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Past trauma and future choices: differences in discounting in low-income, urban African Americans

Published online by Cambridge University Press:  21 February 2018

Carissa van den Berk-Clark ,
Joel Myerson ,
Leonard Green  and
Richard A. Grucza
Carissa van den Berk-Clark*
Affiliation:
Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, USA
Joel Myerson
Affiliation:
Department of Psychological & Brain Sciences, Washington University, St. Louis, MO, USA
Leonard Green
Affiliation:
Department of Psychological & Brain Sciences, Washington University, St. Louis, MO, USA
Richard A. Grucza
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
*
Author for correspondence: Carissa van den Berk-Clark, E-mail: cvanden1@slu.edu
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Abstract

Background

Exposure to traumatic events is surprisingly common, yet little is known about its effect on decision making beyond the fact that those with post-traumatic stress disorder are more likely to have substance-abuse problems. We examined the effects of exposure to severe trauma on decision making in low-income, urban African Americans, a group especially likely to have had such traumatic experiences.

Method

Participants completed three decision-making tasks that assessed the subjective value of delayed monetary rewards and payments and of probabilistic rewards. Trauma-exposed cases and controls were propensity-matched on demographic measures, treatment for psychological problems, and substance dependence.

Results

Trauma-exposed cases discounted the value of delayed rewards and delayed payments, but not probabilistic rewards, more steeply than controls. Surprisingly, given previous findings that suggested women are more affected by trauma when female and male participants’ data were analyzed separately, only the male cases showed steeper delay discounting. Compared with nonalcoholic males who were not exposed to trauma, both severe trauma and alcohol-dependence produced significantly steeper discounting of delayed rewards.

Conclusions

The current study shows that exposure to severe trauma selectively affects fundamental decision-making processes. Only males were affected, and effects were observed only on discounting delayed outcomes (i.e. intertemporal choice) and not on discounting probabilistic outcomes (i.e. risky choice). These findings are the first to show significant differences in the effects of trauma on men's and women's decision making, and the selectivity of these effects has potentially important implications for treatment and also provides clues as to underlying mechanisms.

Keywords

African Americansdelayed outcomesdiscountingsex differencetrauma
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 16 , December 2018 , pp. 2702 - 2709
Copyright
Copyright © Cambridge University Press 2018 

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