Internalizing symptoms and cannabis and alcohol use: Between- and within-person risk pathways with coping motives

Monthly patterns of depressive symptoms and substance use and their relation to longer-term hazardous substance use and mental health problems: Examining mutual maintenance using monthly data from young adults

The current study examined whether young adults showing a pattern of greater substance use on months when experiencing greater levels of depressive symptoms showed long-term hazardous alcohol and cannabis use and elevated depressive symptoms. Data were from 772 young adults in Washington State (mean age = 21.1 years, SD = 1.7; 57 % female). For 24 consecutive months, surveys asked about past-month depressive symptoms and typical number of alcoholic drinks per week and typical number hours high on cannabis per week. Participants completed a survey 30 months after baseline that included measures of depressive symptoms and hazardous alcohol and cannabis use. Multilevel models showed substantial variability in monthly within-person associations of depressive symptoms with alcohol and cannabis use across individuals during the first 24 months. On months when experiencing increased depressive symptoms compared to their average, some young adults used more alcohol or cannabis and some used less. When linking outcomes at 30-month follow-up to person-specific slopes extracted from the multilevel models, results showed that young adults who tended to drink more or use more cannabis when they experienced more depressive symptoms than their average reported greater levels of hazardous alcohol and cannabis use at 30-month follow-up, respectively. Person-specific slopes were not associated with 30-month depressive symptoms. Although there was substantial variability in within-person monthly associations, findings suggest that young adults showing short-term patterns consistent with increased alcohol and cannabis use to regulate depressive symptoms may benefit from prevention and intervention efforts aimed at decreasing risk of longer-term problematic substance use.

Exposure to community violence and internalizing symptoms: The risk of substance use in African American youth

African American adolescents are often disproportionately exposed to community violence, which increases their risk of using substances and developing internalizing symptoms. While these associations are well established in the literature, a limited number of studies have examined substance use as a pathway for the development of internalizing symptoms following exposure to community violence. Using structural equation modeling (SEM) and a cross-sectional design, the current study aimed to explore whether exposure to community violence was associated with substance use. Then, the current study explored whether substance use mediated the association between exposure to community violence and internalizing symptoms while controlling for gender. The sample consisted of 668 African American adolescents from low-resourced neighborhoods in Chicago's Southside. The sample areas were characterized as racially and socioeconomically homogeneous with an average annual income ranging from $24,049 to $35,946, with the city average being $43,628. Results suggested that exposure to community violence was positively associated with substance use. Substance use also mediated the association between exposure to community violence and internalizing symptoms. That is, following exposure to community violence, African American adolescents were more likely to use substances, which increased their susceptibility to developing internalizing symptoms despite gender differences.

Drinking to Cope Motivation in College as a Predictor of Post-College Interpersonal Problems and Depressive Symptoms

BACKGROUND

Evidence indicates that high levels of drinking to cope (DTC) motivation, independent of drinking level, might precede temporally proximal increases in negative affect and interpersonal stress. In the present study, we examined whether high levels of DTC motivation were related to these outcomes prospectively over a 5-year period.

METHOD

We assessed college student drinkers first in college and then approximately 5 years later after leaving the college environment. At both time points participants reported depression symptoms in a one-time survey and daily drinking level, motives, and interpersonal stress via a 30-day diary. Interpersonal chronic stress was also assessed at wave 2 using a semi-structured phone-based interview. Finally, neuroticism, trait avoidance coping, and drinking-related problems were assessed in college and used as control variables.

RESULTS

DTC motivation assessed in college was uniquely and positively related to post-college depressive symptoms, mean levels of daily interpersonal stress, and interview-rated interpersonal stress.

CONCLUSIONS

Engagement in high levels of coping-motivated alcohol use in college could be a risk factor for longer-term internalizing symptoms and interpersonal problems. Individuals with high levels of DTC motivation in college could be a useful target for prevention and intervention.

Internalizing symptoms, negative urgency, and coping motives: Potential pathways to alcohol consequences

OBJECTIVE

Building upon prior research, the present study tested coping motives as a mediator of relations between both negative urgency and internalizing symptoms (depression, anxiety, and stress), and alcohol-related consequences using longitudinal data. We also tested negative urgency as a moderator of prospective relations between specific internalizing symptoms and alcohol-related consequences.

METHOD

The study utilized data from a longitudinal study of young adults (N = 448; Mage = 22.27, SD = 1.25). Participants (56.5% male) were evaluated at baseline and at 12-month and 24-month follow-ups. Mood, impulsivity, coping motives, and alcohol consequences were assessed at baseline, and motives and consequences were assessed at follow-ups.

RESULTS

Prospective indirect effects of internalizing symptoms and negative urgency on alcohol consequences through coping motives were not observed. However, cross-sectional post hoc analyses indicated that higher levels of internalizing and negative urgency were indirectly associated with greater alcohol consequences through coping motives, with similar patterns observed for depression, anxiety, and stress. Although support was found for mediated effects in the cross-sectional model, no evidence was found for negative urgency moderating the impact of internalizing, stress, anxiety, or depression on alcohol consequences in either cross-sectional or longitudinal models.

CONCLUSION

Findings provide cross-sectional but not longitudinal support for coping motives as a potential mechanism through which a broad range of internalizing symptoms are associated with alcohol consequences. Findings did not support interactions between negative urgency and internalizing symptoms. The results highlight the need for further exploration of mediated effects using ecological momentary assessments. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Effect of comorbid psychologic and somatic symptom trajectories on early onset substance use among U.S. youth in the ABCD study

BACKGROUND

Adolescent substance use (SU) is often motivated by a desire to alleviate undesirable symptoms. To test the self-medication hypothesis, we examined associations between comorbid psychologic and somatic symptom trajectories across early adolescence and early onset SU.

METHODS

Using Adolescent Brain Cognitive Development Study® data, we differentiated youth who reported no SU at baseline based on their comorbid anxiety, depression, pain, somatic and somnolence symptom trajectories. The outcome, early onset SU (by age 13-14 years) was derived from self-reported alcohol (≥full drink), tobacco (full regular/e-cigarette), marijuana, or other drug use over 5 years.

RESULTS

8311 participants were classified with Asymptomatic (27.8 %), Low/stable (39 %), Moderate/persistent (25.3 %) or High/worsening trajectories (7.9 %) from age 9.97 ± 0.74 to 13.57 ± 0.88 years. Early onset SU was 56 % higher for Moderate-High compared to Asymptomatic-Low symptom trajectory groups (12.5 % vs. 8.5 %; OR 1.56 [95 % CI 1.33, 1.79]). Adjusted for covariates, the High/worsening group was more likely than the Asymptomatic group to report use of any substance (adj.OR 2.13 [95 % CI 1.40, 3.25], Alcohol (adj.OR 2.80 [95 % CI 1.56, 5.02]), Tobacco (adj.OR 2.09 [95 % CI 1.23, 3.55]), and Marijuana (adj.OR 2.33 [95 % CI 1.36, 3.99]). Longitudinal, time-lagged analyses revealed potential feedback effects of earlier depression on subsequent SU, and earlier SU on later depression (p < 0.001).

CONCLUSION

Higher comorbid symptom trajectories emerging in late childhood increased the likelihood of early onset SU. Since negative feedback loops may contribute to symptom persistency, ongoing and potentially harmful SU for at-risk youth, addressing comorbid symptoms that emerge during late childhood is warranted.

Negative urgency increases risk for coping-motivated cannabis outcomes in socially anxious male emerging adult cannabis users

Tension reduction theory suggests that socially anxious emerging adults use cannabis to cope with negative affect. However, the literature is mixed, indicating that the effect of social anxiety on cannabis use behaviors during emerging adulthood may depend on other moderating factors, such as negative urgency. This study aimed to clarify potential moderators that may strengthen the associations between social anxiety and cannabis outcomes among emerging adults. Emerging adult undergraduates who reported past six-month cannabis use completed an online self-report survey. Results from a mediated moderation revealed that higher social anxiety predicted elevated cannabis use and problems via coping motives, but only for males higher in negative urgency. Findings suggest that socially anxious males higher in negative urgency are at greater risk for coping-motivated cannabis use and related problems. These results may inform screening and treatment approaches aimed at reducing impulsive cannabis use and subsequent harms for these emerging adult males.

Cannabis Vaping Is Associated With Past 30-Day Suicide Attempts and Suicidal Ideation Among Adolescents in a Psychiatric Inpatient Setting

Objective

Increasing evidence links adolescent cannabis use (CU) to suicidal thoughts and behaviors. CU may be associated with both developing and self-medicating psychiatric symptoms. Although relatively new, cannabis vaping is increasing among adolescents. This chart review investigation evaluated the association between cannabis vaping and suicidal thoughts and behaviors among adolescents experiencing acute psychiatric symptomatology.

Method

The sample included 470 adolescents (ages 11-18; 64% biological female) admitted to an inpatient psychiatric hospital between 2021 and 2023. Adolescents completed an assessment battery measuring CU, psychiatric symptoms, and suicidal thoughts and behaviors. Separate regressions tested links between cannabis vaping and 2 outcomes-past 30-day suicide attempt and suicidal ideation (SI)-controlling for age and biological sex.

Results

In this sample, 26.8% reported past 30-day suicide attempts; 44.3% endorsed ever using cannabis, and 31.5% reported past 30-day CU. Of adolescents who ever used cannabis, 30.8% reported their most frequent method was vaping. Vaping as the most frequent cannabis method was associated with past 30-day suicide attempts (adjusted odds ratio = 2.38, p = .002) and greater SI (b = 8.71, p = .020). The association remained significant for suicide attempts, but only marginally significant for SI (p = .087), after controlling for depressive symptoms, impulse control, psychosocial impairment, and past 30-day substance use.

Conclusion

Vaping as the most frequent method of CU was significantly associated with suicide attempts and SI. Because data are cross-sectional, causality cannot be inferred. Nonetheless, cannabis vaping is important to assess among adolescents with acute psychiatric concerns because it may place them at higher risk for suicidal thoughts and attempts.

Age of onset and alcohol and cannabis use disorders among Mexican American young adults: Robust substance-specific effects of early use as a risk factor

We investigated the substance-specific and cross-substance risk associated with early onset (before age 15) of drunkenness and cannabis use in the subsequent development of alcohol (AUD) and cannabis use disorder (CUD) in Mexican American young adults. Survival analyses employed Cox proportional hazards models for AUD and CUD, separately. In cross-risk analyses, we modeled estimates for those participants reporting lifetime use of both substances. Early onset of drunkenness and early onset of cannabis use were associated with shorter time to AUD and CUD, respectively, even after accounting for psychiatric disorders. While there were no cross-risk associations, adjusting for psychiatric disorders and early onset cannabis use attenuated the association of early drunkenness with AUD.

Travel Health-Related Preparation Practices of Institutions of Higher Education and Occurrence of Health-Related Events among Undergraduate Students Studying Abroad, 2018-2021

Background

Knowledge of specific health-related events encountered by students studying abroad and the availability and use of pre-travel healthcare for these students is lacking.

Methods

Anonymous web-based questionnaires were sent to study abroad offices, student health centers, and undergraduate students after studying abroad at eight institutions of higher education in the United States and Ireland from 2018-2021. Analyses were descriptive; relative risks and 95% confidence intervals were calculated for health-related events.

Results

One study abroad office required a pre-travel consultation. All student health centers had pre-travel counseling available. Among 686 students, there were 307 infectious and 1,588 non-infectious health-related issues; 12 students (2%) were hospitalized. Duration of travel and timing of a pre-travel consultation impacted the risk of health-related events. Certain mental health conditions were associated with increased risk of alcohol and drug use.

Conclusion

Future studies should address the optimal timing and best practices to optimize health for students studying abroad.

Delta-8- and Delta-9-THC Use Frequency, Use Motives, and Mental Health Outcomes

Use of delta-8-THC ("delta-8") has proliferated after the passage of the 2018 Farm Bill. Yet, research on the mental health effects of this increasingly popular cannabinoid is scant. The current study sought to examine mental health correlates of delta-8 use frequency and motives, investigate whether delta-8 use motives predict use frequency, and compare use motives and problems between delta-8 and traditional cannabis. Participants consisted of 363 self-reported delta-8 users who completed measures of delta-8 use frequency, motives, and problems that were adapted from comparable measures for cannabis, as well as measures of mental health outcomes. Delta-8 use frequency was unrelated to use problems and other mental health outcomes. Delta-8 use frequency was positively associated with social and coping motives, but negatively associated with enhancement and conformity motives. Coping and conformity motives were associated with greater depression, anxiety, insomnia, and delta-8 use problems. Participants were more likely to report coping and enhancement motives for delta-8 use compared to cannabis use, but less likely to report conformity motives. Further longitudinal research is needed to assess causality for associations between delta-8 use frequency, use motives, and mental health outcomes.

Anxiety, Depression, Coping, Alcohol Use and Consequences in Young Adult College Students

BACKGROUND

Young adult college students experience a high risk for heavy alcohol use and resulting consequences. Symptoms of anxiety and depression increase this risk. Coping style has been associated with alcohol use and consequences, with approach coping being inversely related to use and consequences, and avoidance coping being directing related to use and consequences. The purpose of this study is to examine whether coping style moderates or mediates the relationship between anxiety/depression and alcohol use and consequences.

METHODS

250 young adult college students ages 18 to 25 years (Women = 85, 34%) anonymously self-reported anxiety, depression, coping style, alcohol use and consequences.

RESULTS

Path analysis showed that avoidance coping was positively related to alcohol use (β = 0.33, p < 0.05), social consequences (β = 0.39, p < 0.05), and personal consequences (β = 0.26, p < 0.05), while approach coping was inversely related to use (β = -0.20, p = 0.005). Coping did not moderate the relationship between anxiety and depression and alcohol use or consequences. Avoidance coping mediated the relationship between depression and alcohol use (β = 0.14, p < 0.05), social consequences (β = 0.16, p < 0.05), and personal consequences (β = 0.11, p < 0.05).

CONCLUSION

Findings build on alcohol use and consequences research, and support further research into implementing coping-based alcohol use interventions. Interventions aimed at reducing avoidance coping and increasing approach coping may be beneficial for young adult college students.

Mental and Physical Health-Related Cannabis Motives Mediate the Relationship between Childhood Trauma and Problematic Cannabis Use over Time among Emerging Adult Cannabis Users

BACKGROUND

While growing evidence has identified mental and physical health-related cannabis use motives as significant mechanisms between childhood trauma and problematic cannabis use (PCU) for emerging adults (EA), there is a need to understand the longitudinal stability of these pathways and how they impact PCU as cannabis users age into later adulthood.

METHODS

The current study extends an analysis examining the impact of childhood trauma (e.g., emotional abuse, sexual abuse) on multiple indicators of PCU through a range of cannabis use motives. 339 medical cannabis patient and non-patient EA users from the Los Angeles area were sampled at baseline (mean age = 21.23; SD = 2.48). The present analysis used four waves of follow-up data collected from 2016 to 2018 (W3, W4) and 2019-2020 (W5, W6).

RESULTS

Use of cannabis to cope with nausea, sleep, pain, and emotional distress mediated the relationships between some types of childhood abuse and PCU at W4, though most associations attenuated by later adulthood (W6). Specifically, greater emotional distress and nausea motives were associated with greater PCU in models of emotional abuse and neglect and sexual abuse, with emotional distress continuing to mediate at W6. Conversely, sleep and pain motives were associated with lower PCU in models for emotional neglect.

CONCLUSIONS

Mental and physical health-related motives reflect potential intervenable factors that predict PCU in emerging adulthood among EA cannabis users with histories of childhood trauma. Results highlight the importance of and value for assessing a wide range of motives and PCU outcomes to target and address areas for intervention.

Pot at the End of the Rainbow: Cannabis Use Among Sexual Minorities

Introduction: Gay, lesbian, and bisexual individuals (i.e., sexual minorities) use cannabis more frequently than heterosexuals; however, little research has directly compared sexual minorities' patterns of cannabis use (e.g., quantity, age of onset, forms of cannabis used) with heterosexuals. Some research has identified motivations for cannabis use in sexual minorities, but much of this research has been qualitative and/or narrow in scope (e.g., focused on sexual motivations). To the best of our knowledge, no previous research has used a validated measure to examine motives for cannabis use among sexual minorities. Additionally, cannabis use is known to be associated with mental health symptoms, but little research has examined relationships between cannabis use and mental health in this population. Materials and Methods: Data analyses were performed on archival survey data collected from 10 undergraduate psychology subject pools across the United States (N=4,669) as a part of Project ART (Addictions Research Team). Participants indicated their sexual orientation using a 5-point scale, and responses were used to classify participants into three groups: the majority of the sample (n=3,483) were classified into the heterosexual group, about one quarter were classified into the bisexual group (n=1,081), and a small number were classified into the gay group (n=105). Results: The bisexual group was more likely to report using cannabis. They also reported using cannabis more frequently, were more likely to report use of all product types (i.e., flower, concentrates, and edibles), and reported more severe symptoms of cannabis use disorder (CUD) than the heterosexual group. The bisexual group also reported higher levels of coping and enhancement motives for using cannabis and reported higher levels of all measured mental health symptoms (e.g., depression, suicidality, generalized anxiety, and social anxiety) compared with the heterosexual group. Conclusions: Increased frequency of cannabis use, use of a broad range of different products, and use of cannabis to cope with mental health concerns may be placing bisexual individuals at greater risk of CUD. Findings from this study can be used to guide future research and help target mental health interventions among bisexual individuals.

Bridging the gap between genetic epidemiological research and prevention: A randomized control trial of a novel personalized feedback program for alcohol and cannabis use

BACKGROUND

Risky substance use among college students is widespread and associated with numerous negative consequences. We created an online Personalized Feedback Program (PFP) for college students that targets genetically influenced risk pathways for substance use and provides feedback on four risk domains (Sensation Seeking, Impulsivity, Extraversion, and Neuroticism) along with individualized recommendations and campus resources.

METHODS

A pilot randomized controlled trial was conducted to evaluate the effects of the PFP on alcohol and cannabis use. First-year college students were randomized to one of four groups: (1) control, (2) PFP, (3) computer-delivered brief motivational intervention (BMI), and (4) combined group that included both the PFP and BMI (PFP+BMI). Students completed a baseline survey (n=251) that assessed alcohol and cannabis use and program satisfaction. Two follow-up surveys were administered at 30-days and 3-months post-intervention to evaluate longitudinal effects on substance use.

RESULTS

Participants reported high satisfaction with the PFP. There were no significant effects of intervention group on alcohol use at the follow-up timepoints, though trends were in the expected direction with participants in the PFP group showing decreased odds of alcohol use. There were significant reductions in cannabis use in the PFP group as compared to other groups.

CONCLUSIONS

The PFP was met with high satisfaction and had a positive impact on reducing cannabis use. With cannabis use at a historic high among college-aged adults, further research evaluating the effects of the PFP is warranted.

A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults

Cannabis and anxiety are both rising issues that impact young people. This review seeks to explore the association between anxiety and cannabis in adolescents and young adults (AYA). A database search was run retrospectively from July 2020 through calendar year 2013. Articles had to present outcomes examining cannabis use and symptoms of anxiety, be written in English, contain samples with ≥ 50% who are age 25 or younger, and be published in a peer-reviewed journal. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use. Twenty-three studies found a positive association that greater anxiety among AYA was associated with greater cannabis use. In contrast, seven studies found a negative association that greater anxiety was related to less cannabis use. And finally, 17 studies found no clear association between anxiety and cannabis use. Further research is needed to better understand the relationship between anxiety and cannabis use.

Do Coping Motives and Perceived Impaired Control Mediate the Indirect Links from Childhood Trauma Facets to Alcohol-Related Problems?

INTRODUCTION

The Self-Medication Hypothesis suggests that individuals drink to alleviate undesirable affective states. Behavioral Economics Theory states that individuals deprived of resources (i.e., physically neglected) consume more reinforcing substances when they are available than others. Childhood trauma may indirectly increase impaired control over alcohol (IC; drinking beyond one's own intentions) and thereby increase alcohol use and problems through the employment of coping-motives.

METHOD

A structural equation model that included sex as a covariate examined mediated paths with 612 university students.

RESULTS

Men were less likely to be emotionally abused and were more likely to use greater amounts of alcohol than women did. Physical neglect was directly linked to both more IC and alcohol use. Emotional and sexual abuse were directly linked to more coping motives. Both emotional and sexual abuse were indirectly linked to more alcohol use and its related problems through increased coping motives and IC.

CONCLUSIONS

Consistent with Behavioral Economics Theory, there was a direct link between physical neglect and IC. We also found partial support for the Self-Medication Hypothesis regarding the emotional and sexual abuse trauma dimensions; they indirectly contributed to alcohol use and its related problems via the mediating mechanisms of more coping motives and IC. Our findings suggest coping motives could be a therapeutic target for intervention among those sexually or emotionally abused.

Inhibited personality traits, internalizing symptoms, and drinking to cope during the COVID-19 pandemic among emerging adults

Emerging adults with high levels of inhibited personality traits may be at-risk for drinking to cope during the COVID-19 pandemic. The current research explored mediational pathways between two inhibited personality traits (anxiety sensitivity (AS) and hopelessness (HOP)), internalizing symptoms (anxiety, depression, and COVID-19 distress), and coping drinking motives (drinking to cope with anxiety and drinking to cope with depression) during the pandemic. Cross-sectional data were collected from 879 undergraduate drinkers (79% female, 83% White, 18-25 years old) at five Canadian universities from January-April 2021. Participants self-reported on their personality, anxiety (GAD-7), depressive symptoms (PHQ-9), COVID-19 distress, and coping drinking motives. Mediational path analyses provided evidence of both specific and non-specific pathways between personality and coping motives via internalizing symptoms. Depressive symptoms partially mediated the link between HOP and drinking to cope with depression motives. While anxiety symptoms did not significantly mediate links between AS and coping with anxiety motives in the full model, evidence of mediation was found in a post-hoc sensitivity analysis. COVID-19 distress served as a non-specific mediator. AS and HOP are critical transdiagnostic risk factors that increase vulnerability for internalizing psychopathology and, in turn, risky drinking motives, in the context of the COVID-19 pandemic.

Dynamics of daily positive and negative affect and relations to anxiety and depression symptoms in a transdiagnostic clinical sample

BACKGROUND

Despite interest in transdiagnostic dimensional approaches to psychopathology, little is known about the dynamic interplay of affecting and internalizing symptoms that cut across diverse mental health disorders. We examined within-person reciprocal effects of negative and positive affect (NA, PA) and symptoms (depression and anxiety), and their between-person associations with affective dynamics (i.e., affect inertia).

METHODS

Individuals currently receiving treatment for psychological disorders (N = 776) completed daily assessments of affect and symptoms across 14 treatment days (average). We used dynamic structural equation modeling to examine daily affect-symptom dynamics.

RESULTS

Within-person results indicated NA-symptom reciprocal effects; PA only predicted subsequent depression symptoms. After accounting for changes in mean symptoms and affect over time, NA-anxiety and PA-depression relations remained particularly robust. Between-person correlations indicated NA inertia was positively associated with NA-symptom effects; PA inertia was negatively associated with PA-symptoms effects.

CONCLUSIONS

Results suggest that transdiagnostic affective treatment approaches may be more useful for reducing internalizing symptoms by decreasing NA compared to increasing PA. Individual differences in resistance to shifting out of affective states (i.e., high NA vs. PA inertia) may be a useful marker for developing tailored interventions.

Predicting Young Adult Tobacco, Drug and Alcohol Use Among Participants in the CAMP Trial

The development of substance abuse in youth with asthma have seldom been examined with longitudinal research. The prospective and well-characterized CAMP cohort provides outcome data on youth with asthma over 13 years. This manuscript seeks to determine the contributions of asthma features and child behavioral/emotional functioning to subsequent tobacco, alcohol, and drug use in early adulthood. Childhood smoking exposures as well as parent report and youth report of substance use were prospectively assessed concurrently with assessments of asthma symptoms, study medication, and lung development. Logistic regression models evaluated predictors of adolescent and young adult tobacco, alcohol, and drug use. Use of tobacco products was reported by 33% of youth with mild/moderate asthma. Tobacco use was significantly associated with self-reported externalizing behaviors. Early life passive smoke exposure, especially in utero exposure, makes a significant contribution to tobacco use (OR1.58). Greater risk for tobacco use is conveyed by self-reported externalizing behaviors, which are consistently robust predictors of any future use of tobacco products, alcohol and drugs. These findings provide evidence for health care providers to use routine behavioral screening in youth with asthma.

Increased cannabis intake during the COVID-19 pandemic is associated with worsening of depression symptoms in people with PTSD

BACKGROUND

Some evidence suggests substance use affects clinical outcomes in people with posttraumatic stress disorder (PTSD). However, more work is required to examine links between mental health and cannabis use in PTSD during exposure to external stressors such as the COVID-19 pandemic. This study assessed mental health factors in individuals with self-reported PTSD to: (a) determine whether stress, anxiety, and depression symptoms were associated with changes in cannabis consumption across the pandemic, and (b) to contrast the degree to which clinically significant perceived symptom worsening was associated with changes in cannabis intake.

METHOD

Data were obtained as part of a larger web-based population survey from April 3rd to June 24th 2020 (i.e., first wave of the pandemic in Canada). Participants (N = 462) with self-reported PTSD completed questionnaires to assess mental health symptoms and answered questions pertaining to their cannabis intake. Participants were categorized according to whether they were using cannabis or not, and if using, whether their use frequency increased, decreased, or remained unchanged during the pandemic.

RESULTS

Findings indicated an overall perceived worsening of stress, anxiety, and depression symptoms across all groups. A higher-than-expected proportion of individuals who increased their cannabis consumption reached threshold for minimal clinically important worsening of depression, X2(3) = 10.795, p = 0.013 (Cramer's V = 0.166).

CONCLUSION

Overall, those who increased cannabis use during the pandemic were more prone to undergo meaningful perceived worsening of depression symptoms. Prospective investigations will be critical next steps to determine the directionality of the relationship between cannabis and depressive symptoms.

Cannabis use and social anxiety in young adulthood: A meta-analysis

Young adulthood (ages 18 to 30 years old), a developmental age of exploration, is marked by new experiences and transitions. Cannabis use frequency is highest in young adulthood compared to other age periods. Social anxiety (characterized by fear, shyness, and inhibition in social situations where scrutiny and judgment is possible) is also prevalent during young adulthood. Social anxiety may be a complex predictor of cannabis use frequency and problems (e.g., any negative physical, emotional, or social outcome from use). Social anxiety may act as a risk factor as individuals may use cannabis frequently to manage their fear of negative evaluation and associated unpleasant affective states. The purpose of this meta-analysis was to quantify the magnitude of the associations between social anxiety and two cannabis variables (frequency of use and problems) in young adulthood. A comprehensive literature review was conducted to identify studies that included measures of social anxiety and at least one cannabis-related variable of interest among young adults. Eighteen studies were included in the meta-analysis. Results revealed a small, statistically significant positive association between social anxiety and cannabis problems (r = 0.197, k = 16, p = <0.001), and a nonsignificant association between social anxiety and cannabis use frequency (r = 0.002, k = 16, p = 0.929). The association between social anxiety and cannabis use frequency was moderated by the mean age such that samples with older mean ages exhibited a stronger correlation. Additionally, the association between social anxiety and cannabis problems was moderated by clinically significant levels of social anxiety, such that samples with fewer participants who met clinical levels of social anxiety exhibit a stronger correlation. This meta-analysis supports the idea that there is a complex relation between social anxiety and cannabis outcomes during young adulthood.

Depression, anxiety, and drug usage history indicators among institutionalized juvenile offenders of Brasilia

INTRODUCTION

One of the most serious socio-educational measures for children and adolescents in conflict with the law in Brazil is their internment. This measure may represent an additional source of stress to this population and present significant impacts in the mental health context. This study aims to describe anxiety levels, depression, and addictive consumption, as well as to estimate the causalities and interactions of these variables.

METHODS

Herein, we report a study in which 175 male juveniles from youth detention institutions of the Federal District voluntarily completed the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and a short self-rating questionnaire asking whether and how often they had experienced cannabis, alcohol, and other "hard" psychotropic drugs (e.g., crack, cocaine, amphetamine) 1 year prior to institutionalization.

RESULTS

Of the total participants, 28.00% showed moderate to severe depression scores and 34.28% showed moderate to severe anxiety scores. In addition, the vast majority of participants also reported some antecedent drug abuse, including cannabis, alcohol, and other "hard drugs." The BDI scores moderately correlated with BAI, but none of these parameters considerably correlated with the antecedent drug abuse.

CONCLUSIONS

The data indicate potentially concerning levels of emotional distress in these institutionalized juveniles which seem to be independent of addictive behaviors. These data deserve attention and further investigation. Thus, a need for preventative mental health for the general population and socio-educational intervention aimed at interned youth which can decrease levels of emotional stress is emphasized.

Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S

The COVID-19 pandemic has triggered a public health crisis of unprecedented scale. Increased alcohol use has been extensively documented during other crises, particularly among persons with anxiety and depression. Despite COVID-19's differential impact by age, the association of age, mental health and alcohol use during the pandemic has not been explored. This study aimed to examine whether age modified the association of anxiety and depressive symptoms with alcohol use during the COVID-19 pandemic. Two online surveys were administered to U.S. adult social media users in March and April 2020. Generalized linear models were conducted in 2020 among 5850 respondents (52.9% female; 22.0% aged 18-39 years, 47.0% aged 40-59 years, and 31.0% aged ≥60 years) to examine if age modified the association of anxiety and depression symptomatology and alcohol use. Overall, 29% of respondents reported increased alcohol use. Adjusted odds ratios of reporting increased alcohol use were 1.41 (95% CI = 1.20-1.66) among respondents with anxiety symptoms and 1.64 (95% CI = 1.21-2.23) among those with depressive symptoms compared to those without such symptoms. Whereas respondents aged 18-39 years had the highest probability of reporting increased alcohol use, the probability of older persons (40-59 and ≥60 years) reporting increased drinking was much greater among those with symptoms of anxiety and depression, compared to those without symptoms. These findings warrant age-differentiated public health messaging on the risks of excessive alcohol use and scale-up of substance use services for middle-aged and older adults with symptoms of depression and anxiety.

Longitudinal examination of coping-motivated marijuana use and problematic outcomes among emerging adults

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.

The importance of psychology for shaping legal cannabis regulation

Different patterns of cannabis use can be traced directly back to different interactions between 2 types of variables: pharmacological and environmental. As legal cannabis expands in the U.S. and around the world, state and national regulatory agencies are gaining control over these variables. Specifically, regulatory agencies are increasingly capable of altering (a) the pharmacological properties of cannabis products and (b) the way these products are distributed to the population. Consequently, cannabis regulatory agencies are in a unique position to use evidence from psychological science to alter cannabis consumption patterns in ways that mitigate potential harm to public health. However, most state-level legal cannabis regulatory systems in the U.S. are not yet evidence-based or public health-oriented. This applied review and commentary draws on evidence from the psychological science literature to help regulators better understand the types of behaviors they must address and guide empirically supported regulation of THC-laden cannabis, whether used putatively for medical or recreational reasons. This review is organized into 3 parts that correspond to the 3 primary agents within the cannabis regulation ecosystem: (a) the cannabis consumer, (b) the cannabis industry, and (c) the cannabis regulatory agency. Within this structure, the review addresses critical psychological variables that drive cannabis consumer and industry behaviors and discusses how regulatory agencies can use this information to protect public health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sources of cannabis among young adults and associations with cannabis-related outcomes

BACKGROUND

The ways in which young people learn about cannabis product availability and where they obtain cannabis products are important to understand for prevention and intervention efforts.

METHODS

Young adults who reported past month cannabis use (N = 758) completed an online survey in 2018-2019 on how they obtained cannabis and the products they used in a newly legalized market in Los Angeles (mean age 21.6; 44% Hispanic, 27% white, 15% Asian).

RESULTS

Overall, 59.1% obtained cannabis from recreational cannabis retailers (RCRs), 51.5% from family or friends, 39.1% from medical cannabis dispensaries (MCDs), and 5.5% from strangers or dealers in the past month. Compared to those getting cannabis from family or friends, those getting cannabis from MCDs or RCRs spent more money, used more cannabis products, were more likely to use alone, used greater quantities of bud/flower, and reported more consequences from use. Further, those obtaining cannabis from MCDs were more likely to screen positive for cannabis use disorder (CUD). For type of products, those obtaining cannabis from MCDs or RCRs were more likely to use joints, bongs, pipes, dabs, vape, and consume edibles relative to those obtaining from family or friends. Subgroup differences were found for both source patterns and cannabis-related outcomes. Males and those with a cannabis medical card reported spending more money on cannabis, using more types of products, and indicated more frequent use and greater CUD symptoms and consequences. Compared to Whites, Blacks spent more money on cannabis and used more products, and Hispanics reported using more products and greater quantities of cannabis bud/flower.

CONCLUSIONS

Findings highlight the different ways that young adults obtain cannabis, and how young adults with a medical cannabis card may be at greater risk for problems compared to young adults who use cannabis recreationally.