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Bruins J, Crutzen S, Veling W, Castelein S. How to quit cannabis when you have a mental illness: study from the perspective of patients who have successfully quit. BJPsych Bull 2023:1-7. [PMID: 37694506 DOI: 10.1192/bjb.2023.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
AIMS AND METHOD Research regarding quitting cannabis use often excludes patients with severe mental illness (SMI). We investigated facilitating and impeding factors in SMI patients and their advice to others, using semi-structured interviews with 12 SMI-patients, who were daily cannabis users for ≥12 months and had fully stopped using for ≥6 months. RESULTS Seeking distraction, social contacts in personal environment, avoiding temptation and support from professionals were facilitating factors in stopping. Impeding factors were withdrawal symptoms, user environment, experiencing stress and user's routine. Advice to other patients included to just do it, seek support from others, quit 'cold turkey' and acknowledge that cannabis use is a problem. Advice to mental health professionals is to discuss cannabis use from the start of treatment. CLINICAL IMPLICATIONS It is important to inform patients that cannabis use has negative consequences and limits the effects of treatment. Do not judge cannabis use or force the patient to stop.
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Affiliation(s)
- Jojanneke Bruins
- Lentis Psychiatric Institute, Groningen, The Netherlands
- University of Groningen, Groningen, The Netherlands
| | - Stijn Crutzen
- Lentis Psychiatric Institute, Groningen, The Netherlands
- University of Groningen, Groningen, The Netherlands
| | - Wim Veling
- Lentis Psychiatric Institute, Groningen, The Netherlands
| | - Stynke Castelein
- Lentis Psychiatric Institute, Groningen, The Netherlands
- University of Groningen, Groningen, The Netherlands
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Short NA, Evans MK, Raudales AM, Shapiro M, Weiss NH, Schmidt NB. Anxiety sensitivity and cannabis use motives among trauma-exposed young adult cannabis users. Am J Addict 2022; 31:242-250. [PMID: 35365953 PMCID: PMC9117414 DOI: 10.1111/ajad.13285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 01/18/2022] [Accepted: 03/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Anxiety sensitivity, or fear of anxious arousal, may be an important risk factor for problematic cannabis use. Specifically, anxiety sensitivity may motivate cannabis use to cope with distress, particularly among trauma-exposed individuals. The current study tested associations among anxiety sensitivity, its subdomains, and cannabis use motives in a sample of trauma-exposed cannabis users. We hypothesized elevated anxiety sensitivity, particularly cognitive concerns, would be associated with increased maladaptive coping use motives, after covarying for the number of traumas and cannabis use quantity. METHOD Hypotheses were tested in a cross-sectional study of trauma-exposed young adult cannabis users (N = 56) (Mage = 20.7 years, 59% women, 73% white). Participants completed self-report measures, and a clinical interview assessing cannabis use quantity. RESULTS Multiple regression analyses indicated that elevated anxiety sensitivity was associated with increased cannabis use coping motives, after covarying for the number of traumas experienced and cannabis use quantity. Specifically, higher levels of anxiety sensitivity cognitive and social concerns were associated with coping motives for cannabis use. DISCUSSION AND CONCLUSIONS Anxiety sensitivity, particularly concerns about cognitive dyscontrol and negative social evaluations of anxious arousal, may motivate cannabis use to cope with stress among trauma-exposed cannabis users. Future research should include prospective studies with diverse samples to replicate results and determine whether intervening on anxiety sensitivity could reduce maladaptive coping motives for cannabis use. SCIENTIFIC SIGNIFICANCE The current study replicates prior research indicating anxiety sensitivity, particularly cognitive concerns, is associated with maladaptive cannabis use. Expanding on prior research, findings indicated anxiety sensitivity is associated with coping motives for cannabis use among trauma-exposed cannabis users.
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Affiliation(s)
- Nicole A. Short
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Mariah K. Evans
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Alexa M. Raudales
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Mary Shapiro
- Southeastern Louisiana VA Health Care System, New Orleans, LA
| | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Mitchell Ba BJ, Aurora Ba P, Coifman Phd KG. Personality or pathology? Predictors of early substance use in first-year college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021:1-8. [PMID: 34243686 DOI: 10.1080/07448481.2021.1947297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 06/05/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim of the current study was to examine the dual role of personality and psychopathology in predicting substance use among first-year students. PARTICIPANTS 103 first-semester undergraduate students were recruited via the university subject pool. METHODS Participants completed personality questionnaires, structured clinical interviews, followed by the completion of diary entries each week reporting on substance use throughout their first semester. RESULTS Results indicated that a past diagnosis of an affective (mood/anxiety/stress) disorder was the most significant predictor of substance use. Personality and current psychopathology had no association to substance use. CONCLUSION This finding is consistent with developmental models of substance use relating to emotion-related disease and suggests that greater nuance is needed in understanding substance use risk in college students.
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Affiliation(s)
| | - Pallavi Aurora Ba
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Karin G Coifman Phd
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
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Bray BC, Berglund PA, Evans-Polce RJ, Patrick ME. A Latent Transition Analysis of Self-Reported Reasons for Marijuana Use During Young Adulthood. Eval Health Prof 2021; 44:9-24. [PMID: 33375829 PMCID: PMC7923687 DOI: 10.1177/0163278720984514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Individuals' reasons for marijuana use have been linked to their risk for continued use and development of disordered use. Although individuals tend to have multiple reasons for use, co-occurrence of reasons is not always accounted for in analytic approaches. Latent transition analysis (LTA) is ideal for modeling transitions in co-occurring reasons. Using longitudinal panel data from Monitoring the Future, LTA was used to identify profiles of self-reported reasons for marijuana use among young adults, examine transitions between profiles, and determine whether cohort, gender, race/ethnicity, parent education, grade of first marijuana use, and 4-year college attendance predicted transitions between profiles. Data included senior year cohorts from 1976-2009 and were collected at ages 19/20, 21/22, and 23/24 (weighted n = 7,294; 55.9% female; 79.3% White). Five latent classes were identified: Non-Users and individuals with Experimental, Typical, Get High + Relax, and Escape + Coping Reasons. Transitions among Non-Users, Experimental Reasons, and Typical Reasons were common; generally, those with earlier cohort membership, early initiation, college non-attending parents, and college attendance were more likely to make transitions to higher-risk classes. As the legalization of recreational marijuana use continues to expand, change over time in reasons for use should be considered carefully as interventions are developed and implemented.
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Affiliation(s)
- Bethany C. Bray
- Center for Dissemination and Implementation Science, Department of Medicine, The University of Illinois at Chicago, IL, USA
- The Methodology Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | | | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, The University of Michigan, Ann Arbor, MI, USA
| | - Megan E. Patrick
- Institute for Social Research, The University of Michigan, Ann Arbor, MI, USA
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Moitra E, Anderson BJ, Herman DS, Stein MD. Longitudinal examination of coping-motivated marijuana use and problematic outcomes among emerging adults. Addict Behav 2021; 113:106691. [PMID: 33069107 DOI: 10.1016/j.addbeh.2020.106691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/17/2020] [Accepted: 09/29/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cross-sectional research shows that coping-motivated marijuana use is associated with marijuana use and problems. However, limited research has examined how coping-motivated use might longitudinally relate to these outcomes. We examined the temporal relationship of coping-motivated marijuana use with severity of use and marijuana-related problems. METHOD Participants were 226 emerging adults, aged 18-25 years old, who currently used marijuana. Multilevel generalized linear models were used to evaluate the association between change in coping motives with change in frequency of marijuana use and marijuana problem severity from baseline to 6- and 12-month follow-ups. RESULTS In the adjusted models, frequency of marijuana use was positively associated with between subject differences (IRR = 1.49; 95%CI: 1.30, 1.71; p < .001) but not within subject change over time (IRR = 1.09; 95%CI: 0.97, 1.22; p = .139) in use of marijuana to cope. Additionally, marijuana problem severity scores were associated positively with between subject differences (IRR = 1.45; 95%CI: 1.21, 1.75; p < .001) and within subject changes over time (IRR = 1.30; 95%CI: 1.07, 1.57; p < .01) in use of marijuana to cope. CONCLUSIONS Changes in coping-motivated use of marijuana in emerging adults were directionally associated with changes in marijuana use and marijuana problems up to 12 months post-baseline. Results highlight the possible bi-directional relationship between coping motives and marijuana use and problems. Findings could be valuable in helping practitioners go beyond quantity and frequency as sufficient metrics of marijuana use problems. Motives for use may reflect additional problems and the clinical need to explore these possibilities.
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Scamaldo KM, Tull MT, Gratz KL. Motives for opioid use explain the relation between borderline personality disorder pathology and opioid use problems. Psychiatry Res 2021; 296:113609. [PMID: 33418458 DOI: 10.1016/j.psychres.2020.113609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/25/2020] [Indexed: 12/31/2022]
Abstract
Despite the established relations between borderline personality disorder (BPD) and substance use problems in general, there is a dearth of research on the relation between BPD pathology and opioid use problems, as well as factors that may explain this relation. Therefore, this study examined the indirect relations of BPD pathology to opioid use problems (i.e., prescription opioid misuse, apprehension about prescription opioid use, and opioid cravings) through motives for opioid use (i.e., coping, enhancement, social, and conformity motives) among 68 patients endorsing prescription opioid misuse in a residential correctional substance use disorder (SUD) treatment facility. Participants completed measures of BPD pathology, motives for opioid use, and opioid use problems. Findings revealed significant indirect relations of BPD pathology to opioid misuse through coping and enhancement motives, apprehension about opioid use through coping, enhancement, and social motives, and opioid cravings through coping motives within this SUD sample. Results illustrate the relevance of both emotion- and interpersonal-related motives for opioid use to opioid use problems among patients with BPD pathology in SUD treatment.
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Affiliation(s)
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA..
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Simons RM, Hansen JM, Simons JS, Hovrud L, Hahn AM. Drunkorexia: Normative behavior or gateway to alcohol and eating pathology? Addict Behav 2021; 112:106577. [PMID: 32861988 DOI: 10.1016/j.addbeh.2020.106577] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/06/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022]
Abstract
Drunkorexia is characterized by a group of behaviors designed to minimize caloric intake while maximizing levels of alcohol intoxication. Individuals plan and modify their diet, via skipping meals, exercising, or purging, to save calories for a night of alcohol consumption. Minimal research has examined risk factors related to drunkorexia, and little is known regarding associated problems. We used structural equation modeling to test associations between coping and enhancement motives, drive for thinness, body dissatisfaction, and disordered eating (i.e., bulimia behaviors) and drinking among an at-risk college population (N = 364). Drive for thinness and alcohol coping motives were positively associated with drunkorexia. Notably, drunkorexia was associated with alcohol-related outcomes, but not bulimia. While common risk factors are shared with eating pathology, drunkorexia appears to be a unique construct apart from bulimia behaviors. Results indicate drunkorexia behaviors may extend past normative drinking and place individuals at increased risk of alcohol-related problems. The current study contributes to greater understanding of functional models and maladaptive outcomes related to drunkorexia behaviors.
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Lannoy S, Mange J, Leconte P, Ritz L, Gierski F, Maurage P, Beaunieux H. Distinct psychological profiles among college students with substance use: A cluster analytic approach. Addict Behav 2020; 109:106477. [PMID: 32485549 DOI: 10.1016/j.addbeh.2020.106477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
Substance use in youth is a central public health concern, related to deleterious consequences at psychological, social, and cognitive/cerebral levels. Previous research has identified impulsivity and consumption motives as key factors in the emergence of excessive substance use among college students. However, most studies have focused on a specific substance and have considered this population as a unitary group, ignoring the potential heterogeneity in psychological profiles. We used a cluster analytic approach to explore the heterogeneity in a large sample (N = 2741) of substance users (i.e., tobacco, alcohol, cannabis, ecstasy, cocaine, heroin) on impulsivity and consumption motives. We identified four clusters: The first two clusters, associated with good self-esteem, low anxiety, and moderate substance use, were respectively characterized by low impulsivity and consumption motives (Cluster 1) and by high social and enhancement motives without marked impulsivity (Cluster 2). The two other clusters were conversely related to low self-esteem and high anxiety, and characterized by high consumption motives (particularly conformity) together with elevated urgency (Cluster 3) and by globally increased impulsivity and consumption motives (Cluster 4). These two clusters were also associated with higher substance use. These results highlight the existence of distinct psychological profiles of substance users and underline the need to develop targeted prevention and intervention programs (e.g., focusing on the specific impulsivity facets and consumption motives presented by each subgroup). Based on these findings, we also suggest extending the exploration of distinct profiles of substance users by targeting other psychological variables (e.g., self-esteem).
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Patterson A, Vu M, Haardörfer R, Windle M, Berg CJ. Motives for Alcohol and Marijuana Use as Predictors of Use and Problem Use Among Young Adult College Students. JOURNAL OF DRUG ISSUES 2020; 50:359-377. [PMID: 34290453 PMCID: PMC8291292 DOI: 10.1177/0022042620917101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined (a) differences between alcohol-only users and alcohol-marijuana co-users and (b) motives for use in relation to alcohol and marijuana use and problem use. Spring 2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use measured 4 months later. Correlates of co-use (n = 345; vs. alcohol-only use, n = 1,525) included greater alcohol and marijuana use frequency, problem drinking and marijuana use, and alcohol use motives (p's < .05). Controlling for covariates, alcohol use frequency correlated with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives, but lower Conformity alcohol use motives (p's < .001); greater Coping and Self-enhancement alcohol use motives (p's < .01) predicted problem alcohol use. Marijuana use frequency correlated with greater Coping and Expansion marijuana use motives (p's < .05); greater Expansion marijuana use motives (p = .005) predicted problem marijuana use. College-based substance use interventions should target Coping and Self-enhancement alcohol use motives and Expansion marijuana use motives.
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Do marijuana use motives matter? Meta-analytic associations with marijuana use frequency and problems. Addict Behav 2019; 99:106102. [PMID: 31473571 DOI: 10.1016/j.addbeh.2019.106102] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 07/23/2019] [Accepted: 08/16/2019] [Indexed: 12/23/2022]
Abstract
As laws expanding the accessibility of marijuana proliferate, it is increasingly important to understand how various motivations for use are differentially associated with marijuana use (e.g., frequency, quantity) and problems associated with marijuana use (e.g., reduced productivity, relationship conflict, legal issues). We conducted a meta-analytic review (k = 48, N = 11,274) of the zero-order and partial association between five marijuana use motives (i.e., coping, enhancement, social, conformity, and expansion) and a range of marijuana use outcomes (e.g., use frequency, problematic use). For marijuana use frequency zero-order correlations, we found significant positive correlations for coping, enhancement, social, and expansion, but not conformity. For marijuana use problems zero-order correlations, we found significant positive correlations for all five motives. When adjusting for the other motives, only coping, enhancement, and expansion were significantly positively associated with marijuana use frequency, and conformity was significantly negatively related to marijuana use frequency. For marijuana use problems, only coping and conformity had significant positive correlations. These results show that marijuana use motives are an important part of understanding the frequency of marijuana use and the development of marijuana use problems. These results may have implications for intervention development and public policy.
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Motives for and impairment associated with alcohol and marijuana use among college students. Addict Behav 2019; 88:137-143. [PMID: 30179731 DOI: 10.1016/j.addbeh.2018.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/21/2018] [Accepted: 08/26/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Alcohol and marijuana use are prevalent on college campuses. As recreational marijuana use is legalized, more undergraduate students may use marijuana in combination with alcohol. The motives for, frequency of, and impairment associated with dual use (alcohol and marijuana) compared to alcohol-only use may differ. We examined motives for, frequency of, and impairment associated with alcohol use and dual use at a university in a state where recreational marijuana has been legalized. METHOD Undergraduate college students completed an anonymous online survey (N = 430) concerning alcohol and marijuana frequency, motives, and impairment. Students were classified as either alcohol-only users (n = 279) or dual users (n = 151). RESULTS Analyses indicated that among alcohol-only users, social motives predicted more alcohol use, while among dual users, enhancement motives predicted more alcohol and marijuana use and impairment. Coping motives predicted more marijuana use among dual users, but not more alcohol use. Frequency of alcohol and marijuana use predicted more impairment across both the alcohol-only and dual users. CONCLUSIONS Future research should examine the influence of marijuana use over time to understand how motives may change for previous alcohol-only users.
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Testa M, Wang W, Derrick JL, Leonard KE. Marijuana Use Episodes and Partner Intimacy Experiences: A Daily Report Study. CANNABIS (RESEARCH SOCIETY ON MARIJUANA) 2019; 2:19-28. [PMID: 30923794 PMCID: PMC6433396 DOI: 10.26828/cannabis.2019.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Although marijuana use has been linked to negative consequences for intimate relationships, an emerging literature suggests that under some circumstances it may have positive consequences. Couples who use substances together report better relationship functioning over time and may experience positive short-term outcomes. Using a sample of 183 heterosexual, frequent marijuana-using couples from the community, reporting over 30 consecutive days, we examined whether marijuana use episodes were associated temporally with reports of couple intimacy experiences within the next two hours. We used multilevel modeling, within an Actor Partner Interdependence Model (APIM) framework, modeling male and female outcomes simultaneously. Consistent with hypotheses, simultaneous marijuana use (male and female partners reported use at the same hour) increased the likelihood of an intimate experience for both men and women. However, we also found positive effects for Actor and Partner solo marijuana use on male and female reports of intimacy events. When analyses were limited to marijuana use episodes in which the respondent reported on presence of partner, we found that positive effects on intimate experiences were limited to marijuana use episodes in which partner was present; use without partner did not influence likelihood of intimacy. The robust positive effects of using marijuana with one's partner on intimacy events may serve to reinforce continued couple use and explain the positive effects of concordant substance use on relationship functioning over time.
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