Marijuana use motives: A confirmatory test and evaluation among young adult marijuana users

The present investigation evaluated the measurement model and construct validity of marijuana use motives as measured by the Marijuana Motives Measure (MMM; [Simons, J., Correia, C. J., Carey, K. B., and Borsari, B. E. (1998). Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. Journal of Counseling Psychology, 45, 265-273]). Confirmatory factor analysis (CFA) and incremental tests of validity of marijuana use motives were conducted on a sample of young adult marijuana users (n=227, 127 women; M(age)=20.11, SD=4.30 years). As hypothesized, CFA analysis of marijuana use motives, as indexed by the MMM, demonstrated support for a multidimensional measurement model; specifically, a five-factor solution denoting Enhancement, Conformity, Expansion, Coping, and Social motives for marijuana use, each with satisfactory levels of internal consistency. Subsequent tests of incremental validity suggested that only certain motives were uniquely related to current substance use and cognitive-affective factors. Results are discussed in relation to refining the scientific understanding of marijuana use motives.     

Marijuana motives: young adults' reasons for using marijuana

Previous research has evaluated marijuana motives among adolescents and emerging adults using a predetermined set of motives, largely adapted from the alcohol literature. This research was designed to identify marijuana motives from the perspective of the user. Recent high school graduates who reported using marijuana (N=634) provided self-generated reasons for using. The most frequently reported reasons included enjoyment/fun, conformity, experimentation, social enhancement, boredom, and relaxation. Regression analyses revealed that experimentation was consistently associated with less use and fewer problems whereas enjoyment, habit, activity enhancement, and altered perception or perspectives were associated with heavier use and more problems.     

Development and validation of the Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ) in adult cannabis users in treatment

Background

There are few valid clinical assessment instruments for cannabis. Self-efficacy, or the ability of users to resist temptation, is a central feature of social cognitive theory. This study outlines the development and validation of the Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), which measures the situational confidence to refuse cannabis.

Method

One thousand two hundred and forty-six patients referred for cannabis assessment completed the CRSEQ including measures of cannabis consumption and dependence severity (Severity of Dependence Scale-Cannabis, SDS-C). The CRSEQ was subject to independent exploratory (n = 621, mean age 26.88, 78.6% male) and confirmatory (n = 625, mean age 27.51, 76.8% male) factor analysis.

Results

Three factors: Emotional Relief, Opportunistic and Social Facilitation were identified. They provided a good statistical and conceptual fit for the data. Emotional Relief cannabis refusal self-efficacy was identified as most predictive of cannabis dependence, after controlling for cannabis consumption.

Conclusions

The CRSEQ is recommended as a psychometrically sound and clinically useful measure for cannabis misuse treatment planning and assessment.     

Motivational and mindfulness intervention for young adult female marijuana users

This pilot study tested the efficacy of a brief intervention using motivational interviewing (MI) plus mindfulness meditation (MM) to reduce marijuana use among young adult females. Thirty-four female marijuana users between the ages of 18 and 29 were randomized to either the intervention group (n = 22), consisting of two sessions of MI-MM, or an assessment-only control group (n = 12). The participants' marijuana use was assessed at baseline and at 1, 2, and 3 months posttreatment. Fixed-effects regression modeling was used to analyze treatment effects. Participants randomized to the intervention group were found to use marijuana on 6.15 (z = −2.42, p = .015), 7.81 (z = −2.78, p = .005), and 6.83 (z = −2.23, p = .026) fewer days at Months 1, 2, and 3, respectively, than controls. Findings from this pilot study provide preliminary evidence for the feasibility and effectiveness of a brief MI-MM for young adult female marijuana users.     

Sexual risk taking among young adult dual alcohol and marijuana users

Use of alcohol and marijuana among college students is common and use of these substances may increase the likelihood of risky sexual behavior. The present study found significant associations between risky sexual behavior and both mean BAC per drinking day and marijuana use intensity. However, hypothesized interactions between marijuana use and BAC were not supported. In addition, positive and negative urgency and premeditation were each significantly associated with the likelihood of risky sex. Substance use and facets of impulsivity and self-control exhibited direct associations with risky sexual behavior but hypothesized moderation effects were not supported. Associations between urgency and risky sexual behavior varied as a function of gender and trait positive affect.     

Individual and contextual predictors of severity of marijuana use events among young frequent users

This study used momentary sampling to characterize marijuana events among young frequent users and determine contextual and individual predictors of use severity. Medical clinic outpatients aged 15–24 who used marijuana at least twice a week completed a baseline assessment, then used a handheld computer to report marijuana use at 4–6 signal-prompted times per day and before/after use for 2 weeks. Reports assessed event characteristics (when, with whom, where, how, why, how much, how high). Timestamps identified time, weekend, and duration for each event. Generalized estimating equations tested associations of individual and event-specific contextual characteristics with hits/event, duration, and high. Forty-one youth completed 3868 momentary reports; 40 (98%) reported at least one marijuana use event (N = 432 events; M = 10.5/participant) and thus provided data for these analyses. Marijuana was most commonly used with other people (74% of events), at home (58%), via blunt (66%), and for social or enhancement reasons (86%). Most events (62%) occurred on weekdays; use was least likely in the morning (8%). Most events involved 6 or more hits (81%). Mean high was 5.2 (out of 8). Of events with start and end times (n = 250), mean duration was 46.8 min. Poor mental health and use with a blunt or a bong, in the morning or evening, and on the weekend were associated with 6 or more hits/event. Female gender was associated with greater event duration. Poor mental health predicted higher high. Among youth who used it frequently, marijuana was used in a variety of contexts, with diversity in method, dose, and duration. Contextual factors appeared to predict marijuana dose for a given event, while individual characteristics were more predictive of high and duration.     

Effects of research setting on observed depressive symptoms in marijuana users

A post hoc analysis examined depressive symptoms in regular marijuana smokers interested in nontreatment, laboratory studies, and marijuana-dependent treatment-seekers considering clinical trial participation. Among marijuana-dependent treatment-seeking patients screened for a clinical trial, the mean Beck Depression Inventory Score (BDI) was significantly higher than for marijuana-using volunteers screened for nontreatment laboratory studies. Mean self-reported baseline marijuana use was not significantly different between groups, and BDI score was not correlated with use. Although the methods by which the two groups were selected influenced their characteristics (i.e., treatment-seekers are more likely to be experiencing some degree of clinical distress), it is notable that treatment-seeking, and not marijuana use per se, is associated with significantly higher rates of depression.     

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 use motives: concurrent relations to frequency of past 30-day use and anxiety sensitivity among young adult marijuana smokers

The present investigation examined two theoretically relevant aspects of marijuana motives using the Marijuana Motives Measure (MMM) [Simons, J., Correia, C. J., Carey, K. B., & Borsari, B. E. (1998). Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. Journal of Counseling Psychology 45, 265-273] among 141 (78 female) young adults (M(age)=20.17, S.D.=3.34). The first objective was to evaluate the incremental validity of marijuana motives in relation to frequency of past 30-day use after controlling for the theoretically relevant factors of the number of years using marijuana (lifetime), current levels of alcohol, as well as tobacco smoking use. As expected, coping, enhancement, social, and expansion motives each were uniquely and significantly associated with past 30-day marijuana use over and above the covariates; conformity motives were not a significant predictor. A second aim was to explore whether coping, but no other marijuana motive, was related to the emotional vulnerability individual difference factor of anxiety sensitivity (fear of anxiety). As hypothesized, after controlling for number of years using marijuana (lifetime), past 30-day marijuana use, current levels of alcohol consumption, and cigarettes smoked per day, anxiety sensitivity was incrementally and uniquely related to coping motives for marijuana use, but not other motives. These results are discussed in relation to the clinical implications of better understanding the role of motivation for marijuana use among emotionally vulnerable young adults.     

Short-term effects of marijuana smoking on cognitive behavior in experienced male users

The effects of smoking marijuana on the ability to use abstract concepts was tested in 12 experienced marijuana users. Each subject was tested three times, after smoking prepared 300 mg cigarettes containing either 0, 1.5 or 2.9% ⁹-THC in different sessions according to a Latin Square design. The same number of whole and/or partial cigarettes was smoked by each subject in each of the three sessions. This was determined for individual subjects by the number of 2.9% ⁹-THC marijuana cigarettes that the subject had been willing to smoke in a pre-experimental session up to a maximum of 1200 mg. The following tests of concept formation and usage were used: 1. a letter series test; 2. a word grouping test; 3. a conceptual clustering memory test; 4. a closure speed test; 5. Witkin's Embedded Figures Test; 6. a size weight illusion test; 7. Luchin's Water Jar Test; 8. Luchin's Hidden Word Test; and 9. an anagram test. Marijuana smoking led to a dose-related impairment on the letter series, word grouping, closure speed, and Embedded Figures test. Performance on the size-weight illusion, Luchin's Water Jar, Luchin's Hidden Word, and the anagram tests were unaffected. Conceptual clustering decreased after marijuana smoking. In most cases only the differences between 0 and 2.9% ⁹-THC marijuana were statistically significant.This study is a partial report of a Ph. D. dissertation of J. H. P. submitted to the University of Michigan while on a USPHS predoctoral traineeship, NIMH, USPHS 5TOI MH-0667-13. Also supported in part by grant USPHS MH-11846.     

Comparing injunctive marijuana use norms of salient reference groups among college student marijuana users and nonusers

Marijuana is the most commonly used illicit drug among college students and has the potential for various negative outcomes. Perceptions of what constitutes typical approval/acceptability of a reference group (i.e. injunctive social norms) have been shown to have strong utility as predictors of health-risk behaviors in the college context, yet this construct remains significantly understudied for marijuana use despite its potential for use in social norms-based interventions. The current research evaluated individuals' marijuana approval level and their perceptions of others' marijuana approval level (i.e. injunctive norms) for various reference groups (typical student on campus, one's close friends, and one's parents) as a function of individual user status (abstainers, experimenters, occasional users, and regular users). A diverse sample of 3553 college students from two universities completed an online survey. Among all user status groups, individual approval yielded mean scores paralleling that of perceived close friends' approval and all groups were relatively uniform in their perception of typical students' approval. Higher levels of marijuana use tended to produce higher endorsements of individual approval, perceived close friends' approval, and perceived parental approval. Among occasional and regular users, there were no differences between one's own approval level for use and the perceptions of close friends' approval, nor did they think the typical student was more approving than themselves. Abstainers and experimenters, however, perceived typical students and close friends to have more permissive attitudes than themselves. Implications and future directions for research regarding the role of injunctive marijuana use norms in the development of social norms intervention are discussed.     

Dimensions and severity of marijuana consequences: development and validation of the Marijuana Consequences Questionnaire (MACQ)

The Marijuana Consequences Questionnaire (MACQ) is a 50-item self-report measure modeled after the Young Adult Alcohol Consequences Questionnaire (YAACQ). College students (n=315) completed questionnaires online. A confirmatory factor analysis supported the hypothesized 8-factor structure. The results indicate good convergent and discriminant validity of the MACQ. A brief, unidimensional, 21-item version (B-MACQ) was developed by a Rasch model. Comparison of item severity estimates of the B-MACQ items and the corresponding items from the YAACQ indicates that the severity of alcohol- and marijuana-problems is defined by a relatively unique pattern of consequences. The MACQ and B-MACQ provide promising new alternatives to assessing marijuana-related problems.     

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.     

Behavioral treatment for marijuana dependence: Randomized trial of contingency management and self-efficacy enhancement

Objective

The purpose of the present study was to develop a treatment for marijuana dependence specifically designed to enhance self-efficacy.

Method

The participants were 215 marijuana-dependent men and women randomized to one of three 9-week outpatient treatments: a condition intended to enhance self-efficacy through successful completion of treatment-related tasks (motivational enhancement plus cognitive-behavioral treatment plus contingency management reinforcing completion of treatment homework; MET + CBT + CM_Homework); a condition that controlled for all elements except for reinforcement of homework (MET + CBT + contingency management reinforcing drug abstinence; MET + CBT + CM_Abstinence); or a case management control condition (CaseM). Participants in the two MET + CBT conditions were also asked to complete interactive voice recordings three times per week during treatment to confirm homework completion.

Results

All patients showed modest improvements over time through 14 months, with few between-treatment effects on outcomes. Latent Class Growth Models, however, indicated that a subsample of patients did extremely well over time. This subsample was more likely to have been treated in the CM_Abstinence condition. In turn, this treatment effect appears to have been accounted for by days of continuous abstinence accrued during treatment, and by pre-post increases in self-efficacy.

Conclusions

The most effective treatments may be those that elicit abstinence while increasing self-efficacy.     

Functional MRI of inhibitory processing in abstinent adolescent marijuana users

Background Marijuana intoxication appears to impair response inhibition, but it is unclear if impaired inhibition and associated brain abnormalities persist after prolonged abstinence among adolescent users. We hypothesized that brain activation during a go/no-go task would show persistent abnormalities in adolescent marijuana users after 28 days of abstinence. Methods Adolescents with (n = 16) and without (n = 17) histories of marijuana use were compared on blood oxygen level dependent (BOLD) response to a go/no-go task during functional magnetic resonance imaging (fMRI) after 28 days of monitored abstinence. Participants had no neurological problems or Axis I diagnoses other than cannabis abuse/dependence. Results Marijuana users did not differ from non-users on task performance but showed more BOLD response than non-users during inhibition trials in right dorsolateral prefrontal, bilateral medial frontal, bilateral inferior and superior parietal lobules, and right occipital gyri, as well as during “go” trials in right prefrontal, insular, and parietal cortices (p < 0.05, clusters > 943 μl). Differences remained significant even after controlling for lifetime and recent alcohol use. Conclusions Adolescent marijuana users relative to non-users showed increased brain processing effort during an inhibition task in the presence of similar task performance, even after 28 days of abstinence. Thus, increased brain processing effort to achieve inhibition may predate the onset of regular use or result from it. Future investigations will need to determine whether increased brain processing effort is associated with risk to use.     

Brief Motivational Intervention and telemedicine: A new perspective of treatment to marijuana users

The main purpose of this study was to evaluate the telephone Brief Motivational Intervention (BMI) efficacy in marijuana consumption cessation. A clinical trial was performed on Brazilian citizens, who were randomly divided into experimental (BMI) and minimal intervention (reference material) treatment groups; the study involved 524 participants who were monitored for 6 months. In addition, the data was collected by a free-service call center; both marijuana consumption and level of motivation for behavior change were evaluated, based on the telephone service offered. The proportion of abstainers in the BMI group was significantly greater than in the control group: 73% of the individuals in the BMI group were abstainers. In the control group, 59% of them ceased on using marijuana. The ratio of probability for marijuana cessation was 1.6 times higher in the BMI group. There was no significant difference on the motivation for behavior change in both groups. The collected data demonstrated the telephone BMI's positive efficacy in marijuana consumption cessation.     

Psychometric assessment of the Temptations to Try Alcohol Scale

Effective interventions require an understanding of the behaviors and cognitions that facilitate positive change as well as the development of psychometrically sound measures. This paper reports on the psychometric properties of the Temptations to Try Alcohol Scale (TTAS), including factorial invariance across different subgroups. Data were collected from 3565 6th grade RI middle school students. Structural equation modeling was used to determine the appropriate factorial invariance model for the 9-item TTAS. The measure consists of three correlated subscales: Social Pressure, Social Anxiety, and Opportunity. Three levels of invariance, ranging from the least to the most restrictive, were examined: Configural Invariance, which constrains only the factor structure and zero loadings; Pattern Identity Invariance, which requires factor loadings to be equal across the groups; and Strong Factorial Invariance, which requires factor loadings and error variances to be constrained. Separate analyses evaluated the invariance across two levels of gender (males vs. females), race (white vs. black) ethnicity (Hispanic vs. Non-Hispanic) and school size (small, meaning <200 6th graders, or large). The highest level of invariance, Strong Factorial Invariance, provided a good fit to the model for gender (CFI: .95), race (CFI: .94), ethnicity (CFI: .94), and school size (CFI: .97). Coefficient Alpha was .90 for Social Pressure, .81 for Social Anxiety, and .82 for Opportunity. These results provide strong empirical support for the psychometric structure and construct validity of the TTAS in middle school students.     

A Rasch analysis of the Harm Reduction Self-Efficacy Questionnaire in Portugal

Introduction

A high degree of self-efficacy is required from drug users if they are to adopt long-term abstinence-maintaining or harm-reducing behaviors. Our objective was to analyze the psychometric quality of the Harm Reduction Self-Efficacy Questionnaire (HRSEQ) with the Rating Scale Model (RSM), an extension of the Rasch Model for polytomous items.

Methods

Participants were 419 drug dependents from both harm reduction low threshold methadone program and therapeutic community programs in Portugal (84.5% male).

Results

Indicate that the original 11-category response system did not work adequately in any of the HRSEQ situations (Withdrawal, Negative emotions and Social pressure). There was no gender-related or group-related DIF and thus the findings of neither group nor gender-related difference in harm reduction self-efficacy cannot be plausibly attributed to that technical problem.

Conclusions

After recoding the rating scales by collapsing the eleven categories into four, the HRSEQ scores show good model fit and psychometric adequacy.     

Consumer use and understanding of labelling information on edible marijuana products sold for recreational use in the states of Colorado and Washington

BackgroundIn 2014, the states of Colorado and Washington began allowing retail sales of marijuana for recreational use. The regulatory agencies in these states have implemented specific labelling requirements for edible marijuana products sold for recreational use to help address concerns such as delayed activation time, accidental ingestion, and proper dosing.MethodsWe conducted 12 focus groups with 94 adult consumers and nonconsumers of edibles in Denver and Seattle to collect information on their use and understanding of labelling information on edible marijuana products sold for recreational use. Specifically, we asked participants about the usefulness, attractiveness, ease of comprehension, relevancy, and acceptability of the label information.ResultsSome focus group participants look for and read specific information, such as the potency profile and serving size statement, but do not read or were unfamiliar with other labelling features. The focus groups revealed that participants have some concerns about the current labelling of edibles. In particular, participants were concerned that there is too much information on the labels so consumers may not read the label, there is no obvious indication that the product contains marijuana (e.g., a Universal Symbol), and the information on consumption advice is not clear. Participants in both locations suggested that education in a variety of formats, such as web- and video-based education, would be useful in informing consumers about the possible risks of edibles.ConclusionThe focus group findings suggest that improvements are needed in the labelling of edibles to prevent unintentional ingestion among adult nonusers and help ensure proper dosing and safe consumption among adult users. These findings, along with lessons learned from Colorado and Washington, can help inform the labelling of edibles as additional states allow the sale of edibles for recreational use.     

Neurophysiological and cognitive effects of smoked marijuana in frequent users

Rationale

Previously, we reported that acute marijuana intoxication minimally affected complex cognitive performance of daily marijuana smokers. It is possible that the cognitive tests used were insensitive to marijuana-related cognitive effects.

Objectives

In the current study, electroencephalographic (EEG) signals were recorded as daily marijuana users performed additional tests of immediate working memory and delayed episodic memory, before and after smoking marijuana.

Methods

Research volunteers (N = 24), who reported smoking ∼ 24 marijuana cigarettes/week, completed this study. Participants completed baseline computerized cognitive tasks, smoked a single marijuana cigarette (0%, 1.8%, or 3.9% ?⁹-THC w/w), and completed additional cognitive tasks; sessions were separated by at least 72-hours. Cardiovascular and subjective effects were also assessed throughout sessions.

Results

Overall performance accuracy was not significantly altered by marijuana, although the drug increased response times during task performance and induced a response bias towards labeling “new” words as having been previously seen in the verbal episodic memory task. Marijuana reduced slow wave evoked potential amplitude in the episodic memory task and decreased P300 amplitude and EEG power in the alpha band in the spatial working memory task. Heart rate and “positive” subjective-effect ratings were increased in a ?⁹-THC concentration-dependent manner.

Conclusions

Relative to previous findings with infrequent marijuana users, the frequent users in the current study exhibited similar neurophysiological effects but more subtle performance effects. These data emphasize the importance of taking into account the drug-use histories of research participants and examining multiple measures when investigating marijuana-related effects on cognitive functioning.