Social anxiety and marijuana-related problems: The role of social avoidance

BackgroundPeople with elevated social anxiety seem vulnerable to marijuana-related impairment. Yet little work has examined core facets of social anxiety that may be especially related to marijuana-related problems.MethodThe present study examined the relationships between current (past three months) marijuana-related problems and two aspects of social anxiety (fear in social situations and social avoidance) among current (N = 102) marijuana users.ResultsAlthough both social fear and social avoidance were significantly correlated with marijuana-related problems, only social avoidance was uniquely related to marijuana problems (after controlling for social fear, sex, negative affect, alcohol problems, and marijuana use frequency). Sex moderated the relationship between social avoidance and marijuana-related problems such that men with greater social avoidance exhibited the greatest severity of marijuana-related problems.ConclusionsAvoidance of social situations appears robustly related to marijuana-related problems. This finding has important implications for theoretical models that can inform treatment of co-occurring social anxiety and marijuana problems.     

Mental health problems and interest in marijuana treatment among marijuana-using college students

Background

There is growing recognition that marijuana use among college students is associated with marijuana-related problems. Yet little work has examined whether use is associated with mental health problems and whether there is a dose effect such that individuals engaging in more frequent use evince relatively greater psychiatric impairments. Further, little is known about factors related to interest in marijuana treatment among students experiencing marijuana-related problems.

Method

The current study examined academic and psychiatric functioning as well as interest in marijuana treatment among undergraduates (N = 1,689). Approximately 29% acknowledged marijuana use, with 9.8% using weekly or more.

Results

More frequent marijuana use was related to more academic difficulties. Marijuana use (among both weekly and less frequent users) was related to greater psychiatric impairment. Interest in marijuana treatment was examined among students with 2+ marijuana-related problems (n = 251). Of those, 22.7% expressed interest in marijuana treatment. Factors positively related to treatment interest included: marijuana use frequency, use-related problems, friends' marijuana use, age, employment status, and some types of mental health problems.

Conclusions

Marijuana use among college students is associated with academic, psychiatric, and marijuana-related impairments. However, there is some interest in treatment to manage marijuana use among undergraduates, particularly among those with more frequent and more problematic marijuana use.     

Marijuana use motives and social anxiety among marijuana-using young adults

Given the high rates of co-occurring marijuana use and social anxiety, the present investigation examined the relations among marijuana use motives, marijuana use and problems, and social anxiety in 159 (54.7% female) young adults (M(age)=18.74, SD=1.20). As expected, after covarying for a number of variables related to both marijuana use and social anxiety (e.g. gender, alcohol use problems, anxiety sensitivity), social anxiety predicted greater numbers of marijuana use problems. Interestingly, social anxiety was not related to marijuana use frequency. Also consistent with prediction, social anxiety was a significant predictor of coping and conformity motives for marijuana use above and beyond relevant variables. Finally, coping motives for marijuana use mediated the relation between social anxiety and marijuana use problems. These data provide novel evidence for the unique effects of coping-motivated marijuana use in the link between marijuana-related impairment and social anxiety.     

Post-traumatic stress and marijuana outcomes: The mediating role of marijuana protective behavioral strategies

Abstract

Background: The present study investigated the mediating role of protective behavioral strategies for marijuana (PBSM) on the relationship between posttraumatic stress disorder (PTSD) and marijuana outcomes (i.e. marijuana use frequency, marijuana use quantity, cannabis use disorder (CUD) symptoms, and marijuana-related problems). Methods: Participants were 1,107 traditional age college students (M_age = 20.26, SD?=?3.32; 66.5% White, non-Hispanic; 68.8% female), who reported consuming marijuana at least once in the last 30?days and completed measures of PTSD symptoms, PBSM, and marijuana-related outcomes. Results: PBSM significantly mediated the positive relationships between PTSD symptoms and both CUD symptoms and marijuana-related problems. More specifically, PTSD symptoms were negatively associated with PBSM, which in turn was negatively associated with marijuana use frequency and marijuana use quantity, which were in turn positively associated with CUD symptoms and marijuana-related problems. Conclusion: Taken together, the associations between higher PTSD symptoms and greater experience of CUD symptoms and marijuana-related problems may occur because students use fewer PBSM and thus engage in larger quantity and frequency of marijuana use. These findings lend support to the utility of targeting PBSM as a harm reduction effort for students with PTSD symptoms who use marijuana.     

Expectancy mediated effects of marijuana on menopause symptoms

Background Medical marijuana alleviates a variety of symptoms, including those associated with menopause, such as insomnia, irritability, depression and joint pain. However, little work has addressed the use of marijuana in a population of menopausal women, or the role of menopausal women’s marijuana treatment expectancies in regard to consumption. We hypothesized that menopausal women who used marijuana would expect it to alleviate symptoms that have responded well to the plant in previous research. Based on the marijuana expectancy literature, we also hypothesized that links from menopause symptoms to marijuana use would arise via indirect paths through expectancies. Methods Menopausal and post-menopausal women (N = 115) who endorsed lifetime marijuana use completed an online survey assessing their frequency of use, average intoxication – a proxy for quantity, menopause symptoms, and expectancies of relief from menopause symptoms. Results Women expected marijuana to improve joint/muscle discomfort, irritability, sleep problems, depression, anxiety and hot flashes, but not sex problems, heart discomfort, exhaustion, vaginal dryness and bladder problems. Expectancies mediated the links between menopause symptoms and frequency of use. Average intoxication did not correlate with symptoms or expectations of relief. Symptoms, expectancies, and frequency of marijuana use were all independent of marijuana-related problems. Conclusions Particularly as the population ages, increased research on how medical marijuana might help menopause symptoms without increasing marijuana-related problems could prove heuristic.     

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.     

An affective and cognitive model of marijuana and alcohol problems

This study examined a six-month prospective model of marijuana and alcohol problems among college students. Among marijuana users, there was an indirect positive association between use utility and Time 1 (T1) marijuana-related problems through T1 marijuana use, whereas there was a direct positive association between affect lability and T1 marijuana-related problems. A multi-group analysis of alcohol problems compared models for users of alcohol and marijuana and users of alcohol only. For both groups, there was a direct positive association between T1 use utility and T2 alcohol consumption and an indirect association with T2 alcohol problems via alcohol consumption. Impulsivity was directly and positively associated with T1 alcohol problems among the alcohol-only group. For the alcohol-only group, impulsivity moderated the association between T2 consumption and problems, making it stronger. Associations between affect lability and alcohol problems as well as alcohol consumption and problems were stronger in the alcohol and marijuana group. Results support differential pathways to substance-related problems, an indirect pathway, in which problems are an unintended consequence of goal-directed use activity, as well as direct and interactive pathways in which problems may be viewed as consequences of broader regulatory problems.     

Self-Reported Psychopathology Among Young,Low-Income,Female Ecstasy Users

ABSTRACT

This study examined the association of ecstasy (methylenedioxy-methylamphethamine) use with psychopathology among young, low-income females who sought care at university family planning clinics in Texas between December 2001 and May 2003. Participants reported drug use history and eight problem behavior syndromes by using the Young Adult Self-Report. The prevalence of ecstasy use was approximately 15%. About 90% of ecstasy users reported having used other drugs. Overall, ecstasy users were more likely to have exhibited delinquent behaviors and thought problems than exclusive marijuana users. Ecstasy users who continued to use any illicit drugs showed the most severe psychopathology. These findings indicate that elevated rates of self-reported psychopathology among ecstasy users may be partly attributable to the use of multiple drugs. Furthermore, it will also be important for future studies to assess the extent to which delinquent behaviors and thought problems mediate the transition of marijuana use to ecstasy use.     

Psychometric properties of a valuations scale for the Marijuana Effect Expectancies Questionnaire

Given that marijuana remains the most commonly used illicit substance, identification of the role of potentially malleable cognitive factors in marijuana-related behaviors remains an important goal. The Marijuana Effect Expectancies Questionnaire (MEEQ; Schafer & Brown, 1991) assesses marijuana effect expectancies that are differentially related to marijuana use and use-related problems. Evaluation of the desirability of marijuana effect expectancies may provide additional information regarding cognitions related to marijuana use behaviors. The present study examined the psychometric properties of the Marijuana Effect Expectancy Questionnaire—Valuations Scale (MEEQ-V) which was developed for this study to assess the desirability of marijuana effect expectancies. The sample was comprised of 925 (73.0% female) undergraduate participants, 41.9% of whom endorsed lifetime marijuana use and 24.7% of whom reported current (past three-month) use. The MEEQ-V scales demonstrated adequate internal consistency. Most (but not all) MEEQ-V scales were correlated with their corresponding MEEQ scale. There was some support for convergent validity. MEEQ-V scales were differentially related to frequency of marijuana use and use-related problems. Most MEEQ-V scales were related to frequency of marijuana use above and beyond variance attributable to corresponding MEEQ scales. Results suggest that assessment of desirability of marijuana's effects could provide unique and important information about cognitions related to marijuana use behaviors.     

Marijuana effect expectancies: relations to social anxiety and marijuana use problems

High social anxiety is related to marijuana problems, yet the nature of this relation remains unclear. We examined relations between marijuana effect expectancies, social anxiety, and marijuana among undergraduates (N=337). Social anxiety was related positively to Negative Expectancies and negatively to Tension Reduction Expectancies. Among socially anxious individuals, greater belief that marijuana produces Cognitive and Behavioral Impairment was associated with greater marijuana use rates. Negative Expectancies mediated the social anxiety-marijuana problems link. These data provide new insight into problematic marijuana use among this high-risk group.     

Daily marijuana use and suicidality: the unique impact of social anxiety

Despite a clear relationship between marijuana use and suicidality, little is known about psychological vulnerability factors that may interact with marijuana use to increase suicidality among this high-risk group. The present study examined the moderational impact of social anxiety on the relationship between marijuana use status (current users vs abstainers) and suicidality among 343 community adults. We also examined whether social anxiety moderated the relation between more frequent use (daily vs less frequent) among the 134 current marijuana users. Although social anxiety did not moderate the relation between use status and suicidality, it did moderate the relation between daily use status and suicidality after controlling for a wide range of relevant variables (e.g., demographics, depression, negative affect, and other types of anxiety). The overall model accounted for 59% of the variance in suicidality such that daily marijuana users with elevated social anxiety reported the highest suicidality. Findings highlight the importance of considering social anxiety in efforts to understand and prevent suicidality among this high-risk population.     

Don’t wake and bake: morning use predicts cannabis problems

Heavy, frequent cannabis use covaries with cannabis-associated problems. With cannabis policy changing worldwide, identifying risk factors for cannabis-associated problems is crucial. While researchers have consistently studied frequency and quantity of use as important risks, clinical lore suggests that the timing of use might also contribute to problems. Similar to morning use of alcohol among alcohol-dependent individuals, morning use of marijuana may indicate dependence and increased cannabis-related impairment. Morning use also has the potential to lend itself to straightforward intervention. The present study sought to examine the relation between morning cannabis use and self-reported cannabis-associated problems. The study compared daily marijuana users who reported morning use (n?=?257) to daily marijuana users who reported no use before noon (n?=?76) using the brief Cannabis-Associated Problems Questionnaire. Morning users reported significantly more problems than non-morning users, and morning use accounted for significant unique variance in problems. Exploratory mediational analyses did not support the idea that morning use led to problems via withdrawal. The present study provides evidence that timing of cannabis use is an important factor in examining the cannabis-associated problems.     

Marijuana and self-regulation: Examining likelihood and intensity of use and problems

It is important to understand the individual differences that contribute to greater frequency or intensity of marijuana use, or greater frequency of experiencing marijuana-related problems. The current study examined several elements of behavioral and emotional self-regulation as predictors of the likelihood and intensity of both marijuana use and marijuana-related problems. As predicted, indices of behavioral self-regulation (self-control, sensation seeking) were better predictors of marijuana use, while indices of emotional self-regulation (affect, distress tolerance, and emotional instability) better predicted marijuana-related problems. Surprisingly, urgency was not related to use but was predictive of problems, and there were no significant interactions between behavioral and emotional self-regulation in predicting either use or problems. From these findings we conclude that while behavioral dysregulation may put individuals at risk for using marijuana, or using it more frequently, it is those individuals with difficulty in emotional self-regulation that are at risk for experiencing negative consequences as a result of their marijuana use. Clinically, these data are relevant; clinicians might focus more on addressing emotional regulation in order to lessen or eliminate the consequences of marijuana use.     

Personal strivings and marijuana use initiation,frequency, and problems

This study examined relations between perceived conflict/utility of marijuana use in achieving valued personal goals and marijuana use initiation, marijuana use frequency, and marijuana-related problems. Personal strivings are higher order goals that may influence marijuana use to the extent that they are congruent or incongruent with use. Participants were 592 young adults who generated lists of personal strivings independent of the substance use assessment. They then evaluated their 10 most important strivings with regard to the perceived conflict/utility of several levels of marijuana use in achieving their most important strivings. Less marijuana use-striving conflict was positively associated with use initiation and frequency. A significant gender interaction emerged in the prediction of use frequency; marijuana use-striving conflict was more strongly associated with use frequency for men than women. The relationship between use-striving conflict and marijuana-related problems was mediated fully by use frequency.     

Marijuana Motivations Across Adolescence: Impacts on Use and Consequences

Background. Motivational models for marijuana use have focused on reasons to use marijuana, but rarely consider motives to abstain. Objectives: We examined how both adolescent marijuana abstinence motives and use motives contribute to marijuana use and problems at the end of emerging adulthood. Methods. 434 community recruited youth who had not initiated marijuana use at baseline were followed from adolescence (at ages 12, 15, and 18 years) into emerging adulthood (age 25 years). Motives to abstain and to use marijuana, marijuana consumption, and marijuana-related problems were assessed across time. Results. Endorsing more motives to abstain from marijuana across adolescence predicted less marijuana use in emerging adulthood and fewer marijuana-related problems when controlling for past motives to abstain and marijuana-related behavior. Positive reinforcement use motives related to increased marijuana consumption and problems, and negative reinforcement motives predicted problems when controlling for past marijuana use motives and behaviors. Expansion motives during adolescence related to lower marijuana use in emerging adulthood. When considered together, motives to abstain buffered the effect of negative reinforcement motives on outcomes at age 25 for youth endorsing a greater number of abstinence motives. Conclusions/ Implications. Given these findings, inclusion of both motives to use and abstain is warranted within comprehensive models of marijuana use decision making and may provide important markers for prevention and intervention specialists.     

Support for Marijuana Legalization and Predictors of Intentions to Use Marijuana More Often in Response to Legalization Among U.S. Young Adults

Background: As of 2015, more than half of U.S. states have legalized, medicalized, or decriminalized marijuana. Objective: This study examined the prevalence and correlates of support for marijuana legalization in a national sample of young adults and the intention to use marijuana more frequently if it were legalized. Methods: Data were from Wave 7 (weighted N = 3532) of the Truth Initiative Young Adult Cohort, a national sample of men and women aged 18–34. We assessed demographics, past 30-day substance (alcohol, tobacco, marijuana, other drug use), depression and anxiety, social smoking, marijuana harm perceptions (relative to cigarettes), and state-level marijuana policies as correlates of support for marijuana legalization and intentions to use marijuana more often if it were legalized. Multivariable models of correlates of support for legalization and intentions to use marijuana were conducted separately for the full sample and for nonmarijuana users. Results: Weighted estimates showed that 39% of the full sample and 9% of nonmarijuana users supported marijuana legalization. Multivariable models showed that lower marijuana harm perceptions and lifetime and past 30-day tobacco use were common predictors of support for marijuana legalization and intentions to use marijuana among non-users of marijuana. Conclusions/Importance: Over a third of the sample supported marijuana legalization. Tobacco use and perceptions that marijuana is less harmful than cigarettes were robust risk correlates of support for marijuana legalization and intentions to use more frequently among nonusers. Public health campaigns should target these factors to deter marijuana-related harm in susceptible young adults.     

Psychometric evaluation of the Marijuana Reduction Strategies Self-Efficacy Scale with young recreational marijuana users

Introduction

This study evaluated the cue-reactivity and several psychometric properties of a questionnaire designed to assess marijuana users' self-efficacy to employ 21 specific cognitive-behavioral strategies to reduce their marijuana use.

Method

Using a web-based recruitment and data-collection procedure, 513 regular marijuana users completed dependent measures following marijuana-related or control cue exposure.

Results

Although exposure to marijuana-related stimuli significantly increased reported craving, mean reduction-strategy self-efficacy scores did not differ as a function of cue exposure. Reliability analyses supported retaining all 21 items as a single scale. Reduction-strategy self-efficacy was positively associated with marijuana-refusal self-efficacy and with recent past use of reduction strategies, was negatively associated with quantity and frequency of marijuana use and marijuana-related problems, and was positively but weakly associated with general self-efficacy. The most frequently reported strategies that were employed reflected restricting marijuana use to once per day, not keeping a large stash available, turning down unwanted hits, and not obtaining more marijuana right away if one's supply runs out.

Conclusions

These findings further support the reliability and validity of the questionnaire when administered to a diverse sample of regular marijuana users.     

Abstinence symptoms during withdrawal from chronic marijuana use

Although marijuana is the most commonly used illicit drug in the United States, it is not established whether withdrawal from chronic use results in a clinically significant abstinence syndrome. The present study was conducted to characterize symptoms associated with marijuana withdrawal following chronic use during a supervised 28-day abstinence period. Three groups of participants were studied: (a) current chronic marijuana users, (b) former chronic marijuana users who had not used marijuana for at least 6 months prior to the study, and (c) marijuana nonusers. Current users experienced significant increases in anxiety, irritability, physical tension, and physical symptoms and decreases in mood and appetite during marijuana withdrawal. These symptoms were most pronounced during the initial 10 days of abstinence, but some were present for the entire 28-day withdrawal period. These findings support the notion of a marijuana withdrawal syndrome in humans.