Psychometric evaluation of the marijuana and stimulant effect expectancy questionnaires for adolescents

Development and Validation of the Positive Outcomes of Cannabis Use Scale (POCUS) Among Predominantly White Adults in the United States

Operant conditioning and social learning theories suggest that positive cannabis use-related outcomes are a primary contributor to maintained use and risk for dependence. However, currently there does not exist a reliable, validated measure of positive cannabis-related outcomes. This study sought to develop and psychometrically evaluate the Positive Outcomes of Cannabis Use Scale (POCUS). We collected three samples, college students (N = 883), community adults (N = 214), and college students (N = 615), of predominantly White adults in the United States who completed an online survey. Exploratory and confirmatory factor analyses evaluated scale structure and identified four factors: social enhancement, mood enhancement, cognitive enhancement, and sexual enhancement. Positive outcomes were positively associated with recent use, controlling for expectancies and negative outcomes. Positive outcomes were also differentiated from positive expectancies and more influential in predicting typical use frequency. Findings indicate that the POCUS is psychometrically sound and clinically useful for measuring positive cannabis use-related outcomes among predominantly White adults in the United States.

The protective role of valuing cultural activities on cannabis use in reserve-Dwelling First Nation youth

Cannabis legalization and use across North America disproportionately negatively affects North American Indigenous (NAI) youth. Cultural activities may function as an alternative reinforcer to protect against substance use and promote engagement in substance-free activities. The present study explored the role of valuing cultural activities on positive cannabis expectancies and past-month cannabis use. This was a secondary data analysis of data from one NAI adolescent population reporting any past-month cannabis use. 106 NAI adolescents (50% female) from a Canadian reserve community completed surveys in spring 2017. The Institutional Review Board, tribal chief, and council approved this study and informed consent, assent, and parental permission were obtained from participants. Linear regression results revealed significant main effects of positive cannabis expectancies (b = 2.926, SE = 1.198, p = .017, 95%CI[0.542, 5.309]) and valuing cultural activities (b= -0.471,SE = 0.234, p=.048, 95%CI[-0.937, -0.005]) on cannabis use, but no significant interaction between cannabis expectancies and valuing cultural activities. Previous research found valuing cultural activities significantly moderates the relationship between positive alcohol expectancies and alcohol use. Divergent findings may relate to the different historical significance of alcohol versus cannabis. Alcohol was used as a method to colonize NAIs. Thus, our non-significant interaction may result from cannabis not holding the same historical significance in comparison to alcohol for First Nation people, although this is only a hypothesis and should be confirmed with a follow up study. Despite this, calls from Indigenous communities emphasize the need for strength-based approaches and our results indicate that valuing culture is still significantly related to reduced cannabis use, independent of cannabis expectancies.

Investigating the Relation between Anxiety Sensitivity and Substance Use: What Are the Roles of Social Anxiety and Outcome Expectancies?

Objective: Research on the association between anxiety sensitivity (AS) and substance use is mixed, with some studies showing a positive association and others showing no association. Other relevant variables, such as social anxiety and outcome expectancies, may help us understand how and for whom AS is linked to substance use. This study tested (a) the associations between AS and alcohol use, cannabis use, and drinking games and pregaming behaviors among young adults, and (b) the mediating role of social anxiety and moderating role of outcome expectancies in these associations. Method: Participants (N = 199, 69% women) were young adults (19 to 25 years) who completed a 30-minute online self-report questionnaire on their substance use. Results: Results revealed significant negative associations between AS and drinking game and pregaming participation. AS was not directly associated with other substance use outcomes. The association between AS and hazardous cannabis use was moderated by relaxation and tension reduction expectancies, but outcome expectancies did not moderate any of the other associations between AS and substance use outcomes. Social anxiety mediated the associations between AS and hazardous cannabis use and both drinking game and pregaming participation. Conclusions: Findings highlight the complex association between AS and different substance use outcomes. Outcome expectancies and social anxiety may help explain how AS is associated with hazardous cannabis use and drinking game/pregaming participation, respectively. More effective interventions can be developed by understanding the relation between AS and substance use.

Induced negative affect's impact on self-reported cannabis use, expectancies, and problems

Substance use disorders and affective disturbances often covary. Even momentary experiences of negative affect (NA) appear linked with substance use. While strong evidence of these relations exists, NA might bias endorsements of substance use due to hindered recall and reporting processes. This hypothesis warrants further research, as accurate assessment of substance-related variables is crucial in both research and treatment settings. The present study examined the influence of NA on reporting of cannabis variables using an affect-induction paradigm. Over 700 individuals recruited from Amazon's MTurk participated. After reporting demographics and baseline affect, participants were randomly assigned to either a NA induction or control condition. Follow-up measures assessed post-induction affect and cannabis-related variables. Results revealed that the NA induction task significantly increased NA and decreased positive affect relative to the control condition. Participants assigned to the NA induction reported greater negative cannabis expectancies and more cannabis problems, even after controlling for age and educational attainment. Cannabis use and cannabis problems appeared positively related. Future research should continue to assess for the influence of NA in reporting of cannabis variables. Should subsequent work find differences in reporting of substance use that appear to covary with negative affect, clinicians and researchers alike should be mindful of the implications of potentially biased reporting on assessment, intervention, and research outcomes.

Expectancies that Predict Cannabis Initiation in Response to Legalization

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.

Marijuana use experiences and expectancies of urban youth in India

Objective:

To gain information on the marijuana experiences and expectancies of youth in an urban Indian area, which may be used for forming the framework for the development of effective primary prevention strategies in the future.

Method:

This was a cross-sectional study conducted in various colleges of Mumbai; 260 students from three colleges who were above 18 years were selected by systematic random sampling. The participant had to fill a sociodemographic questionnaire and marijuana effect expectancy questionnaire (MEEQ-B) and it was analyzed by using the SPSS software.

Results:

A significant association was found between negative marijuana expectancies and type of family, with cannabis users and non-users, who want to try cannabis and those who are aware of the legal issues and harmful effects of cannabis.

Conclusion:

Preventive drug education should begin in early adolescence and should deter or delay drug use through changes in knowledge, attitude, behavior, and expectation. Adolescent drug education must meet the needs of those naive to drugs as well as those experiencing initial drug exposure. This is the first study which highlights the youth experiences and expectancies about marijuana in India.

Developing a Smartphone-Based Adjunct Intervention to Reduce Cannabis Use Among Juvenile Justice-Involved Adolescents: A Multiphase Study Protocol (Preprint)

Background

Adolescents involved in the juvenile justice system who use cannabis are at an increased risk of future substance use disorders and rearrest. Many court-involved, nonincarcerated (CINI) youth are referred for services in the community and often encounter multiple barriers to care, highlighting the need for minimally burdensome services that can be delivered in justice settings. Digital health interventions are accessible, easy to implement, and can provide ongoing support but have not been developed to address the unique needs of CINI youth who use cannabis.

Objective

This multiphase study will aim to develop, implement, and pilot test a novel smartphone app, Teen Empowerment through Computerized Health (TECH), to reduce cannabis and other substance use among CINI youth. TECH is conceptualized as a digital adjunct to a brief computerized intervention delivered by our family court partner.

Methods

Following the principles of user-centered design, phase I interviews with CINI youth aged 14-18 years (n=14-18), their caregivers (n=6-8), and behavioral health app developers (n=6-8) will guide the TECH design decisions. Next, in phase II, CINI youth (n=10) will beta test the TECH app prototype for 1 month; their feedback regarding feasibility and acceptability will directly inform the app refinement process. Finally, in phase III, CINI youth (n=60) will participate in a pilot randomized controlled trial for 6 months, comparing the preliminary effectiveness of the adjunctive TECH app on cannabis use outcomes.

Results

Phase I data collection began in September 2020 and was completed in December 2021; 14 CINI youth, 8 caregivers, and 11 behavioral health app developers participated in the study. Phases II and III will occur in 2022 and 2023 and 2023 and 2025, respectively.

Conclusions

This body of work will provide insight into the feasibility and acceptability of a smartphone-based adjunctive intervention designed for CINI youth. Phase III results will offer a preliminary indication of the effectiveness of the TECH app in reducing cannabis use among CINI youth.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35402

Development and validation of the Stimulant Refusal Self-Efficacy Questionnaire (SRSEQ) in stimulant users in treatment

BACKGROUND

Self-efficacy is a core component of Social Cognitive Theory. Refusal self-efficacy is an individual's belief in their ability to refuse a substance in specific high-risk situations. Change in refusal self-efficacy is predictive of positive treatment outcomes. Measurement of refusal self-efficacy is critical as it directs coping skills development techniques though existing behavioural treatments. There is no validated measure of stimulant refusal self-efficacy. This study developed and validated the Stimulant Refusal Self-Efficacy Questionnaire (SRSEQ) to measure confidence in the ability to refuse stimulants in specific high-risk situations.

METHOD

Two hundred and seven stimulant-using patients referred for assessment completed the SRSEQ and measures including stimulant dependence severity (Severity of Dependence Scale-Stimulant, SDS-S). Confirmatory Factor Analysis (CFA) using structural equation modelling (SEM) was conducted to test the theoretically-driven three-factor structure of the SRSEQ. Criterion validity was tested with severity of stimulant dependence.

RESULTS

The CFA supported the three-factor structure. Emotional Relief (β = -0.27, p = .008), Opportunistic (β = -0.24, p = .013) and Social Facilitation (β = -0.32, p < .001) refusal self-efficacy were uniquely associated with stimulant dependence severity, explaining 55.1% variance.

CONCLUSIONS

The SRSEQ is psychometrically sound and may be clinically useful to assist with assessment and treatment planning for stimulant use disorder.

Measuring Gambling Outcome Expectancies in Adolescents: Testing the Psychometric Properties of a Modified Version of the Gambling Expectancy Questionnaire

The Gambling Expectancy Questionnaire (GEQ; Gillespie et al. 2007a) is a 23-item scale assessing three positive outcome expectancies (Enjoyment/Arousal, Money, Self-Enhancement) and two negative outcome expectancies (Over-Involvement, Emotional Impact) related to gambling. It is the most used instrument to assess gambling outcome expectancies in adolescents and it has good psychometric properties. To allow a greater and more useful application of the scale, the present study aimed to modify the GEQ to make it usable with all adolescents, regardless of their gambling behaviour and to verify its psychometric properties. To that aim, the items were modified and the response scale was reduced from a seven-point to a five-point Likert scale. To verify the adequacy of the modified scale, two studies were conducted among Italian adolescents. In the first study (n = 501, 75% males, Mage = 16.74, SD = .88), after having removed four items and relocating another through explorative factor analysis, the original five-factor structure of the scale was confirmed by applying a confirmatory factor analysis. Reliability and validity evidence were also provided. The second study (n = 1894, 61% males, Mage = 15.68, SD = .71) attested its invariance across gambling behaviour status and gender. The modified version of the GEQ (GEQ - MOD) can be profitably used for research and preventive purposes with youth.

Precision Mental Health Care for Cannabis Use Disorder: Utility of a bioSocial Cognitive Theory to Inform Treatment

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.

A mobile phone-based brief intervention with personalized feedback and interactive text messaging is associated with changes in driving after cannabis use cognitions in a proof-of-concept pilot trial

Driving after cannabis use (DACU) is a significant public health concern and represents one of the riskiest cannabis-related behaviors. Though years of research has demonstrated that cannabis use impairs driving ability, many college students report believing that cannabis use does not impair their driving abilities. This perception of low danger may contribute to a permissive attitude toward DACU. The present proof-of-concept pilot study examined the preliminary efficacy of a mobile phone-based intervention with personalized feedback and text messaging to increase perceptions of dangerousness of DACU. Participants were 77 college cannabis users (65.8% women; average age = 21.2; 88.3% Caucasian) who endorsed DACU at least three times in the past 3 months. After completing baseline measures, participants were randomly assigned to one of three conditions: (a) personalized feedback plus interactive text messaging (PFT), (b) personalized feedback only (PF), or (c) informational control (IC). Participants completed outcome measures 3 months post intervention. Repeated measures mixed models revealed that compared to those in the IC condition, cannabis users in the PFT condition reported significantly greater increases over time in the perception of dangerousness of DACU. These findings provide initial support for the short-term efficacy of a mobile phone-based intervention for changing perceptions related to dangerousness of DACU among college cannabis users. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cannabis use in civilian college students and college student service members/veterans: the moderating effect of anxiety

Background: Cannabis is the most commonly used illicit drug on college campuses. Research suggests that Student Service Members/Veterans (SSM/V) may be more likely to use alcohol than civilian students, but little research has focused on cannabis use in these two samples. Objectives: The purpose of the current study was to compare cannabis use frequency, cannabis use disorder (CUD) symptoms, and cannabis-related problems between civilian students and SSM/V. A second aim was to determine if group differences in these outcomes were moderated by symptoms of depression, stress, or anxiety. Methods: The sample included 164 college SSM/V (80.4% female, 19.6% male) and 456 civilian (78% female, 22% male) college students. Participants completed an online survey assessing demographics, number of days of past month cannabis use, cannabis-related problems, CUD symptoms, and a measure of anxiety, depression, and stress. Results: Negative binomial regressions indicated no significant differences in number of days of past-month cannabis use or past-year cannabis-related problems between civilian students and SSM/V, although SSM/V reported more past-year CUD symptoms. Moderation analyses revealed that at elevated levels of anxiety, SSM/V students used cannabis more frequently than civilian students. Conclusion: These findings indicate that when experiencing elevated levels of anxiety, SSM/V use cannabis more frequently than civilian students, suggesting that anxiety may be a more prominent risk factor for frequency of cannabis use for SSM/V compared to civilian students. Education, prevention, and intervention efforts specifically addressing anxiety in this demographic are needed.

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.

Development and psychometric validation of a novel measure of sensory expectancies associated with E-cigarette use

INTRODUCTION

E-cigarette dependence measures largely focus on e-cigarette use ("vaping") that is linked to nicotine use, and measures assessing sensory aspects of vaping that may influence use (e.g., taste) are limited in scope. Thus, we developed the novel Sensory E-cigarette Expectancies Scale (SEES).

METHODS

In Summer 2017, 610 adult e-cigarette users (48.7% male, 84.9% White, 37.41[±12.15] years old) completed an online survey that included 23 SEES items. Psychometric analyses included evaluating latent structure, internal consistency, measurement invariance, mean differences, and test-criterion relationships.

RESULTS

Factor analyses supported a 9-item, 3-subscale structure (taste/smell, pleasure/satisfaction, vapor cloud production). Subscales evidenced internal consistency and scalar invariance by sex, race, smoking status (current/not), vaping status (daily/not), e-liquid nicotine content (yes/no), and device type (cig-a-likes/vape-pens/Advanced Personal Vaporizers [APVs]/Mods). Women and daily e-cigarette users reported stronger SEEs for taste/smell and pleasure than their counterparts. Non-white participants reported stronger SEEs for cloud production than White participants. Cig-a-like users reported the weakest SEEs for taste/smell and weaker SEEs linked to cloud production than APV/mod users. SEES scores evidenced convergence with nicotine dependence (mean r = .36). Finally, SEES scores predicted vaping frequency and habitual vaping concurrently and incrementally beyond nicotine dependence.

CONCLUSIONS

The SEES evidenced good psychometric properties, suggesting that the measure can be used to assess sensory vaping expectancies in adults. Importantly, SEES scores indicated that sensory expectancies are related, yet distinct, from nicotine dependence. Future research should evaluate how SEEs relate to product characteristic preferences and patterns of vaping including the development and maintenance of addiction.

Total and differential white blood cell count in cannabis users: results from the cross-sectional National Health and Nutrition Examination Survey, 2005-2016

BACKGROUND

Elevated white blood cell (WBC) count in tobacco cigarette smokers compared to non-smokers has been well documented, but little is known on circulating WBC counts and cannabis use.

METHODS

The National Health and Nutrition Examination Survey (2005-2016) is designed to be nationally representative of United States non-institutionalized population. The current study includes adult participants 20-59 years of age (n= 16,430) who underwent a detailed examination in the mobile examination center (MEC). Cannabis use was measured using Audio Computer-Assisted Self-Interview. Cannabis use was classified into never, former, occasional (1-7 days of the past 30 days), and heavy (>7 days of the past 30 days). WBC count was measured using the Coulter Counter method.

RESULTS

Total WBC count was higher among heavy cannabis users when compared to never users (β = 189; 95% confidence interval: 74, 304, p = 0.001). Among circulating WBC types, modest differences were observed for neutrophil count. Neither former nor occasional cannabis use was associated with total or differential WBC counts.

CONCLUSIONS

A modest association between heavy cannabis use and WBC count was detected. Additional research is needed to understand the immune related effects of different modes of cannabis use and to elucidate the role of proinflammatory chemicals generated from smoking cannabis.

Factors related to methamphetamine relapse risk among clients in the substance rehabilitation center of National Narcotics Board in West Java, Indonesia

Purpose

This purpose of this paper is to describe methamphetamine relapse risk, examine the relationship between factors in the dynamic model of relapse and methamphetamine relapse risk.

Design/methodology/approach

A total of 165 clients from the Substance Rehabilitation Center of National Narcotics Board in West Java, Indonesia were recruited. The research instruments included a demographic characteristic questionnaire and eight different tests: Drug Taking Confidence Questionnaire; Stimulant Effect Expectancy Questionnaire; Stage of Change Readiness and Treatment Eagerness Scale version 8.0 for Drug; Coping Strategies Inventory Short Form; Positive Affect and Negative Affect Schedule; Desire for Speed Questionnaire; Social Support Questionnaire; and the Stimulant Relapse Risk Scale. Descriptive statistics were used to analyze the data. Pearson’s product moment correlation was used to test the relationship among variables.

Findings

Clients (63 percent) were at a moderate level of methamphetamine relapse risk (mean=56.33, SD=10.54). Outcome expectancy, positive emotional state, negative emotional state and craving were positive and had a significant correlation with relapse risk (r=0.261, r=0.380, r=0.370, r=0.509, p<0.01, respectively). Self-efficacy was negative and had a significant correlation with relapse risk (r=−0.316, p<0.01). Motivation, coping and social support had no correlation with relapse risk.

Originality/value

Two-thirds of the clients in a rehabilitation center have a tendency to relapse following treatment. Nursing intervention for early detection of methamphetamine relapse risk during treatment by using standardized instruments should be implemented.

Positive expectancies mediate the association between sensation seeking and marijuana outcomes in at-risk young adults: A test of the acquired preparedness model

BACKGROUND AND OBJECTIVES

The acquired preparedness model (APM) integrates personality trait research and psychosocial learning, which are theorized to ultimately increase risk for problematic substance use outcomes.

METHODS

The present study uses the APM to examine the potential mediational role of positive and negative expectancies on the relationship between impulsivity and two marijuana outcomes (ie, frequency of use and marijuana use disorder [MUD] symptom count) among an at-risk sample of young adults with history of antisocial behavior and substance use in adolescence and their siblings (n = 312).

RESULTS

Results suggest a significant indirect effect of sensation seeking on recent marijuana use through positive marijuana expectancies. There also was a significant indirect effect of sensation seeking on past-year MUD symptoms through positive expectancies. No significant indirect effects through negative expectancies were found for either outcome.

DISCUSSION AND CONCLUSIONS

Our findings are consistent with the APM and suggest that higher sensation seeking is related to increased positive beliefs about marijuana outcomes, which is related to higher marijuana use and more MUD symptoms.

SCIENTIFIC SIGNIFICANCE

These findings suggest that positive expectancies are an important risk factor for marijuana use and misuse, particularly for at-risk individuals with elevated rates of sensation seeking. Positive marijuana expectancies may be important to address in interventions for at-risk individuals. (Am J Addict 2018;XX:1-6).

Correlates of cannabis vape-pen use and knowledge among U.S. college students

INTRODUCTION

The proliferation of electronic devices, such as vape-pens, has provided alternative means for cannabis use. Research has found cannabis-vaping (i.e., vape-pen use) is associated with lower perceived risks and higher cannabis use. Knowledge of these products may increase likelihood of subsequent use. As policies for cannabis shift, beliefs that peers and family approve of this substance use (injunctive norms) increase and there has been an increase in vape-pen use among young adults (18-35 year olds); however, correlates thereof remain unknown. Young adults often engage in cross-substance use with cannabis and alcohol, making alcohol a potential correlate of cannabis vape-pen use and knowledge. Therefore, we examined alcohol use and other potential correlates of vape-pen use and knowledge among a sample of university students.

METHODS

This secondary data analysis utilized surveys at multiple colleges in the U.S. (N = 270). Alcohol use, social anxiety, cannabis expectancies, injunctive and descriptive norms and facets of impulsivity were examined as correlates of vape-pen use and knowledge using bivariate correlations and logistic regressions.

RESULTS

Alcohol use was correlated with cannabis vape-pen use and knowledge. Frequency of cannabis use, peer injunctive norms, and positive expectancies were associated with increased likelihood of vape-pen use. Lack of premeditation, a facet of impulsivity, was associated with cannabis vape-pen knowledge.

CONCLUSIONS

Given the unknown nature and consequences of cannabis vape-pens, the present findings offer valuable information on correlates of this behavior. Further, correlates of knowledge of vape-pens may point to areas for education and clinical intervention to prevent heavy cannabis vape-pen use.

Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety

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.

Marijuana Use, Marijuana Expectancies, and Hypersexuality among College Students

Research supports links between marijuana effect expectancies and risky sexual behaviors among marijuana users, but associations between marijuana expectancies and hypersexuality have yet to be investigated. The current study examined links between marijuana lifetime use and hypersexuality among university students. A hierarchical regression adjusting for gender and alcohol use was used to determine the degree to which marijuana use and expectancies accounted for variance in hypersexuality. Marijuana lifetime use and hypersexuality were significantly and positive related. After adjusting for covariates, perceptual and cognitive enhancement expectancies positively correlated with hypersexuality, while tension reduction and relaxation expectancies negatively correlated with hypersexuality.

Longitudinal associations between marijuana-related cognitions and marijuana use in African-American and European-American girls from early to late adolescence

This study examined marijuana-related cognitions and marijuana use in African-American (AA) and European-American (EA) girls, with the aim of characterizing their interrelationships from early to late adolescence. Identifying differences by race in these relationships would have implications for tailoring interventions to specific subgroups. Data were drawn from the Pittsburgh Girls Study, an urban community sample (56.8% AA, 43.2% EA; n = 2,172) recruited at ages 5-8 years and assessed each year. Cross-lagged panel models were conducted separately by race to identify patterns of association between marijuana use and related cognitions (i.e., intentions to use, positive attitude toward use, positive and negative expectancies) assessed at ages 12-17 years. Results indicated that AA girls consistently reported higher negative expectancies than EA girls and greater intention to use marijuana, but they did not differ from EA girls on positive expectancies. In cross-lagged models, bidirectional effects between negative expectancies and marijuana use were observed in AA and EA girls across all ages, and at most ages for intentions to use, but were largely absent in both groups for positive attitude. Bidirectional effects of marijuana use with positive expectancies were observed only in AA girls at certain ages. Overall, results demonstrate more similarities than differences between AA and EA girls in the longitudinal associations between marijuana-related cognitions and marijuana use. Results highlight the role of negative expectancies as shaping and being shaped by marijuana use. Interventions that target negative expectancies to reduce marijuana use may be useful for AA and EA adolescent girls. (PsycINFO Database Record

Expectancy of impairment attenuates marijuana-induced risk taking

BACKGROUND

Marijuana use has been associated with increased risk-taking and impulsive behavior. While pharmacologic effects of marijuana can lead to inhibitory impairment, expectancy of potential impairment may result in compensatory behavioral response by decreasing impulsive decisions and risky behaviors. With the increases in marijuana use and related problems, a better understanding of the individual characteristics associated with marijuana intoxication and risky behavior is needed. This study examined the role of impairment expectancies in marijuana's acute effects on behavioral measures of impulsivity and risk-taking.

METHODS

Participants (N=136) were regular marijuana users. A balanced placebo design (BPD) was used crossing marijuana administration (i.e., 0% Tetrahydrocannabinol (THC) vs. 2.8% THC) with stimulus expectancy (i.e., Told Placebo vs. Told THC). Marijuana outcome expectancies were measured by self-report and dependent measures included a number of behavioral impulsivity tasks and the balloon analogue risk task (BART).

RESULTS

Among participants who received THC, higher expectancies for cognitive-behavioral impairment (CBI) were related to lower risk-taking on the BART. Among those who received placebo, there was no association between CBI expectancies and BART performance. CBI expectancies did not moderate the stimulus expectancy effect on the BART nor drug or stimulus expectancy effects on impulsivity measures.

CONCLUSIONS

Results provide initial evidence that expectancies of greater impairment are associated with compensatory behavior on a risk-taking task under acute marijuana intoxication. Future studies should examine the role of impairment expectancies on risk behaviors of substantial public health concern, such as driving while under the influence of marijuana.

Development and initial validation of a marijuana cessation expectancies questionnaire

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%;M_age=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.

Perceived safety and controllability of events: Markers of risk for marijuana use in young adults?

Drawing on constructs from the trauma literature, the current study evaluated perceptions of safety and controllability of events as potential markers of risk for marijuana use. In addition, we characterized these perceptions in relation to individual level substance abuse risk factors (marijuana expectancies, impulsivity, depression, and anxiety), gender, and race. Data were collected via web survey from college students at two northeastern universities (n=228, 82.0% female). Controllability of events (CE) was rated significantly higher by Blacks than Whites. Safety/vulnerability (SV) and CE were associated with impulsivity, depression, and anxiety. CE was also associated with marijuana expectancies. Logistic regression analyses revealed a modest but significant association between SV and lifetime use even after adjusting for race, gender, age, and individual level substance abuse risk factors (odds ratio=1.10, 95% confidence intervals:1.02-1.18). No association between SV and past 3month frequency of use or between CE and either marijuana outcome was found. Findings support a link between perceptions of safety and ever using marijuana. They further demonstrate overlap of both perceived safety and controllability of events with substance use related risk factors, and suggest that they differ by race. Additional studies that assess substance use more broadly and query trauma history, using larger, more diverse samples, are needed to more fully grasp the relevance of these constructs to substance use, including their potential as targets for substance abuse prevention efforts.

Treatment seeking in cannabis dependence: The role of social cognition

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.

Risk Factors for Driving After and During Marijuana Use

OBJECTIVE

Use of marijuana before or while driving significantly contributes to driving impairment and elevated risk of motor vehicle accidents; however, this risk behavior is common among users. Little is known about the etiology of driving while under the influence of marijuana.

METHOD

Guided by social learning theory, this study examined marijuana outcome expectancies and other driving-related cognitions as predictors of the frequency of driving after smoking marijuana (DASM) and smoking marijuana while driving (SMWD). A community sample of 151 (64% male) non-treatment-seeking frequent marijuana users completed questionnaires on variables of interest.

RESULTS

Perceived driving-related peer norms (i.e., perception that fewer friends disapprove of DASM and SMWD and of riding with a driver under the influence of marijuana) were associated with lower frequency of both DASM and SMWD. Perceived dangerousness of DASM was also associated with decreased frequency of DASM.

CONCLUSIONS

Our findings suggest a range of potentially important targets for interventions intended to reduce the likelihood and frequency of driving while under the influence of marijuana.

The Interactive Influence of Cannabis-Related Negative Expectancies and Coping Motives on Cannabis Use Behavior and Problems

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.

A novel application in the study of client language: Alcohol and marijuana-related statements in substance-using adolescents during a simulation task

The current study explored whether laboratory-based techniques can provide a strategy for studying client language as a mechanism of behavior change. Specifically, this study examined the potential of a simulation task to elicit healthy talk, or self-motivational statements in favor of healthy behavior, related to marijuana and alcohol use. Participants (N = 84) were adolescents reporting at least 10 lifetime substance use episodes recruited from various community settings in an urban Pacific Northwest setting. Participants completed the Adolescent Simulated Intoxication Digital Elicitation (A-SIDE), a validated paradigm for assessing substance use decision making in peer contexts. Participants responded to 4 types of offers in the A-SIDE: (a) marijuana, (b) food (marijuana control), (c) alcohol, and (d) soda (alcohol control). Using a validated coding scheme adapted for the current study, client language during a structured interview assessing participants' response to the simulated offers was evaluated. Associations between percent healthy talk (PHT, calculated by dividing the number of healthy statements by the sum of all substance-related statements) and cross-sectional outcomes of interest (previous substance use, substance use expectancies, and behavioral willingness) were explored. The frequency of substance-related statements differed in response to offer type; rate of PHT did not. PHT was associated with behavioral willingness to accept the offer. However, PHT was not associated with decontextualized measures of substance use. Associations between PHT and global expectancies were limited. Simulation methods may be useful in investigating the impact of context on self-talk and to systematically explore client language as a mechanism of change. (PsycINFO Database Record

College Student Drug Prevention: A Review of Individually-Oriented Prevention Strategies

The current paper highlights the college years as a risk period for development, continuation, and escalation of illicit substance use and substance use disorders and reviews the literature related to the prevention and treatment of these disorders in college populations. Despite widespread implementation of college drug prevention programs, a review of the literature reveals few controlled trials targeting this population. However, alcohol prevention has been extensively studied, and many efficacious interventions for college drinking share theoretical and methodological underpinnings with interventions shown to be efficacious in drug prevention and treatment with other populations (i.e., school-based prevention, adolescent and adult drug treatment). These interventions could be adapted to target drug prevention on college campuses. Barriers to implementation and evaluation of these interventions on campus are discussed, and suggestions are made for future research and programmatic directions.

Professional and youth perspectives on higher education-focused interventions for youth transitioning from foster care

Youth transitioning from foster care to adulthood access and succeed in college at much lower rates than the general population. A variety of services exist to support youth with their postsecondary goals, but few if any have evidence for their effectiveness. As part of a National Institute on Drug Abuse-funded intervention development project to design Fostering Higher Education, a structured, testable postsecondary access and retention intervention for youth transitioning from foster care to adulthood, focus groups were conducted with community stakeholders to collect recommendations for how to most effectively structure the intervention. Analyses of focus group findings resulted in four theme groups: (1) general recommendations for intervention development; (2) recommendations for an educational advocacy intervention component; (3) recommendations for a mentoring intervention component; and (4) recommendations for a substance abuse prevention intervention component. These themes offered a variety of important insights for developing interventions in a way that is usable for youth and feasible for communities to implement.

How Harmonious and Obsessive Passion for Alcohol and Marijuana Relate to Consumption and Negative Consequences

OBJECTIVE

Although the concepts of harmonious and obsessive passion have been productive in explaining why people eagerly engage in such activities as sports, Internet use, and gambling, previous research has not yet extended these models to explain alcohol and marijuana use among college students. The current research was conducted to clarify the relationships among harmonious and obsessive passion, alcohol and marijuana use, and negative consequences.

METHOD

Two studies were conducted using online assessments. In Study 1, 748 heavy drinking college students (58% female) were recruited and completed measures of passion for drinking alcohol, alcohol use, and alcohol-related negative consequences. In Study 2, 352 regular marijuana-using students (54% female) were recruited and completed assessments of marijuana passion, marijuana use, and marijuana-related consequences.

RESULTS

Study 1 found that among heavy drinking college students, harmonious passion was a stronger predictor of increased consumption than was obsessive passion, whereas obsessive passion was a stronger predictor of alcohol-related problems than was harmonious passion. Study 2 revealed similar findings with regard to harmonious passion predicting marijuana consumption; however, unlike Study 1, no significant difference between the passions was found in predicting marijuana-related problems.

CONCLUSIONS

This research provides a novel perspective on motivation for alcohol and marijuana use. Findings suggest that understanding the locus of young adults' passion for substance use may be helpful in identifying those who are likely to develop a substance use disorder and therefore may be the most in need of assistance and intervention.

Testing the Acquired Preparedness Model: Predicting College Student Gambling Frequency and Symptomatology

The acquired preparedness model posits that impulsivity influences the development of outcome expectancies that then influence the engagement in a specific risk taking behavior. The purpose of this study was to test the acquired preparedness model for gambling behavior of college students using a multidimensional approach to impulsivity. Employing a structural equation approach, it was predicted that a full mediational model that includes multiple dimensions of impulsivity and multiple outcome expectancies would predict gambling frequency and gambling symptomatology. Support was found for the acquired preparedness model in understanding why some college students gamble more frequently or problematically. Specifically, better model fit was found for the full mediational model that included outcome expectancies to predict both frequency and gambling symptomatology than the model that included the direct relation between impulsivity and gambling.

Validation of the Marijuana Effect Expectancies Questionnaire (MEEQ) in a Non-Clinical French-Speaking Adolescent Sample

Teenagers commonly use cannabis. Expectancies related to the effects of cannabis play an important role in its consumption and are frequently measured with the Marijuana Effect Expectancies Questionnaire (MEEQ). This study aims to assess the psychometric properties (factor structure, internal consistency reliability, criterion validity) of the French MEEQ. A sample of 1,343 non-clinical teenagers (14–18 years) were recruited to answer a self-report questionnaire; 877 of them responded twice (one-year interval). A four-factor structure was obtained: Cognitive Impairment and Negative, Relaxation and Social Facilitation, Perceptual Enhancement and Craving and Negative Behavioral Effect Expectancies. It is concluded that the French MEEQ constitutes an appropriate tool to measure cannabis effect expectancies among adolescents.

Dissociation between implicit and explicit expectancies of cannabis use in adolescence

Cannabis is one of the most commonly drugs used by teenagers. Expectancies about its effects play a crucial role in cannabis consumption. Various tools have been used to assess expectancies, mainly self-report questionnaires measuring explicit expectancies, but implicit measures based on experimental tasks have also been developed, measuring implicit expectancies. The aim of this study was to simultaneously assess implicit/explicit expectancies related to cannabis among adolescent users and non-users. 130 teenagers attending school (55 girls) were enrolled (Age: M=16.40 years); 43.84% had never used cannabis ("non-users") and 56.16% had used cannabis ("users"). They completed self-report questionnaires evaluating cannabis use, cannabis-related problems, effect expectancies (explicit expectancies), alcohol use, social and trait anxiety, depression, as well as three Implicit Association Tests (IAT) assessing implicit expectancies. Adolescents manifested more implicit affective associations (relaxation, excitation, negative) than neutral ones regarding cannabis. These were not related to explicit expectancies. Cannabis users reported more implicit relaxation expectancies and less negative explicit expectancies than non-users. The frequency of use and related problems were positively associated with the explicit expectancies regarding relaxation and enhancement, and were negatively associated with negative explicit expectancies and negative implicit expectancies. Findings indicate that implicit and explicit expectancies play different roles in cannabis use by adolescents. The implications for experimentation and prevention are discussed.

Marijuana use/cessation expectancies and marijuana use in college students

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.

Social anxiety and cannabis cravings: The influences of parent injunctive norms and tension reduction expectancies

OBJECTIVES

Socially anxious cannabis users are influenced by cannabis expectancies and normative perceptions. The present study examines the influence of psychosocial factors on cannabis use vulnerability factors as the result of interactions between norms perceptions, social anxiety, and expectancies.

METHODS

Participants were 149 (36.2% female) current cannabis users aged 18-36 (M=21.01, SD=3.09). Hierarchical multiple regressions were employed to investigate the predictive value of the social anxiety X injunctive norms X expectancies interaction on cannabis cravings.

RESULTS

A three-way interaction emerged in the prediction of cannabis cravings. Simple slopes analyses showed that among individuals with perceptions of greater parent approval of cannabis use (higher injunctive norms), social anxiety was associated with greater cannabis craving when expectancies regarding relaxation and tension reduction were greater (t=2.54, p=.01, β=1.12).

CONCLUSIONS

Among cannabis users with perceptions of greater injunctive norms, social anxiety was associated with greater cannabis craving when tension reduction expectancies were greater. However, social anxiety was unrelated to cannabis craving when expectances were low. This suggests that cannabis craving among socially anxious adults was greatest when cannabis use was viewed as acceptable and expected to reduce tension, and highlights the importance of considering norms, expectancies, and social anxiety in understanding cannabis-related behaviors.

Patterns of Substance Use Across the First Year of College and Associated Risk Factors

Starting college is a major life transition. This study aims to characterize patterns of substance use across a variety of substances across the first year of college and identify associated factors. We used data from the first cohort (N = 2056, 1240 females) of the "Spit for Science" sample, a study of incoming freshmen at a large urban university. Latent transition analysis was applied to alcohol, tobacco, cannabis, and other illicit drug uses measured at the beginning of the fall semester and midway through the spring semester. Covariates across multiple domains - including personality, drinking motivations and expectancy, high school delinquency, peer deviance, stressful events, and symptoms of depression and anxiety - were included to predict the patterns of substance use and transitions between patterns across the first year. At both the fall and spring semesters, we identified three subgroups of participants with patterns of substance use characterized as: (1) use of all four substances; (2) alcohol, tobacco, and cannabis use; and (3) overall low substance use. Patterns of substance use were highly stable across the first year of college: most students maintained their class membership from fall to spring, with just 7% of participants in the initial low substance users transitioning to spring alcohol, tobacco, and cannabis users. Most of the included covariates were predictive of the initial pattern of use, but covariates related to experiences across the first year of college were more predictive of the transition from the low to alcohol, tobacco, and cannabis user groups. Our results suggest that while there is an overall increase in alcohol use across all students, college students largely maintain their patterns of substance use across the first year. Risk factors experienced during the first year may be effective targets for preventing increases in substance use.

A-SIDE: Video simulation of teen alcohol and marijuana use contexts

OBJECTIVE

This investigation examined the concurrent validity of a new video simulation assessing adolescent alcohol and marijuana decision making in peer contexts (A-SIDE).

METHOD

One hundred eleven youth (60% female; age 14-19 years; 80% White, 12.6% Latino; 24% recruited from treatment centers) completed the A-SIDE simulation, self-report measures of alcohol and marijuana use and disorder symptoms, and measures of alcohol (i.e., drinking motives and expectancies) and marijuana (i.e., expectancies) cognitions in the laboratory.

RESULTS

Study findings support concurrent associations between behavioral willingness to use alcohol and marijuana on the simulation and current use variables as well as on drinking motives and marijuana expectancies. Relations with use variables were found even when sample characteristics were controlled. Interestingly, willingness to accept nonalcoholic beverages (e.g., soda) and food offers in the simulation were inversely related to recent alcohol and marijuana use behavior.

CONCLUSIONS

These findings are consistent with prior work using laboratory simulations with college students and provide preliminary validity evidence for this procedure. Future work is needed to examine the predictive utility of the A-SIDE with larger and more diverse samples of youth.

College student beliefs about wagering: an evaluation of the adolescent gambling expectancies survey

Expectancy theory posits that decisions to engage in a given behavior are closely tied to expectations of the outcome of that behavior. Gambling outcome expectancies have predicted adolescent gambling and gambling problems. When high school students' outcome expectancies were measured by Wickwire et al. (Psychol Addict Behav 24(1):75-88 2010), the Adolescent Gambling Expectancy Survey (AGES) revealed five categories of expectancies that were each predictive of gambling frequency and pathology. The present study aimed to explore if the AGES could be successfully replicated with college students. When administered to a diverse college student population, factor analyses identified five factors similar to those found in the high school sample. Several factors of the AGES were also found to predict gambling frequency and gambling problems for college students. Gambling frequency and gambling activity preference were also addressed.

Evaluation of the current opioid misuse measure among substance use disorder treatment patients

The Current Opioid Misuse Measure (COMM) has demonstrated promising psychometric properties among pain clinic and primary care patients. Given the high prevalence of the nonmedical use of prescription opioids among substance use disorder patients, the COMM may also be useful in substance use disorder treatment settings. The purpose of this study was to assess the factor structure and validity of the COMM in a sample of substance use disorder patients. Participants (n = 351) were recruited from a large residential substance use disorder treatment center and completed the COMM and several questionnaires assessing various substance use and health functioning characteristics. Factor analyses yielded a two-factor solution; however, each of the items in the second factor cross-loaded onto the first factor and just one factor was retained. To provide support for this new 11-item COMM, we found that higher scores on this COMM were associated with greater drug use severity, greater endorsement of positive, negative, and pain relief outcome expectancies related to opioid use, increased pain intensity, and decreased physical and mental health functioning. These findings provide initial support for the psychometric properties of this version of the COMM adapted for substance use disorder treatment settings. Given its promising psychometric properties, the 11 items of the COMM to evaluate the nonmedical use of prescription opioids have potential utility among substance use disorder patients. The COMM could be used to examine nonmedical use over the course of treatment and to aid treatment planning. It could also be used in research as an outcome measure.

A longitudinal study of cannabis use initiation among high school students: Effects of social anxiety, expectancies, peers and alcohol

This study identified protective and risk factors of cannabis use initiation, including expectancies and social anxiety. A questionnaire was completed twice by 877 teenagers. Logistic regressions, mediation and moderation analyses were performed. Significant risk factors were alcohol use, peer users, perceptual enhancement, and craving expectancies. Protective factors were negative behavior expectancies and social anxiety. Social anxiety protected from initiation through the mediating role of perceptual enhancement and craving expectancies, whatever the role of peer users and alcohol use. Findings are discussed in terms of risk and protection, in an overall approach including internalizing factors. Results support the identification of an internalizing profile of adolescents for prevention or treatment and the importance of social anxiety and expectancies in intervention.

Cannabis use expectancies mediate the relation between depressive symptoms and cannabis use among cannabis-dependent veterans

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.