Motives for and impairment associated with alcohol and marijuana use among college students

COVID and college: how the pandemic impacted alcohol use disorder status among students

Objective: Alcohol consumption patterns during the COVID-19 pandemic have varied notably. Participants: We examined the acute impact of the pandemic on alcohol use disorder (AUD) in a generalizable sample of college students who were surveyed pre-pandemic and re-surveyed in May 2020. Method: Items assessed pre-pandemic included DSM-5 AUD and mental health symptoms. A COVID-19 impacts questionnaire was administered, and alcohol and mental health items re-assessed. Results: AUD symptoms decreased from pre-pandemic to during the pandemic, demonstrating a change in trajectory compared to prior cohorts. Students with persistent AUD reported greater concurrent symptoms of PTSD, depression, and alcohol consumption than those with remitted AUD (ps ≤ .02), but not increased COVID-19 impact. Persistent AUD status was predicted by higher sensation seeking and alcohol consumption. Conclusions: Students with concurrent mental health problems are at continued risk for persistent AUD. Findings highlight the impact of the college environment and social context for drinking on AUD.

Narcissism and alcohol use: The mediating role of drinking motives among college students

Objective: The current study examined associations between grandiose and vulnerable subclinical narcissistic traits and alcohol use among college students and whether drinking motives mediated these associations.

Methods and Participants: Young adult college students who reported past month alcohol use were invited to complete self-report online surveys (N = 406; 81% female; Mage = 20.13, SD = 1.69; 10% Hispanic; 85% White).

Results: Results from path analysis using structural equation modeling indicated that there were no direct associations between grandiose or vulnerable subclinical narcissistic traits and alcohol use. However, several drinking motives mediated these associations. Specifically, the association between grandiose traits and alcohol use was mediated by enhancement and social motives. Similarly, the association between vulnerable traits and alcohol use was mediated by enhancement, social and coping motives.

Conclusions: Findings highlight a potential mechanism by which personality traits may contribute to a health risk behavior among young people.

A Cross-Cultural Comparison of Negative Alcohol-Related Consequences in the United States and Sweden: Measurement Invariance of the Rutgers Alcohol Problem Index

Commensurate measures of alcohol-related consequences across countries and cultures are critical for addressing the global burden of hazardous alcohol use. The Rutgers Alcohol Problem Index (RAPI), developed and validated in the United States, is a popular measure of alcohol problems. This study examined measurement invariance of the RAPI across samples of U.S. and Swedish high school seniors. Latent mean differences in alcohol problems across countries and differences in associations between alcohol problems with alcohol use and protective behavioral strategies (PBS) were also examined. The RAPI was scalar invariant. Swedish students reported fewer problems than U.S. students (latent mean difference = -0.19, p = .047). In both samples, the RAPI was positively correlated with alcohol use frequency and quantity (ps < .001), and negatively correlated with PBS use (ps < .05). Overall, the RAPI demonstrated measurement invariance, and we found evidence for its validity across samples of U.S. and Swedish high school seniors.

Does cannabis use impact cognitive behavioural therapy outcomes for anxiety and related disorders? A preliminary examination

OBJECTIVES

The current study examined whether cannabis use frequency and cannabis-related problem severity (as per the Cannabis Use Disorder Identification Test-Revised) predicted outcomes of cognitive behavioural therapy (CBT) for anxiety and related disorders. It was predicted that greater frequency of cannabis use and greater cannabis-related problem severity would be associated with dampened treatment outcomes compared to less severe cannabis use presentations.

METHODS

Participants were 253 adults seeking treatment for anxiety and related disorders. Cannabis use was categorized as non-use (n = 135), infrequent use (using monthly to 4 times per month; n = 45), and frequent use (using 2 or more times per week; n = 73). Individuals who reported using cannabis completed cannabis use and cannabis-related problem measures before starting a CBT group. Participants also completed a weekly symptom-specific measure of anxiety symptoms throughout CBT.

RESULTS

As hypothesized, frequent cannabis use was associated with poorer outcomes in CBT for anxiety and related disorders compared to non-use. Despite this, individuals who used cannabis frequently still experienced a statistically significant decrease in their anxiety symptoms from pre-to post-CBT, with a large effect size (d = -0.87). Cannabis-related problems was not a significant predictor of CBT outcomes.

CONCLUSIONS

Cannabis use frequency was associated with poorer CBT outcomes for anxiety and related disorders, however these individuals still made notable treatment gains. The mechanism driving this relationship remains unclear. Future studies should attempt to replicate the current findings and examine possible mechanisms.

Neighborhood social environment change in late adolescence predicts substance use in emerging adulthood

This study examines associations of changes in perceived and objective (census-based) neighborhood social environment variables during adolescence with alcohol and marijuana outcomes in emerging adulthood using two waves of data (2013-14 and 2019-20) from a cohort in Southern California (n = 1249). Increasing perceived disorganization predicted greater alcohol consequences and socialization with peers using marijuana. Decreasing objective neighborhood SES predicted fewer alcohol consequences and greater socialization with peers drinking alcohol. Unexpectedly, both decreasing and increasing perceived social cohesion predicted fewer alcohol consequences. Increasing perceived social cohesion predicted lower solitary alcohol use. Findings identify potential environmental targets to prevent substance use during the transition to emerging adulthood, but more research is warranted to understand the complex findings for alcohol consequences.

Real-world simultaneous alcohol and cannabis use: An ecological study of situational motives and social and physical contexts

OBJECTIVE

Given the adverse outcomes associated with simultaneous alcohol and marijuana (SAM) use, understanding factors that give rise to occasions of simultaneous use is critical. This study examines the relationships between situational motives and contexts and three situational outcomes: simultaneous alcohol and marijuana use (SAM) use versus cannabis-only use, number of cannabis uses, and subjective effects.

METHOD

Past-month SAM users (n = 341; 52% female; 75% White; 10% Latinx/Hispanic; age 18-24) from three U.S. college campuses completed 8 weeks of surveys up to five times a day. Three-level generalized linear mixed-effects models tested the effects of situational motives and social and physical contexts on occasion type (SAM vs. cannabis-only), cannabis use, and subjective effects.

RESULTS

Situational social and enhancement motives were related to greater odds of SAM relative to cannabis-only use; expansion motives were reported more often on cannabis-only occasions. Using with others and at friends' places, being with others consuming cannabis, and being with others who are intoxicated were more likely when combining alcohol with cannabis. Increased number of cannabis uses and subjective effects in a social context were evident only on cannabis-only occasions. Using alone and using at home were greater on cannabis-only occasions and were associated with lower cannabis use and subjective effects.

CONCLUSIONS

The combination of alcohol and cannabis use occurs during social situations and when motivated by positive reinforcement but number of cannabis uses is not increased when consuming cannabis with alcohol in social situations. Characterizing the complex interplay of situational factors that contribute to risky use will inform interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Examining the Prospective Associations Between Mindfulness Facets and Substance Use in Emerging Adulthood

AIMS

Emerging adulthood (i.e. ages 18-25) is a developmental phase associated with frequent alcohol and cannabis use, placing this population at risk for substance use problems. Depression and anxiety (i.e. emotional psychopathology) are also prevalent during this phase, and some emerging adults use substances to cope with these negative emotions. Mindfulness-a multifaceted construct-involves being present in a nonjudgmental and nonreactive way. Certain mindfulness facets are particularly relevant in buffering against substance use. A recent longitudinal study [Single A, Bilevicius E, Johnson EA. et al. (2019) Specific facets of trait mindfulness reduce risk for alcohol and drug use among first-year undergraduate students. Mindfulness  10:1269-1279] showed that specific mindfulness facets (i.e. acting with awareness, nonjudging of inner experience and nonreactivity to inner experience) predicted decreased alcohol and drug use in undergraduates. These pathways were explained by low levels of emotional psychopathology.

METHODS

This study expanded this recent work by using a three time-point longitudinal design and by including measures of both alcohol and cannabis use and related problems. Using MTurk, participants (N = 299) completed online measures of trait mindfulness, depression, anxiety, alcohol and cannabis use and related problems at three time-points, each 2 weeks apart. Structural equation modeling was used to test the hypotheses.

RESULTS

The acting with awareness and nonjudging of inner experience facets predicted fewer alcohol problems, but not alcohol use, and this effect was mediated by low levels of emotional psychopathology. These results were not supported for cannabis use and problems.

CONCLUSION

This study demonstrates that there may be differences in the pathways from trait mindfulness to alcohol and cannabis use during emerging adulthood.

Alcohol and Cannabis Cross Motives, Class Analysis, and Substance Use among Concurrent Users

Background: Substance use motives refer to an individual's reasons for engaging in substance use. Although the respective alcohol and cannabis literatures have linked specific substance-use motives to indices of use, less is known about motives in concurrent users, particularly examination of cross-motives (e.g., cannabis motives predicting alcohol use). Methods: The present work examined motives for use in a sample of concurrent users to assess relations between motives and alcohol and cannabis outcomes (quantity, frequency, and use disorder symptoms) using both variable- and person-centered approaches. Finally, the present work aimed to discern the impact of timeframe selection for defining concurrent use (i.e., past year, past two weeks). Participants (N = 524) consisted of individuals that endorsed having used both alcohol and cannabis in the past year with subsample (N = 192) of individuals endorsing past two-week concurrent use. Results: Univariate linear regression analyses revealed small to medium positive relations between all alcohol motives and alcohol outcomes and small to medium positive relations between cannabis social, coping, enhancement, and expansion motives and cannabis use. Regressions examining cross-motives and multivariate models revealed wide variability in relations. Mixture analyses revealed a three-class solution (i.e., High Motives, Positive Alcohol, and Low Conformity) for past year concurrent users and a two-class solution (i.e., Low Motives and High Motives) for past two-week concurrent users. Discussion: Examination of motive classes revealed differences in substance, particularly cannabis, outcomes as a function of class membership. Findings are useful in classifying concurrent users' motives and highlight the importance of timeframe selection.

Marijuana, but not alcohol, use frequency associated with greater loneliness, psychological distress, and less flourishing among young adults

OBJECTIVE

To assess whether frequency of marijuana and alcohol use are cross-sectionally associated with indicators of social and emotional well-being including loneliness, psychological distress, and flourishing across important life domains among young adults.

METHOD

The study sample included 562 participants ages 22-29 who were originally recruited from an urban Pacific Northwest region in the US as part of a longitudinal study of social role transitions and alcohol use. At one assessment, participants completed an online survey that included a 3-item measure of loneliness, a 4-item measure of depression and anxiety symptoms, and a 12-item measure of flourishing as well as measures of marijuana and alcohol use frequency. Linear and generalized linear models were used to estimate associations of marijuana and alcohol use frequency with indicators of well-being.

RESULTS

Greater frequency of marijuana use was associated with higher levels of loneliness, higher levels of psychological distress, and lower levels of flourishing, with the greatest difference observed for daily marijuana users compared to non-users. However, these indicators of well-being did not significantly differ by levels of alcohol use frequency.

CONCLUSION

Study findings suggest that frequent users of marijuana, but not alcohol, may experience more loneliness, more psychological distress, and less flourishing. Intervention approaches for frequent marijuana users may be warranted to reduce impacts of loneliness and psychological distress and improve overall well-being.

Distinct psychological profiles among college students with substance use: A cluster analytic approach

Substance use in youth is a central public health concern, related to deleterious consequences at psychological, social, and cognitive/cerebral levels. Previous research has identified impulsivity and consumption motives as key factors in the emergence of excessive substance use among college students. However, most studies have focused on a specific substance and have considered this population as a unitary group, ignoring the potential heterogeneity in psychological profiles. We used a cluster analytic approach to explore the heterogeneity in a large sample (N = 2741) of substance users (i.e., tobacco, alcohol, cannabis, ecstasy, cocaine, heroin) on impulsivity and consumption motives. We identified four clusters: The first two clusters, associated with good self-esteem, low anxiety, and moderate substance use, were respectively characterized by low impulsivity and consumption motives (Cluster 1) and by high social and enhancement motives without marked impulsivity (Cluster 2). The two other clusters were conversely related to low self-esteem and high anxiety, and characterized by high consumption motives (particularly conformity) together with elevated urgency (Cluster 3) and by globally increased impulsivity and consumption motives (Cluster 4). These two clusters were also associated with higher substance use. These results highlight the existence of distinct psychological profiles of substance users and underline the need to develop targeted prevention and intervention programs (e.g., focusing on the specific impulsivity facets and consumption motives presented by each subgroup). Based on these findings, we also suggest extending the exploration of distinct profiles of substance users by targeting other psychological variables (e.g., self-esteem).

Cross-fading motives for simultaneous alcohol and marijuana use: Associations with young adults' use and consequences across days

BACKGROUND

Many young adults engage in simultaneous alcohol and marijuana (SAM) use so that their effects overlap. Little is known about motivations for dual substance use and associations with use and consequences. This study examined daily-level associations between cross-fading motives and levels of alcohol and marijuana use and consequences.

METHODS

Young adults who reported SAM use in the month prior were surveyed in two 14-day bursts. Data included 1049 SAM use days from 281 young adults (age 18-25; M age = 21.80, SD = 2.16; 50 % women). Multilevel models assessed between- and within-person effects of cross-fading motives (i.e., to enhance the effects of marijuana and/or alcohol use by using them simultaneously) on alcohol and marijuana use and consequences, after adjusting for general enhancement, social, coping, and conformity motives and the amount of alcohol and marijuana used that day.

RESULTS

On 76 % of SAM use days, participants endorsed cross-fading motives (i.e., to enhance the effect of alcohol or marijuana or to get drunk and high at the same time). Having stronger cross-fading motives was associated with greater alcohol use, perceived intoxication, and positive alcohol consequences at the between- and within-person levels. In addition, between-person, individuals who reported stronger cross-fading motives on average reported more negative alcohol consequences and positive marijuana consequences on average. Cross-fading motives on a given day were not associated with marijuana use or marijuana consequences that day.

CONCLUSIONS

Cross-fading motives were common and varied from day to day. Understanding the motivational context for dual substance use may support future interventions for cross-fading.

The Relationship between Negative Affect and Alcohol and Marijuana Use Outcomes among Dual Users

Background: Past research with college students has found that substance use motives, particularly coping motives, mediate the relationship between negative affect and alcohol- and marijuana-related outcomes. Objectives: This study aimed to investigate substance use motives of dual users of both substances (past 30-day use; not necessarily simultaneous use) and identify any mediation effects that are either common to both substances or substance-specific. Methods: The majority of dual users (n = 2,034) identified as being White, non-Hispanic (63.8%), female (69.08%), and reported a mean age of 20.24 (SD = 3.16) years. To test study aims, path models were conducted such that negative affect (stress, depressive and anxiety symptoms) were independently modeled as predictors of substance use outcomes (i.e. quantity and consequences) via substance use motives. Results: All three negative affect symptoms were indirectly related to both alcohol and marijuana consequences via coping motives, such that higher negative affect was associated with higher coping motives; which in turn were positively associated with consequences. Substance-specific effects were also found: (a) stress was indirectly related to both alcohol and marijuana use quantity via enhancement motives, (b) depressive/anxiety symptoms were indirectly related to alcohol use quantity via enhancement motives, and (c) all three negative affect symptoms were indirectly related to both marijuana use quantity and negative consequences via expansion motives. Conclusions: Findings suggests that dual users of alcohol and marijuana with negative affect symptoms engage in substance use for similar reasons as single substance users with negative affect symptoms. Intervention efforts should examine ways to replace substance-related coping and expansion methods with non-substance-related methods.

Cross-domain correlates of cannabis use disorder severity among young adults

BACKGROUND

Correlates of cannabis use and dependence among young adults have been widely studied. However, it is not known which factors are most strongly associated with severity of cannabis use dependence (CUD) severity. Identification of the salient correlates of CUD severity will be of increasing clinical significance as use becomes more socially normative.

METHODS

This study used a data-driven, hypothesis-free approach to examine the most robust correlates of CUD severity among a sample of 76 young adults (ages 18 to 25 years) who used cannabis at least weekly. Seventy-one candidate variables were examined for association with CUD severity. These included demographic variables, self-reported and psychodiagnostic assessments of mood and anxiety, self-reported measures of personality, cannabis and other substance use characteristics, and objective and subjective measures of cognition.

RESULTS

Of the 71 candidate variables considered, 27 were associated with CUD severity on a univariate level at a p-value ≤.20. Correlates of CUD severity in the multivariable model using stepwise selection were: more frequent cannabis use in the past 90 days, greater expectancies that cannabis causes cognitive and behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on a test of sustained attention. Internal validation tests support high prediction accuracy of all variables in the multivariable model, except for lower reaction time variability.

CONCLUSIONS

Cannabis use frequency, beliefs about use, perceived cognitive abilities, and anxiety are robustly associated with CUD severity in young adult, regular cannabis users, and may be important in guiding prevention and treatment efforts.