Impulsivity differences in recreational cannabis users and binge drinkers in a university population

Background

Recreational cannabis use and alcohol binge drinking are the most common drug consumption patterns in young adults. Impulsivity and several psychopathological signs are increased in chronic drug users, but the implications of recreational use are still poorly understood.

Methods

We evaluated impulsivity, sensation-seeking traits, impulsive decision-making, inhibitory control and possible symptoms of depression, anxiety and psychosis in three groups of young university adults: recreational cannabis users (N = 20), alcohol binge drinkers (N = 22) and non-drug users (N = 26).

Results

The cannabis and binge drinking groups had increased scores for impulsivity and sensation-seeking traits. Both groups also exhibited increased impulsive decision-making on the two-choice task and the Iowa Gambling task; however, only the cannabis group was significantly different from the non-drug group regarding inhibitory control (Go/No-Go and Stop tasks). The cannabis and binge drinking groups did not show differences in the psychopathological symptoms evaluated.

Conclusions

Our observations of this population of non-dependent drug users are consistent with the increased impulsivity traits and behaviors that have been described previously in chronic drug abusers. In this study, compared to no drug use, the recreational use of cannabis was associated with a major dysfunction of the different facets of impulsive behaviors. However, alcohol binge drinking was related only to impulsive decision-making. These results suggest that impulsivity traits and behaviors are present not only in chronic drug abusers but also in recreational drug users. Future work should continue to investigate the long-term effects of these common consumption patterns on various impulsive behaviors and psychopathological symptoms.     

Cannabis use and delinquent behaviors in high-school students

The aim of the study was to evaluate the relative contributions of cannabis use, alcohol use, psychopathic and borderline personality traits, and depressive symptoms in the prediction of delinquent behaviors. Participants were 312 high-school students who completed self-report questionnaires. Hierarchical multiple regression analyses were conducted to investigate the contribution of cannabis use and potential confounding variables to delinquent behaviors in the total sample and in cannabis users. Cannabis use was no more a significant independent predictor of delinquent behaviors after adjustment for alcohol use and psychopathological variables. However, among users, frequency of use remained a significant predictor of delinquency after adjustment for those confounders.     

Relations between cannabis use and dependence, motives for cannabis use and anxious, depressive and borderline symptomatology

This study investigated the relations between anxious, depressive and borderline symptomatology, motivations for cannabis use, and cannabis use and dependence among 212 adolescents and young adults, 114 of whom were cannabis users. Motives for cannabis use were assessed using the Marijuana Motives Measure (Simons, J., Correia, C. J., Carey, K. B., & Borsari, B. E. (1998). Validating a Five-Factor Motives Measure: Relations with use, problems and alcohol motives. Journal of Counseling Psychology, 45, 265-273.). In three sets of regression analyses, motives, cannabis use frequency, and cannabis dependence served as criterion variables. First, when motives were regressed on psychopathological measures, borderline symptomatology predicted expansion motives in both boys and girls. Second, when frequency of use was regressed on motives and psychopathological measures, enhancement motives were the only significant predictor among boys and expansion motives were the only significant predictor among girls. Finally, when cannabis dependence was regressed on motives and psychopathological measures, borderline symptomatology was the only significant predictor in boys and expansion motives were the only significant predictor in girls. This study suggests the importance of motives and borderline symptomatology in the understanding of cannabis use and dependence among adolescents and young adults.     

Clarifying the Relation between Social Interaction Anxiety and Cannabis Use: Personality as a Distinguishing Factor

Background: Individuals with social interaction anxiety, a facet of social anxiety disorder, are heterogeneous with respect to approaching or avoiding risky behaviors, including substance use. Additionally, the relation between social anxiety and cannabis use frequency has been inconsistent in the literature. Objective: The present study aimed to clarify the relation between social interaction anxiety and cannabis use by examining the effects of personality traits known to differentially predict substance use, including sensation seeking, emotion dysregulation, urgency, behavioral approach, and behavioral inhibition. Methods: We explored heterogeneity in social interaction anxiety using finite mixture modeling to discern profiles differing in mean scores on measures of social interaction anxiety and personality. We then examined how profiles differed in their likelihood of cannabis use. Results: The profile with low social interaction anxiety and high scores on personality measures was the most likely to use cannabis at all time periods. Two profiles with high social interaction anxiety scores were discerned. Between these two profiles, the profile with the highest levels of social interaction anxiety and most measured personality traits was more likely to use cannabis across all measured time periods. The profile with the high social interaction anxiety and low scores on personality measures was the least likely to use cannabis. Conclusions: Results of the present study identified personality traits most associated with increased risk of cannabis use for people high and low in social interaction anxiety, including facets of emotion regulation, urgency, and sensation seeking.     

Cannabis use and suicidal ideations in high-school students

Background

The association of cannabis use and suicidal ideations in adolescents has been inconsistent. This discrepancy may reflect differences in controlled confounders. In particular, no study has controlled for personality disorder traits linked to both cannabis use and suicidality such as borderline and psychopathic personality traits.

Method

Participants were 972 high-school students who completed questionnaires assessing cannabis use, suicidal ideations, depressive symptoms, social anxiety symptoms, and borderline and psychopathic personality traits.

Results

Cannabis use was not a significant independent predictor of suicidal ideations after adjustment for confounding personality traits in the total sample and in the subsample of cannabis users.     

Association between schizotypal and borderline personality disorder traits,and cannabis use in young adults

The aim of the study was to examine the association of schizotypal and borderline personality traits to cannabis use. Participants were 476 college students (95 males; 381 females; mean age of males = 21; mean age of females = 20.7) who completed self-report questionnaires assessing cannabis use, schizotypal and borderline personality traits. Problematic cannabis use, depressive symptoms, borderline and schizotypal traits were significantly inter-correlated. A logistic regression analysis showed that only borderline traits contributed significantly to cannabis use in the total sample. A multiple regression analysis showed that only schizotypal traits were positively and uniquely associated to problematic cannabis use symptoms among users. These results may imply that schizotypal traits are not a risk factor for initiating use, but may facilitate the development of problematic use symptoms among users. This study showed the necessity of taking into account schizotypal traits when exploring the relationships between depressive symptoms, borderline traits and cannabis use.     

Contribution of health motive to cannabis use among high-school students

The Marijuana Motives Measure (MMM), which is derived from a scale measuring alcohol use motives, has been the main instrument used to explore the role of motives in cannabis use and related problems. Two studies attempted to developed specific cannabis use motives but none of them showed a unique association to cannabis use and problems when controlling for MMM motives. The aim of our study was to examine if additional motives contributed to problematic use beyond MMM motives and psychopathological symptoms. Participants were 249 high-school students who completed the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) assessing cannabis use and problematic use, the MMM and a new scale measuring motives derived from clinical experience with adolescents using cannabis (CED motives), and scales measuring anxiety and depressive symptoms and borderline personality traits. Among the 107 participants using cannabis, 39 reached the cut-off score for problematic cannabis use. Hierarchical multiple regression analyses controlling for psychopathological variables showed that only one CED motives, Health (sleep, form, energy, appetite, health), was a significant predictor of both frequency of use and problematic use symptoms. The importance of Health motive may be linked to the role of depressive symptoms and may have implication for treatment. We suggest to add the Health subscale to the MMM and to further study the role of health motive in both use and dependence.     

Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation

Rationale 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) has become a widely used recreational drug among young people. This is of great concern, since MDMA is neurotoxic in animal studies and its use has been associated with psychological distress and a variety of self-reported psychiatric symptoms. However, exploring the origins of psychopathology in ecstasy users is hampered by the frequent polydrug use and by the cross-sectional design of all investigations, so far.Objectives The present study combines a cross-sectional with a longitudinal approach to further clarify the impact of the use of other illicit drugs on psychopathological symptoms reported by ecstasy users.Methods At baseline, we administered self-rating scales for impulsivity, sensation seeking and general psychological complaints to 60 recreational ecstasy users and 30 matched controls. From the initial sample of ecstasy users, 38 subjects were re-examined 18 months later.Results At baseline, ecstasy users reported significantly more psychological complaints than controls. However, self-reported psychopathology was mainly associated with regular cannabis use. At follow-up, subjects who had abstained from ecstasy use during the follow-up period did not differ from those reporting continued consumption. In contrast, subjects with regular concomitant cannabis use during the follow-up period reported more anxiety, interpersonal sensitivity and obsessive-compulsive behaviour than cannabis-abstinent users. Finally, higher levels of obsessive-compulsive behaviour, interpersonal sensitivity, depression, anxiety, phobic anxiety and paranoid ideation were significantly correlated with the duration of regular interim cannabis use.Conclusions The present findings suggest that self-reported psychopathology in ecstasy users is predominantly attributable to concomitant use of cannabis. Abstinence from cannabis and not ecstasy seems to be a reliable predictor for remission of psychological complaints in ecstasy users.     

Impulsivity in Hong Kong-Chinese club-drug users

To investigate the relationship between personality, club-drug use and high-risk drug-related behaviour, 360 club-drug users and 303 non-drug users in Hong Kong were assessed on measures of two impulsivity dimensions, reward drive and rash impulsivity, and a related trait of punishment sensitivity. The most frequently used drugs were ketamine, ecstasy, and cannabis, with the majority of participants using two or more drugs on any one occasion. Club-drug users were more rash-impulsive and reward-driven, and less punishment-sensitive than non-drug users (p<0.001). Rash impulsivity, but not reward drive or punishment sensitivity, was significantly (p<0.001) associated with risky drug-related behaviour. There was no association between any personality traits and preferred drug. These findings suggest that, while those who use club drugs are generally more impulsive and less punishment-sensitive, some discrete facets of impulsivity are associated with differing patterns of drug-use behaviour.     

Anxiety sensitivity components in relation to alcohol and cannabis use,motives, and problems in treatment-seeking cigarette smokers

Anxiety sensitivity (AS)— fear of anxiety symptoms and their potential negative consequences—has been implicated in the development of substance use problems and motivation to use substances for coping with distress, though the AS components (physical, cognitive, and social concerns) have not been studied extensively in relation to alcohol- and cannabis-related variables. In a cross-sectional design, self-report measures of AS and alcohol and cannabis use, motives, and problems were administered to 364 treatment-seeking cigarette smokers with a history of alcohol and cannabis use. In both adjusted and unadjusted analyses, linear regression models indicated that AS cognitive concerns are related to cannabis-use conformity motives, alcohol-use coping motives, and alcohol problems; AS physical and cognitive concerns are related to greater cannabis problems specifically in males; and AS social concerns are associated with greater social, coping, enhancement, and conformity drinking motives. AS cognitive and physical concerns were also related to greater alcohol and cannabis problems, respectively, in subsamples limited to 214 current alcohol users and 170 current cannabis users. Together with prior work, current findings suggest that it may be beneficial to focus more on addressing AS cognitive concerns in individuals with tobacco-alcohol problem comorbidity, whereas it may be beneficial to focus on addressing both AS physical and cognitive concerns in males with tobacco-cannabis problem comorbidity. In addition, cigarette smokers high in AS social concerns may benefit from relaxation training to lessen their social anxiety as well as behavioral activation to enhance their positive affect.     

Diagnostic and symptomatological features in chronic psychotic patients according to cannabis use status

The prevalence and the clinical meaning of cannabis use in patients with chronic psychosis has not been systematically explored. The authors have compared the diagnostic and symptomatological characteristics of 111 male patients affected by chronic psychosis with and without past or current use of cannabis. Sixty-six patients were still using or had used cannabis; in all cases the use preceded the onset of psychotic symptoms. Forty-three patients were cannabis-positive on urinary screening at the moment of hospitalization and 23 were currently cannabis-free but reported the use of cannabis in the past. Forty-five patients were negative on urinary screening and reported no past history of cannabis use. In evaluating the psychopathological features, the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Rating Scale (AORS) were used. The three groups showed similar demographic data, except for age, which was lower in current cannabis users than in nonusers; no differences were found between current and past users. As regards diagnostic features, "mood cluster" was significantly better represented in cannabis users and "schizophrenic cluster" in nonusers; bipolar spectrum disorders were more frequently reported than unipolar ones. When past and current users were grouped together, only blunted affect score was significantly higher in nonusers than in users, while clastic violence showed higher scores in users. These data indicate that chronic, psychosis, whether associated with past or with current use of cannabis, is frequently associated with bipolar spectrum disorders and tends to display less blunted affect and more clastic behavior.     

Relative contributions of acculturation and psychopathological factors to cannabis use among adolescents from migrant parents

Immigrant adolescents and adolescents born of immigrant parents are at increased risk of substance use which has been linked to difficulties in acculturation processes. However very few studies have examined the role of the different acculturation strategies and none of them have controlled for relevant psychopathological and socio-familial factors. The aim of this study was to investigate the role of acculturation in cannabis use in a sample of adolescents born of immigrant parents taking into account potential confounding variables. A sample of 292 high school students born in France from at least one foreign parent completed a questionnaire assessing cannabis use, acculturation orientations, ethnic identity and the most relevant potential confounders (depressive symptoms, sensation seeking, borderline and psychopathic traits, alcohol and tobacco use, parental attachment, life events, socioeconomic status and academic achievement). A regression analysis showed that acculturation orientations and ethnic identity explained a significant part of the variance in the frequency of cannabis use. Individualism, integration and assimilation were negatively associated with the frequency of cannabis use suggesting they might serve as protective factors.     

Cannabis Use and Social Anxiety in Adolescence: The Role of Facilitation Expectancies

Cannabis use is frequently related to social anxiety in young adulthood, but the nature of this relationship is unclear. Moreover, much research has been conducted on the role of cannabis effects expectancies and their relationship to social anxiety among young adults, but less is known about adolescence. The study examined the relationship between social anxiety, cannabis use patterns, and cannabis effects expectancies among a nonclinical sample of 1,305 adolescents (51% female). Non-users reported higher social anxiety scores than non-problematic and risky users. Compared to users, non-users had more negative expectancies. Risky and problematic users showed higher social and sexual facilitation expectancies and perceptual and cognitive enhancement expectancies. In addition, social anxiety was related to global negative expectancies and social and sexual facilitation expectancies. Moreover, we found that among socially anxious adolescents, social and sexual facilitation expectancies are dissuasive reasons to use cannabis. Clinical implications and future directions are discussed.     

Risky Cannabis Use is Associated with Alexithymia,Frontal Lobe Dysfunction,and Impulsivity in Young Adult Cannabis Users

Abstract

Risky or problematic alcohol use by young adults has been found to be associated with factors such as alexithymia, frontal lobe dysfunction, reward sensitivity, and impulsivity. One interpretation is that these factors reflect inherent traits that predispose to risky substance use in general, a notion examined in the present study. Alexithymia, everyday frontal lobe functioning, sensitivity to reward and punishment, and impulsivity were examined in 138 young adult cannabis users who were divided into Low Risk (n = 99) and Risky (n = 39) users according to their Cannabis Use Disorder Identification Test (CUDIT) scores. Risky cannabis use was significantly positively associated with alexithymia, multiple signs of frontal lobe dysfunction in everyday life, and impulsivity. A broader pattern of dysfunction was indicated for risky cannabis use than for risky alcohol use in this sample. Findings are interpreted as likely reflecting not only inherent traits that predispose to risky substance use in general, but also perhaps residual effects of recent heavy cannabis use in the Risky user group. Longitudinal research is needed to disentangle these competing possibilities.     

Diagnostic and Symptomatological Features in Chronic Psychotic Patients According to Cannabis Use Status

Abstract

The prevalence and the clinical meaning of cannabis use in patients with chronic psychosis has not been systematically explored. The authors have compared the diagnostic and symptomatological characteristics of 111 male patients affected by chronic psychosis with and without past or current use of cannabis. Sixty-six patients were still using or had used cannabis; in all cases the use preceded the onset of psychotic symptoms. Forty-three patients were cannabis-positive on urinary screening at the moment of hospitalization and 23 were currently cannabis-free but reported the use of cannabis in the past. Forty-five patients were negative on urinary screening and reported no past history of cannabis use. In evaluating the psychopathological features, the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Rating Scale (AORS) were used. The three groups showed similar demographic data, except for age, which was lower in current cannabis users than in nonusers; no differences were found between current and past users. As regards diagnostic features, “mood cluster” was significantly better represented in cannabis users and “schizophrenic cluster” in nonusers; bipolar spectrum disorders were more frequently reported than unipolar ones. When past and current users were grouped together, only blunted affect score was significantly higher in nonusers than in users, while clastic violence showed higher scores in users. These data indicate that chronic psychosis, whether associated with past or with current use of cannabis, is frequently associated with bipolar spectrum disorders and tends to display less blunted affect and more clastic behavior.     

Characteristics of clinically anxious versus non-anxious regular, heavy marijuana users

Both the key mechanism of action for marijuana (the endocannabinoid system) and the symptoms associated with marijuana withdrawal suggest an important link to anxiety. Despite this link, there is a dearth of research on the characteristics of heavy marijuana users with clinical-level anxiety compared to those with heavy marijuana use alone. Over 10,000 participants (friends or affiliates of the National Organization for the Reform of Marijuana Laws) provided data via online survey. After careful, conservative screening, anxiety, other psychopathology, other drug use, and marijuana-related problems were examined in 2567 heavy marijuana users. Subsequently, 275 heavy users with clinical-level anxiety were compared to demographically-equivalent non-anxious heavy users on psychopathology, drug use, and cannabis-related problems. Among several psychological variables (including anxiety, depression, schizotypy, and impulsivity), anxiety was most strongly predictive of amount of marijuana used and marijuana-related problems. Group comparison (n=550 total) revealed that clinically anxious heavy users exhibited more use, more non-anxiety psychopathological symptoms, and a greater number and severity of marijuana-related problems than their non-anxious peers. The findings reveal that anxiety shows an important relation to marijuana use and related problems among regular, heavy users. Further examinations of common and unique factors predisposing individuals for anxiety and marijuana abuse appear warranted.     

Cannabis use and delinquent behaviors in a non-clinical sample of adolescents

The aim of the study was to evaluate the contribution of cannabis to the prediction of delinquent behaviors. Participants were 615 high-school students who completed self-report questionnaires. Hierarchical multiple regression analyses showed that cannabis use was a significant independent predictor of delinquent behaviors after adjustment for alcohol use, psychopathological and socio-familial variables. Cannabis use was associated with greater numbers of delinquent behaviors among adolescents with higher scores on psychopathic traits or depressive symptoms.     

Cannabis use motives and personality risk factors

According to the model of substance abuse of Conrod, Pihl, Stewart, and Dongier (2000), four personality factors (i.e., anxiety sensitivity [AS], introversion/hopelessness [I/H], sensation seeking [SS], and impulsivity [IMP]) are associated with elevated risk for substance use/misuse, with each personality factor being related to preference for particular drugs of abuse (e.g., AS with anxiolytics). However, cannabis use has not been consistently linked to any one of these personality factors. This may be due to the heterogeneity in cannabis use motives. The present study explored the association between these four personality risk factors and different cannabis use motives. Cannabis users completed an interview about their motives for cannabis use as well as the self-report Substance Use Risk Profile Scale (SURPS; Woicik, Conrod, Stewart, & Pihl, 2009), which measures the four personality risk factors. Results showed that AS was associated with conformity motives and I/H was associated with coping motives for cannabis use. SS was positively associated with expansion motives and IMP was associated with drug availability motives. Thus, personality risk factors in the model of Conrod et al. (2000) are associated with distinct cannabis use motives in a pattern consistent with theory.     

Cross-domain correlates of cannabis use disorder severity among young adults

BackgroundCorrelates of cannabis use and dependence among young adults have been widely studied. However, it is not known which factors are most strongly associated with severity of cannabis use dependence (CUD) severity. Identification of the salient correlates of CUD severity will be of increasing clinical significance as use becomes more socially normative.MethodsThis study used a data-driven, hypothesis-free approach to examine the most robust correlates of CUD severity among a sample of 76 young adults (ages 18 to 25 years) who used cannabis at least weekly. Seventy-one candidate variables were examined for association with CUD severity. These included demographic variables, self-reported and psychodiagnostic assessments of mood and anxiety, self-reported measures of personality, cannabis and other substance use characteristics, and objective and subjective measures of cognition.ResultsOf the 71 candidate variables considered, 27 were associated with CUD severity on a univariate level at a p-value ≤.20. Correlates of CUD severity in the multivariable model using stepwise selection were: more frequent cannabis use in the past 90 days, greater expectancies that cannabis causes cognitive and behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on a test of sustained attention. Internal validation tests support high prediction accuracy of all variables in the multivariable model, except for lower reaction time variability.ConclusionsCannabis use frequency, beliefs about use, perceived cognitive abilities, and anxiety are robustly associated with CUD severity in young adult, regular cannabis users, and may be important in guiding prevention and treatment efforts.