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González-Cano-Caballero M, Torrejón-Guirado MC, Cano-Caballero MD, Mac Fadden I, Barrera-Villalba MDC, Lima-Serrano M. Adolescents and youths' opinions about the factors associated with cannabis use: a qualitative study based on the I-Change model. BMC Nurs 2023; 22:114. [PMID: 37046264 PMCID: PMC10091594 DOI: 10.1186/s12912-023-01283-z] [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: 12/18/2022] [Accepted: 03/31/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND To learn about the experiences and opinions of adolescent non-consumers and regular cannabis users about cannabis use and the factors that determine its use, using the I-Change explanatory model as a basis. METHODS Qualitative methodology with a content analysis was used. Focus groups were conducted with adolescents who were non-regular cannabis users (those who had not tried cannabis or had only experimented with it before) and semi-structured interviews were conducted with adolescent and young adult in recovery who were in a detoxification program. A deductive analysis of the audio-recorded and transcribed interviews was performed, using the domains of the I-Change Model as a reference. RESULTS Personal problems, social problems or family problems can lead to cannabis use. There was a lack of knowledge and low risk perception about consumption of this drug. There are other factors that influence consumption, the perception of advantages, such as the feeling of freedom and the influence of the peer group. The consumption of this substance in girls is changing, becoming more and more equal to that of boys. The family has an important role to play in preventing drug use. CONCLUSION Knowledge of these factors is of vital importance as a prior step to the development of efficient intervention measures adjusted to the needs identified and the characteristics of the population.
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Affiliation(s)
| | - María-Carmen Torrejón-Guirado
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, 41009, Spain
- Department of Health Promotion, School for Public Health and Primary Care CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - María Dolores Cano-Caballero
- Deputy Directorate of Care. Virgen de las Nieves University Hospital, Granada, 18014, Spain.
- Department of Nursing, Faculty of Health Sciences, University of Granada, Av. de la Ilustración, 60, 18071, Granada, Spain.
| | | | | | - Marta Lima-Serrano
- Department of Nursing, School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, 41009, Spain
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Bolts OL, Prince MA, Noel NE. Expectancies that Predict Cannabis Initiation in Response to Legalization. Subst Use Misuse 2023; 58:939-946. [PMID: 37036094 DOI: 10.1080/10826084.2023.2198596] [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: 04/11/2023]
Abstract
Background: Recent and prospective changes to nonmedical/recreational cannabis laws in the United States and abroad raise questions about how legalization may influence cannabis use behaviors. Objectives: In the current study, we examined links between legalization, context-specific likelihood of using cannabis, and cannabis expectancies using cross-sectional survey data from 121 college students who had never used or were abstaining from cannabis in a U.S. state where laws prohibit nonmedical cannabis. Results: We found that across scenarios, 61% of students reported they would be more likely to use cannabis if it were legal. Social/sexual facilitation expectancies predicted a higher likelihood of using cannabis after legalization in a social context. Relaxation/tension reduction expectancies predicted a higher likelihood of using in an anxiety relief context. Perceptual/cognitive enhancement expectancies predicted a higher likelihood of using in a pain relief context. Cognitive/behavioral impairment expectancies predicted a lower likelihood of using in social, pain relief, relaxation, and concert contexts. Global negative effects expectancies predicted a lower likelihood of using in relaxation and concert contexts. Conclusions: Our findings suggest that among college students who do not use cannabis, expectancies are linked to cannabis use likelihood in certain contexts if cannabis were legal. This work highlights cannabis expectancies and contexts as possible targets for evidence-based public health education and clinical prevention initiatives related to the potential increase in cannabis use associated with cannabis policy implementation. College students may benefit from initiatives that address cannabis expectancies and enhance harm reduction skills to help them effectively navigate contexts in which cannabis is available to them.
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Affiliation(s)
- Olivia L Bolts
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Nora E Noel
- Department of Psychology, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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3
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Gullo MJ, Papinczak ZE, Feeney GFX, Young RM, Connor JP. Precision Mental Health Care for Cannabis Use Disorder: Utility of a bioSocial Cognitive Theory to Inform Treatment. Front Psychiatry 2021; 12:643107. [PMID: 34262487 PMCID: PMC8273258 DOI: 10.3389/fpsyt.2021.643107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/27/2021] [Indexed: 11/21/2022] Open
Abstract
Globally, cannabis is the most frequently used controlled substance after alcohol and tobacco. Rates of cannabis use are steadily increasing in many countries and there is emerging evidence that there is likely to be greater risk due to increased concentrations of delta-9-tetrahydrocannabinol (THC). Cannabis use and Cannabis Use Disorder (CUD) has been linked to a wide range of adverse health outcomes. Several biological, psychological, and social risk factors are potential targets for effective evidence-based treatments for CUD. There are no effective medications for CUD and psychological interventions are the main form of treatment. Psychological treatments based on Social Cognitive Theory (SCT) emphasize the importance of targeting 2 keys psychological mechanisms: drug outcome expectancies and low drug refusal self-efficacy. This mini-review summarizes the evidence on the role of these mechanisms in the initiation, maintenance, and cessation of cannabis use. It also reviews recent evidence showing how these psychological mechanisms are affected by social and biologically-based risk factors. A new bioSocial Cognitive Theory (bSCT) is outlined that integrates these findings and implications for psychological cannabis interventions are discussed. Preliminary evidence supports the application of bSCT to improve intervention outcomes through better targeted treatment.
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Affiliation(s)
- Matthew J. Gullo
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Zoë E. Papinczak
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Gerald F. X. Feeney
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Ross McD. Young
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Metro North Health, Herston, QLD, Australia
| | - Jason P. Connor
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, QLD, Australia
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Discipline of Psychiatry, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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4
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Choi NG, DiNitto DM. Marijuana use/nonuse among those aged 50+: comparisons of use-to-nonuse, initiation/reinitiation, and continued use over 24 months. Aging Ment Health 2021; 25:1134-1142. [PMID: 32114789 DOI: 10.1080/13607863.2020.1732292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To examine: (1) correlates of use-to-nonuse (use 13-24 months ago, but no past-year use), initiation/reinitiation (no use 13-24 months ago, but past-year use), and continued use over a 24-month period; and (2) associations of past-year marijuana use disorder with use/nonuse among older adults. METHOD The 2015-2017 National Survey on Drug Use and Health provided data (N = 26,322 aged 50+). We used multinomial and binary logistic regression analyses to compare users-to-nonusers and initiators/reinitiators to continued users (N = 2304). RESULTS In the 50-64 age group, 2.1% were users-to-nonusers, 2.2% initiators/reinitiators, and 7.2% continued users. In the 65+ age group, the corresponding percentages were 0.7%, 0.7%, and 2.4%. Residence in states with medical marijuana laws, nicotine dependence, and other illicit drug use were associated with a lower likelihood of use-to-nonuse than continued use. Alcohol use disorder was associated with a higher likelihood of initiation/reinitiation. Parole/probation status was associated with higher likelihood of use-to-nonuse. Moderate/great marijuana risk perceptions were associated with a higher likelihood of both use-to-nonuse and initiation/reinitiation. The odds of marijuana use disorder did not differ between continued users and initiators/reinitiators or between medical and recreational users. CONCLUSION Most older users continued using over 24 months. Substantial numbers had marijuana and other substance use problems that require treatment.
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Affiliation(s)
- Namkee G Choi
- University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, USA
| | - Diana M DiNitto
- University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, USA
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5
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Turna J, MacKillop J. Cannabis use among military veterans: A great deal to gain or lose? Clin Psychol Rev 2021; 84:101958. [PMID: 33486280 DOI: 10.1016/j.cpr.2021.101958] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/11/2020] [Accepted: 01/06/2021] [Indexed: 12/16/2022]
Abstract
Policy changes have resulted in dramatic increases in access to cannabis for medical purposes. Veterans are disproportionately affected by conditions for which medical cannabis is often pursued, making an evidence-based perspective on risks versus benefits of high priority. The current review sought to examine the state of the evidence on the correlates and consequences of cannabis use among veterans. Using a comprehensive search strategy, 501 articles were identified and 86 studies met criteria for inclusion. The literature was predominated by cross-sectional studies (67%) of male veterans (71.4%-100% male) from the United States (93.0%). Three overarching themes emerged, comprising cannabis associations with other substance use, mental health, and physical health outcomes. The balance of the evidence associated cannabis use with negative health outcomes, with consistent positive associations with other substance use, psychiatric disorders, and self-harm/suicidality. Few studies examined the therapeutic effects of cannabis, thus limiting the potential to evaluate evidence of efficacy. Priority areas for future research are studies using designs that can examine the directionality of links between cannabis and health in veterans more conclusively, and studies directly examining therapeutic efficacy of cannabis-based therapies in veterans. Methodologically rigorous design will be essential to inform clinical recommendations and practices guidelines in an era of burgeoning access to cannabis.
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Affiliation(s)
- Jasmine Turna
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5(th) St, Hamilton, ON L9C 0E3, Canada; Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5(th) St, Hamilton, ON L9C 0E3, Canada
| | - James MacKillop
- Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5(th) St, Hamilton, ON L9C 0E3, Canada; Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5(th) St, Hamilton, ON L9C 0E3, Canada; Homewood Research Institute, 150 Delhi St. Riverslea Building, Guelph, ON N1E 6K9, Canada.
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6
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Waddell JT, Corbin WR, Meier MH, Morean ME, Metrik J. The Anticipated Effects of Cannabis Scale (AECS): Initial development and validation of an affect- and valence-based expectancy measure. Psychol Assess 2021; 33:180-194. [PMID: 33151731 PMCID: PMC9973752 DOI: 10.1037/pas0000881] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prior research suggests that cannabis expectancies are related to cannabis misuse and problems. Although there are established measures of cannabis expectancies, existing measures have psychometric limitations and/or are lengthy. Existing measures typically have a two-factor structure of positive and negative expectancies, but recent conceptualizations of alcohol expectancies support a valence- (positive vs. negative) and arousal-based (high vs. low arousal) structure. Thus, the present study sought to test a similar structure for cannabis. Cannabis expectancy items underwent 2 preliminary studies, assessing item valance/arousal (n = 233) and relevance to cannabis (n = 124). A final pool of 76 items underwent exploratory factor analysis (n = 303), and remaining items underwent confirmatory factor analysis in a separate sample (n = 469). Lastly, an additional sample (n = 435) examined validity. Results suggested a 3-factor structure (general positive, high arousal negative, low arousal negative) for the 17-item Anticipated Effects of Cannabis Scale (AECS), which was invariant across cannabis use frequency, sex, and race/ethnicity. Positive expectancies were strongly associated with cannabis use, whereas low arousal negative expectancies were protective against cannabis frequency; high arousal negative expectancies were strongly associated with more negative consequences and dependence symptoms. In addition, the proposed interpretation of AECS test scores showed evidence of incremental validity relative to another abbreviated measure. The current study provides initial support for the AECS, a brief, psychometrically sound cannabis expectancies measure. The AECS captures the full range of cannabis effects and may be suited to test discrepancies between cannabis expectancies and subjective response. Additional research is needed to validate its structure and predictive utility. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Jane Metrik
- Center for Alcohol and Addictions Studies, Brown University School of Public Health
- Providence Veterans Affairs Medical Center, Providence, Rhode Island, United States
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7
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Testing the biosocial cognitive model of substance use in cannabis users referred to treatment. Drug Alcohol Depend 2019; 194:216-224. [PMID: 30453107 DOI: 10.1016/j.drugalcdep.2018.09.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND The bioSocial Cognitive Theory (bSCT) hypothesizes two pathways linking dimensions of impulsivity to substance use. The first predicts that the association between reward sensitivity and substance use is mediated by positive outcome expectancies. The second predicts that the relationship between rash impulsiveness and substance use is mediated by refusal self-efficacy. This model has received empirical support in studies of alcohol use. The present research provides the first application of bSCT to a cannabis treatment population and aims to extend its utility to understanding cannabis use and severity of dependence. DESIGN 273 patients referred for cannabis treatment completed a clinical assessment that contained measures of interest. SETTING A public hospital alcohol and drug clinic. MEASUREMENTS The Sensitivity to Reward Scale, Dysfunctional Impulsivity Scale, Cannabis Expectancy Questionnaire, Cannabis Refusal Self-Efficacy Questionnaire and Severity of Dependence Scale-Cannabis were completed, along with measures of cannabis consumption. FINDINGS The bSCT model provided a good fit to the data for cannabis use and severity of dependence outcomes. The association between reward sensitivity and each cannabis outcome was fully mediated by positive cannabis expectancies and cannabis refusal self-efficacy. The relationship between rash impulsiveness and each cannabis outcome was fully mediated by cannabis refusal self-efficacy. CONCLUSIONS Findings support the application of the bSCT model to cannabis use and dependence severity and highlight the important role of social cognitive mechanisms in understanding the association between impulsivity traits and these outcomes. The differential association of impulsivity traits to social cognition may assist targeted treatment efforts.
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8
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Jacobus J, Squeglia LM, Escobar S, McKenna BM, Hernandez MM, Bagot KS, Taylor CT, Huestis MA. Changes in marijuana use symptoms and emotional functioning over 28-days of monitored abstinence in adolescent marijuana users. Psychopharmacology (Berl) 2017; 234:3431-3442. [PMID: 28900686 PMCID: PMC5693666 DOI: 10.1007/s00213-017-4725-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/17/2017] [Indexed: 12/11/2022]
Abstract
RATIONALE Advancing marijuana prevention and intervention efforts are important given the decreasing perception of harm among adolescents and increasing marijuana legalization. OBJECTIVES This study evaluates how a monitored abstinence protocol may contribute to emotional functioning and changes in marijuana problems that can enhance successful outcomes for non-treatment-seeking adolescent marijuana users. METHODS Adolescent marijuana users (n = 26) and demographically matched controls (n = 30) completed 28 days of monitored abstinence confirmed by biweekly urine toxicology. Participants were given measures of emotional functioning, marijuana use symptoms, and reward sensitivity during monitored abstinence. RESULTS All participants (n = 56) completed the protocol, and 69% of marijuana users (n = 18 of 26) were confirmed abstinent for 28 days, with all users showing decreasing marijuana use. Reductions in subsyndromal depression, positive marijuana use expectancies, and poor sleep quality were observed by the end of the monitored abstinence period (n = 26, p values < .05). Marijuana users also reported more attentional impulsivity and less responsiveness to reward stimuli during the second week of abstinence compared to controls. Later age of onset of regular marijuana use and more cumulative lifetime use were associated with a greater degree of emotional change and increased recognition of the negative effects of marijuana use. CONCLUSIONS Monitored abstinence programs may be beneficial in reducing marijuana use, subsyndromal emotional distress symptoms, and changing beliefs about marijuana use. Future prevention and intervention efforts may consider targeting reward sensitivity and impulsivity, in addition to marijuana use, expectancies, and emotional functioning.
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Affiliation(s)
- Joanna Jacobus
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA. .,Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
| | - Lindsay M. Squeglia
- Medical University of South Carolina, Department of Psychiatry and
Behavioral Sciences, Addiction Sciences Division, Charleston, SC, USA
| | - Silvia Escobar
- University of California San Diego, Department of Psychiatry, La
Jolla, California, USA
| | - Benjamin M. McKenna
- Veterans Affairs San Diego Healthcare System, La Jolla, California,
USA,University of California San Diego, Department of Psychiatry, La
Jolla, California, USA
| | | | - Kara S. Bagot
- University of California San Diego, Department of Psychiatry, La
Jolla, California, USA
| | - Charles T. Taylor
- University of California San Diego, Department of Psychiatry, La
Jolla, California, USA
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9
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Di Blasi M, Cavani P, Pavia L, Tosto C, La Grutta S, Lo Baido R, Giordano C, Schimmenti A. Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety. Front Psychiatry 2017; 8:249. [PMID: 29213247 PMCID: PMC5702633 DOI: 10.3389/fpsyt.2017.00249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/08/2017] [Indexed: 01/20/2023] Open
Abstract
The relationship between social anxiety (SA) and cannabis use among adolescents and young adults is a highly debated topic. In this cross-sectional study, we tested whether cannabis use expectancies mediated the association between SA and cannabis use severity in a sample of 343 young adults (74.3% male) who used cannabis. They completed self-report measures for the screening of problematic cannabis use (Cannabis Use Problems Identification Test) and SA symptoms (Social Interaction Anxiety Scale and Social Phobia Scale). A multiple mediation analysis was used to test whether marijuana effect expectancies mediate SA effect on problematic cannabis use. SA was negatively associated with cannabis use severity in this sample, and we found evidence that cannabis use expectancies fully mediated this relationship. Specifically, global negative effect expectancies influence the relationship between SA and problematic cannabis use. These findings may inform current prevention strategies and clinical intervention for young adults who use cannabis.
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Affiliation(s)
- Maria Di Blasi
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Paola Cavani
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Laura Pavia
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Crispino Tosto
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Sabina La Grutta
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Rosa Lo Baido
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Cecilia Giordano
- Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy
| | - Adriano Schimmenti
- Department of Human and Social Sciences, UKE, Kore University of Enna, Enna, Italy
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10
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Metrik J, Farris SG, Aston ER, Kahler CW. Development and initial validation of a marijuana cessation expectancies questionnaire. Drug Alcohol Depend 2017; 177:163-170. [PMID: 28600928 PMCID: PMC5567860 DOI: 10.1016/j.drugalcdep.2017.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 03/06/2017] [Accepted: 04/02/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The present research examines anticipated consequences of ceasing or reducing marijuana use with initial development and psychometric validation of a measure of marijuana cessation expectancies. METHODS The 46-item Marijuana Cessation Expectancies Questionnaire (MCEQ) was initially developed from the content validity analysis of free responses about expected outcomes of stopping and decreasing marijuana use generated by 94 participants. The closed-ended MCEQ was subsequently administered to 151 non-treatment seeking regular marijuana users (used on M=64.7% of the prior 60days, SD=25.1%;Mage=21.4, SD=3.96; 38.4% female). RESULTS Exploratory factor analyses identified six MCEQ factors that accounted for 61% of variance, which were related to expected improvement in: 1) performance/motivation, 2) problems with authority, and 3) interpersonal functioning, and expected worsening of 4) mood states and 5) fun experiences, and 6) changes in appetite/weight from cessation/reduction of marijuana use. Internal consistency of full scale items was good (α=0.86) and moderate to high for all factors (α's=0.60-0.89). The MCEQ items showed good concurrent validity with key measures and incremental associations with change indices (prior history of cessation/reduction attempt, benefits of reduction, importance of change), beyond the effects of marijuana use expectancies. CONCLUSIONS These data provide initial support for the MCEQ and suggest it is closely linked to reduction/cessation decisions in marijuana users. MCEQ may be used clinically to enhance existing behavioral treatments and motivational interventions for problem marijuana use.
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Affiliation(s)
- Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA; Providence Veterans Affairs Medical Center, Providence, RI, 02908, USA; The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI 02906, USA.
| | - Samantha G. Farris
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI 02906,The Miriam Hospital, Centers for Behavioral and Preventative Medicine, Providence, RI, 02906,Butler Hospital, Providence, RI, 02906
| | - Elizabeth R. Aston
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903
| | - Christopher W. Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903
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11
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Papinczak ZE, Connor JP, Feeney GFX, Young RM, Gullo MJ. Treatment seeking in cannabis dependence: The role of social cognition. Drug Alcohol Depend 2017; 170:142-146. [PMID: 27894043 DOI: 10.1016/j.drugalcdep.2016.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Relatively few cannabis dependent individuals seek treatment and little is known about the determinants of treatment seeking. Social Cognitive Theory (SCT) provides a useful framework for examining human behaviour and motivation which may be helpful in explaining treatment seeking. This study examined the differences in cannabis outcome expectancies and cannabis refusal self-efficacy between treatment seekers and non-treatment seekers with cannabis dependence. DESIGN Non-treatment seekers were referred to an illicit drug diversion program. Treatment seekers commenced an outpatient cannabis treatment program and completed a comprehensive assessment that included measures of cannabis outcome expectancies and refusal self-efficacy. SETTING A public hospital alcohol and drug outpatient clinic. PARTICIPANTS 269 non-treatment seekers and 195 individuals commencing cannabis dependence treatment. MEASUREMENTS The Cannabis Expectancy Questionnaire (CEQ), Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), Severity of Dependence Scale - Cannabis (SDS-C), General Health Questionnaire (GHQ-28) and Readiness to Change Questionnaire (RTC) were completed. FINDINGS Treatment seekers had significantly higher levels of negative cannabis outcome expectancies and significantly lower levels of emotional relief refusal self-efficacy (belief in ability to resist using cannabis when experiencing negative affect) (ps<0.001). Treatment seekers had significantly higher levels of psychological distress and self-perceived cannabis dependence compared to non-treatment seekers (ps<0.001). CONCLUSIONS High negative cannabis outcome expectancies and low emotional relief refusal self-efficacy may play a key role in motivation to seek treatment.
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Affiliation(s)
- Zoe E Papinczak
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; School of Psychology, The University of Queensland, Brisbane, QLD 4029, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; Discipline of Psychiatry, School of Medicine, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
| | - Ross McD Young
- Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; Faculty of Health, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Matthew J Gullo
- Centre for Youth Substance Abuse Research, Faculty of Health Sciences, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
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12
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Gullo MJ, Matveeva M, Feeney GFX, Young RM, Connor JP. Social cognitive predictors of treatment outcome in cannabis dependence. Drug Alcohol Depend 2017; 170:74-81. [PMID: 27883947 DOI: 10.1016/j.drugalcdep.2016.10.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/18/2016] [Accepted: 10/24/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Drug-related outcomes expectancies and refusal self-efficacy are core components of Social Cognitive Theory. Both predict treatment outcome in alcohol use disorders. Few studies have reported expectancies and refusal self-efficacy in cannabis dependence. None have examined both, although both constructs are key targets in Cognitive-Behavioural Therapy (CBT). This study tests the predictive role of expectancies and refusal self-efficacy in treatment outcome for cannabis dependence. DESIGN Outpatients completed a comprehensive assessment when commencing cannabis treatment and predictors of treatment outcome were tested. SETTING A university hospital alcohol and drug outpatient clinic. PARTICIPANTS 221 cannabis-dependent patients participated in a 6-week CBT program where the goal was abstinence. MEASUREMENTS Cannabis Expectancy Questionnaire and Cannabis Refusal Self-Efficacy Questionnaire, cannabis dependence severity [Severity of Dependence Scale], psychological distress [General Health Questionnaire] at baseline; the timeline follow-back procedure at baseline and each session. FINDINGS Patients reporting lower confidence in their ability to resist cannabis during high negative affect (emotional relief refusal self-efficacy) had a lower likelihood of abstinence (p=0.004), more days of use (p<0.001), and larger amount used (p<0.001). Negative cannabis expectancies predicted greater likelihood of abstinence (p=0.024). Higher positive expectancies were associated with lower emotional relief self-efficacy, mediating its association with outcome (p<0.001). CONCLUSIONS Emotional relief refusal self-efficacy and negative expectancies are predictive of better treatment outcomes for cannabis dependence. Positive expectancies may indirectly predict poorer outcome because of a negative association with self-efficacy, but this conclusion remains tentative as directionality could not be established.
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Affiliation(s)
- Matthew J Gullo
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Marya Matveeva
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
| | - Ross McD Young
- Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; Faculty of Health, Queensland University of Technology, Brisbane QLD 4059, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane QLD 4059, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; School of Medicine, The University of Queensland, Brisbane, QLD 4029, Australia
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13
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Foster DW, Jeffries ER, Zvolensky MJ, Buckner JD. The Interactive Influence of Cannabis-Related Negative Expectancies and Coping Motives on Cannabis Use Behavior and Problems. Subst Use Misuse 2016; 51:1504-11. [PMID: 27356272 PMCID: PMC4965297 DOI: 10.1080/10826084.2016.1188947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The present study tested whether coping motives for cannabis use moderate the effect of negative expectancies on cannabis use. METHODS Participants were 149 (36.2% female, 61.59% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of cannabis-related expectancies and motives for use. Hierarchical multiple regressions were employed to investigate the predictive value of the interaction between negative expectancies and coping motives on cannabis use outcomes. RESULTS Results revealed interactions between negative expectancies and coping motives with respect to past 90 day cannabis use frequency and cannabis problems. Global negative effects expectancies were associated with less frequent cannabis use, particularly among those with fewer coping motives. However, negative expectancies were related to more cannabis problems, particularly among those with higher coping motives. CONCLUSIONS These results suggest it may be advisable to take coping motives into account when addressing expectancies among cannabis users.
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Affiliation(s)
- Dawn W Foster
- a Department of Psychiatry , Yale School of Medicine , New Haven , Connecticut , USA.,b Division of Substance Abuse, Connecticut Mental Health Center , New Haven , Connecticut , USA
| | - Emily R Jeffries
- c Department of Psychology , Louisiana State University , Baton Rouge , Louisiana , USA
| | - Michael J Zvolensky
- d Department of Psychology , University of Houston , Houston , Texas , USA.,e Health Promotion Department , MD Anderson Cancer Center , Houston , Texas , USA
| | - Julia D Buckner
- c Department of Psychology , Louisiana State University , Baton Rouge , Louisiana , USA
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14
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Hughes JR, Naud S, Budney AJ, Fingar JR, Callas PW. Attempts to stop or reduce daily cannabis use: An intensive natural history study. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 30:389-97. [PMID: 26828641 DOI: 10.1037/adb0000155] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We attempted to replicate and add to our prior study of attempts to stop or reduce cannabis use among daily cannabis users trying to change on their own, by observing a larger sample and adding further clinically relevant outcomes. Daily users (n = 193) who intended to stop or reduce sometime in the next 3 months called an Interactive Voice Response system each morning for 3 months to report on cannabis use, attempts to stop or reduce, withdrawal symptoms, and so forth, on the prior day. This study replicated our prior findings that (a) cannabis users trying to change make many, and often rapid, transitions among use as usual, reduction, and abstinence; (b) reduction attempts are more common than abstinence attempts; (c) quit and reduction attempts are short-lived and few participants achieve long-term abstinence; (d) alcohol and drug use are not greater on abstinence days; and (e) few users seek treatment. Novel findings included (f) a greater number of days of abstinence or intentional reduction predicted a greater decline in cannabis dependence, (g) most users do not prepare before their quit attempt, (h) coping outcomes during abstinence predict increased duration of abstinence, (i) tobacco use is less common on days of abstinence, and (j) withdrawal symptoms occur even with short quit attempts. Replication tests in more generalizable samples and of longer duration are indicated. Further natural history studies are likely to provide information to help improve the content of psychological treatments for cannabis use. (PsycINFO Database Record
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Affiliation(s)
- John R Hughes
- Center for Behavior and Health, Department of Psychiatry
| | - Shelly Naud
- Department of Mathematics and Statistics, University of Vermont
| | | | - James R Fingar
- Center for Behavior and Health, Department of Psychiatry
| | - Peter W Callas
- Department of Mathematics and Statistics, University of Vermont
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15
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Brackenbury LM, Ladd BO, Anderson KG. Marijuana use/cessation expectancies and marijuana use in college students. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 42:25-31. [PMID: 26678375 DOI: 10.3109/00952990.2015.1105242] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Research suggests that marijuana expectancies are associated with problematic marijuana use; however, these marijuana-related cognitions remain relatively understudied. OBJECTIVE This study examined marijuana-related decision-making among college students by exploring the relationships among marijuana expectancies and marijuana use variables. METHOD College students (N = 357) endorsing lifetime marijuana use completed an online survey on marijuana use expectancies, marijuana cessation expectancies, marijuana use, and future marijuana use intentions. A simple regression framework was used to test the effect of each type of expectancies on marijuana outcome; a hierarchical regression framework tested the unique predictive validity when both types were entered into the same model. RESULTS Both marijuana use expectancies and marijuana cessation expectancies independently predicted a number of marijuana use variables. Additionally, marijuana use expectancies and marijuana cessation expectancies contributed significant unique variance to the prediction of marijuana use. CONCLUSIONS It is important to consider both use expectancies and cessation expectancies, as these two domains of marijuana-related cognitions appear to act independently, rather than as opposite ends of the same construct. Longitudinal studies are needed to further examine how these factors interact to influence marijuana use and problems over time.
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Affiliation(s)
| | - Benjamin O Ladd
- b Department of Psychology , Washington State University Vancouver , Vancouver , WA , USA
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16
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Babson KA, Ramo DE, Baldini L, Vandrey R, Bonn-Miller MO. Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders. JMIR Res Protoc 2015; 4:e87. [PMID: 26187404 PMCID: PMC4527004 DOI: 10.2196/resprot.3852] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 05/27/2015] [Accepted: 06/24/2015] [Indexed: 12/21/2022] Open
Abstract
Background Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention. Objective This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone–delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt. Methods Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually. Results Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation. Conclusions This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention.
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Affiliation(s)
- Kimberly A Babson
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, United States.
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17
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Cannabis use expectancies mediate the relation between depressive symptoms and cannabis use among cannabis-dependent veterans. J Addict Med 2015; 8:130-6. [PMID: 24365805 DOI: 10.1097/adm.0000000000000010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The current study examined the cross-sectional associations between depressive symptoms and cannabis use, and the mediating role of positive and negative expectancies of cannabis use. METHODS Participants (n = 100) were cannabis-dependent veterans recruited as part of a larger self-guided cannabis quit study. Baseline (prequit) data were used. Depressive symptoms were assessed using the General Depression subscale of the Inventory of Depression and Anxiety Symptoms (IDAS), and cannabis use expectancies were assessed using the Marijuana Effect Expectancies Questionnaire. Quantity of cannabis use in the past 90 days was assessed with the Timeline Follow-Back. RESULTS A parallel multiple mediation path analysis was conducted to simultaneously examine the effects of positive and negative expectancies as mediators of the relation between IDAS-Depression and prequit cannabis use. Results indicated that depressive symptoms were indirectly related to cannabis use through positive, but not negative, expectancies. This effect was unique to IDAS-Dysphoria symptoms. CONCLUSIONS Depressive symptoms, particularly cognitive-affective symptom features, may be important to consider in better understanding positive cannabis effect expectancies among veterans in regard to cannabis use.
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18
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Barrowclough C, Marshall M, Gregg L, Fitzsimmons M, Tomenson B, Warburton J, Lobban F. A phase-specific psychological therapy for people with problematic cannabis use following a first episode of psychosis: a randomized controlled trial. Psychol Med 2014; 44:2749-2761. [PMID: 25065535 DOI: 10.1017/s0033291714000208] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cannabis use is high amongst young people who have recently had their first episode of psychosis, and is associated with worse outcomes. To date, interventions to reduce cannabis consumption have been largely ineffective, and it has been suggested that longer treatment periods are required. METHOD In a pragmatic single-blind randomized controlled trial 110 participants were randomly allocated to one of three conditions: a brief motivational interviewing and cognitive behavioural therapy (MI-CBT) intervention (up to 12 sessions over 4.5 months) with standard care from an early intervention service; a long MI-CBT intervention (up to 24 sessions over 9 months) with standard care; or standard care alone. The primary outcome was change in cannabis use as measured by Timeline Followback. RESULTS Neither the extended nor the brief interventions conferred benefit over standard care in terms of reductions in frequency or amount of cannabis use. Also the interventions did not result in improvements in the assessed clinical outcomes, including symptoms, functioning, hospital admissions or relapse. CONCLUSIONS Integrated MI and CBT for people with cannabis use and recent-onset psychosis does not reduce cannabis use or improve clinical outcomes. These findings are consistent with those in the published literature, and additionally demonstrate that offering a more extended intervention does not confer any advantage. Many participants were not at an action stage for change and for those not ready to reduce or quit cannabis, targeting associated problems rather than the cannabis use per se may be the best current strategy for mental health services to adopt.
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Affiliation(s)
- C Barrowclough
- Institute of Brain, Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - M Marshall
- Institute of Brain, Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - L Gregg
- Institute of Brain, Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - M Fitzsimmons
- Lancashire Care NHS Foundation Trust,Preston, Lancashire,UK
| | - B Tomenson
- Institute of Population Health,University of Manchester,Manchester,UK
| | - J Warburton
- Lancashire Care NHS Foundation Trust,Preston, Lancashire,UK
| | - F Lobban
- Division of Health Research,Lancaster University,Lancaster,UK
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Galang JN, Babson KA, Boden MT, Bonn-Miller MO. Difficulties in emotion regulation are associated with panic symptom severity following a quit attempt among cannabis dependent veterans. ANXIETY STRESS AND COPING 2014; 28:192-204. [PMID: 25034429 DOI: 10.1080/10615806.2014.934228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Prior research suggests that difficulties in emotion regulation are associated with elevations in panic symptoms. The present study aimed to extend this work by prospectively examining the relation between difficulties in emotion regulation and panic symptoms over the course of a self-guided cannabis cessation attempt. DESIGN AND METHOD One hundred and four cannabis-dependent military veterans participated in the study. Difficulties in emotion regulation and panic symptoms were assessed at baseline and at each week during a four-week cessation attempt for a total of five time-points. RESULTS Fewer difficulties in emotion regulation were associated with a greater reduction in panic symptoms during the self-guided cannabis cessation period. RESULTS remained significant after statistically adjusting for mean substance use (i.e., cannabis, alcohol, and tobacco) during the study period. CONCLUSIONS RESULTS are discussed in terms of integrating adaptive emotion regulation skills training into existing evidence-based treatments for cannabis dependence.
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Affiliation(s)
- Jessica N Galang
- a Department of Psychiatry and Behavioral Sciences, School of Medicine , Johns Hopkins University , 600 North Wolfe Street, Baltimore , MD 21287 , USA
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Earleywine M, Bolles JR. Marijuana, Expectancies, and Post-Traumatic Stress Symptoms: A Preliminary Investigation. J Psychoactive Drugs 2014; 46:171-7. [DOI: 10.1080/02791072.2014.920118] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Mitch Earleywine
- Professor of Psychology and Director of Clinical Training, University at Albany, State University of New York, Albany, NY
| | - Jamie R. Bolles
- Graduate Associate Researcher in Psychology, University at Albany, State University of New York, Albany, NY
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