including a reminder cue generated as part of the episodic future thinking (EFT) intervention and a prompt to remember these episodes in vivid detail.

Group Type EXPERIMENTAL

Episodic Future Thinking

Intervention Type BEHAVIORAL

The adapted episodic future thinking (EFT) intervention will focus on generation of vivid, substance-free, rewarding events that could happen in the future with their children.

Interventions

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Episodic Future Thinking

The adapted episodic future thinking (EFT) intervention will focus on generation of vivid, substance-free, rewarding events that could happen in the future with their children.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Parent of child between 6-10 years of age
* Able to provide informed consent and take part in all study procedures in English
* Have current diagnosis of SUD
* Currently reside with their child at least 50% of the time
* Be willing to receive daily postcards

Exclusion Criteria

* Active suicidality/homicidally
* Active bipolar disorder, schizophrenia, or psychosis.
* Only one parent-child dyad from each family.
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Maryland, College Park

OTHER

Sponsor Role collaborator

University of Kansas

OTHER

Sponsor Role collaborator

Henry Ford Health System

OTHER

Sponsor Role lead

Responsible Party

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Julia Felton

Assistant Scientist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Julia Felton, PhD

Role: PRINCIPAL_INVESTIGATOR

Henry Ford Health

Locations

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Odyssey Village

Flint, Michigan, United States

Site Status

Countries

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United States

References

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Staton-Tindall M, Sprang G, Clark J, Walker-Barnes R, Craig CD. Caregiver Substance Use and Child Outcomes: A Systematic Review. Journal of Social Work Practice in the Addictions. 2013;13(1):6-31. doi:10.1080/1533256X.2013.752272

Reference Type BACKGROUND

Committee on Child Maltreatment Research, Policy, and Practice for the Next Decade: Phase II; Board on Children, Youth, and Families; Committee on Law and Justice; Institute of Medicine; National Research Council; Petersen AC, Joseph J, Feit M, editors. New Directions in Child Abuse and Neglect Research. Washington (DC): National Academies Press (US); 2014 Mar 25. Available from http://www.ncbi.nlm.nih.gov/books/NBK195985/

Reference Type BACKGROUND
PMID: 24757747 (View on PubMed)

Herrenkohl RC, Herrenkohl EC, Egolf BP. Circumstances surrounding the occurrence of child maltreatment. J Consult Clin Psychol. 1983 Jun;51(3):424-31. doi: 10.1037//0022-006x.51.3.424. No abstract available.

Reference Type BACKGROUND
PMID: 6863704 (View on PubMed)

Whipple EE, Richey CA. Crossing the line from physical discipline to child abuse: how much is too much? Child Abuse Negl. 1997 May;21(5):431-44. doi: 10.1016/s0145-2134(97)00004-5.

Reference Type BACKGROUND
PMID: 9158904 (View on PubMed)

Alati R, Baker P, Betts KS, Connor JP, Little K, Sanson A, Olsson CA. The role of parental alcohol use, parental discipline and antisocial behaviour on adolescent drinking trajectories. Drug Alcohol Depend. 2014 Jan 1;134:178-84. doi: 10.1016/j.drugalcdep.2013.09.030.

Reference Type BACKGROUND
PMID: 24479151 (View on PubMed)

Young NK, Boles SM, Otero C. Parental substance use disorders and child maltreatment: overlap, gaps, and opportunities. Child Maltreat. 2007 May;12(2):137-49. doi: 10.1177/1077559507300322.

Reference Type BACKGROUND
PMID: 17446567 (View on PubMed)

Reynolds B. A review of delay-discounting research with humans: relations to drug use and gambling. Behav Pharmacol. 2006 Dec;17(8):651-67. doi: 10.1097/FBP.0b013e3280115f99.

Reference Type BACKGROUND
PMID: 17110792 (View on PubMed)

Bickel WK, Marsch LA. Toward a behavioral economic understanding of drug dependence: delay discounting processes. Addiction. 2001 Jan;96(1):73-86. doi: 10.1046/j.1360-0443.2001.961736.x.

Reference Type BACKGROUND
PMID: 11177521 (View on PubMed)

Amlung M, Vedelago L, Acker J, Balodis I, MacKillop J. Steep delay discounting and addictive behavior: a meta-analysis of continuous associations. Addiction. 2017 Jan;112(1):51-62. doi: 10.1111/add.13535. Epub 2016 Sep 1.

Reference Type BACKGROUND
PMID: 27450931 (View on PubMed)

MacKillop J, Amlung MT, Few LR, Ray LA, Sweet LH, Munafo MR. Delayed reward discounting and addictive behavior: a meta-analysis. Psychopharmacology (Berl). 2011 Aug;216(3):305-21. doi: 10.1007/s00213-011-2229-0. Epub 2011 Mar 4.

Reference Type BACKGROUND
PMID: 21373791 (View on PubMed)

Felton JW, Collado A, Ingram K, Lejuez CW, Yi R. Changes in delay discounting, substance use, and weight status across adolescence. Health Psychol. 2020 May;39(5):413-420. doi: 10.1037/hea0000833. Epub 2020 Jan 9.

Reference Type BACKGROUND
PMID: 31916829 (View on PubMed)

Milligan K, Meixner T, Tremblay M, Tarasoff LA, Usher A, Smith A, Niccols A, Urbanoski KA. Parenting Interventions for Mothers With Problematic Substance Use: A Systematic Review of Research and Community Practice. Child Maltreat. 2020 Aug;25(3):247-262. doi: 10.1177/1077559519873047. Epub 2019 Oct 14.

Reference Type BACKGROUND
PMID: 31610688 (View on PubMed)

Neger EN, Prinz RJ. Interventions to address parenting and parental substance abuse: conceptual and methodological considerations. Clin Psychol Rev. 2015 Jul;39:71-82. doi: 10.1016/j.cpr.2015.04.004. Epub 2015 Apr 24.

Reference Type BACKGROUND
PMID: 25939033 (View on PubMed)

Kaminski JW, Valle LA, Filene JH, Boyle CL. A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol. 2008 May;36(4):567-89. doi: 10.1007/s10802-007-9201-9. Epub 2008 Jan 19.

Reference Type BACKGROUND
PMID: 18205039 (View on PubMed)

Liu L, Feng T, Chen J, Li H. The value of emotion: how does episodic prospection modulate delay discounting? PLoS One. 2013 Nov 28;8(11):e81717. doi: 10.1371/journal.pone.0081717. eCollection 2013.

Reference Type BACKGROUND
PMID: 24312341 (View on PubMed)

Peters J, Buchel C. Episodic future thinking reduces reward delay discounting through an enhancement of prefrontal-mediotemporal interactions. Neuron. 2010 Apr 15;66(1):138-48. doi: 10.1016/j.neuron.2010.03.026.

Reference Type BACKGROUND
PMID: 20399735 (View on PubMed)

Lin H, Epstein LH. Living in the moment: effects of time perspective and emotional valence of episodic thinking on delay discounting. Behav Neurosci. 2014 Feb;128(1):12-9. doi: 10.1037/a0035705.

Reference Type BACKGROUND
PMID: 24512061 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NAP: 14781-29

Identifier Type: -

Identifier Source: org_study_id

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