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Brown T, Ackerman RA, Kroon E, Kuhns L, Cousijn J, Filbey FM. The role of sleep in the link between cannabis use and memory function: evidence from a cross-sectional study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:547-556. [PMID: 38917114 DOI: 10.1080/00952990.2024.2362832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/29/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024]
Abstract
Background: It is known that cannabis use affects memory and sleep problems independently. However, to date, how memory and sleep problems may interact as a result of cannabis use remains unknown.Objectives: We performed a secondary analysis of existing data to determine whether sleep quality mediates the association between cannabis use and memory and whether sex moderated these effects.Methods: A total of 141 adults with cannabis use disorder (CUD) (83 men) and 87 without CUD (39 men) participated in this study. Outcome measures included self-reported sleep problems from the past 7 days (Marijuana Withdrawal Checklist), learning and memory performance via the short visual object learning task (sVOLT), short visual object learning task delayed (sVOLTd), and verbal memory via the N-back. Bootstrapped mediation and moderated mediation analyses were run to test if sleep quality mediated the association between cannabis use and memory outcomes and whether sex moderated these effects, respectively.Results: Sleep quality mediated the effect of group (i.e. adults with and without CUD) on sVOLT efficiency scores (indirect effect ß = -.08, 95% CI [-0.14, -0.04]) and sVOLTd efficiency scores (indirect effect ß = -.09, 95% CI [-0.14, -0.04]), where greater sleep difficulties was associated with poorer memory performance (decreased efficiency scores). Sex did not moderate these relationships.Conclusion: These initial findings of a mediating role of sleep in the association between CUD and visual learning memory highlight potential critical downstream effects of disrupted sleep in those with CUD and suggest the importance of investigating sleep in CUD.
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Affiliation(s)
- T Brown
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - R A Ackerman
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - E Kroon
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - L Kuhns
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - J Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - F M Filbey
- Department of Psychology, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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2
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Ciesluk B, Erridge S, Sodergren MH, Troup LJ. Cannabis use in the UK: a quantitative comparison of individual differences in medical and recreational cannabis users. Front Psychol 2024; 14:1279123. [PMID: 38259543 PMCID: PMC10802163 DOI: 10.3389/fpsyg.2023.1279123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024] Open
Abstract
There is a paucity of research, especially in the UK, that investigates individual differences in both medical and recreational cannabis users. A cross-sectional survey study design was used to assess recreational cannabis users and medical cannabis users currently living in the UK. Recreational cannabis users were invited to take part via social media. Medical cannabis users were recruited from Sapphire Medical Clinics, London, UK, which provides treatment with prescribed cannabis-based medicinal products. Demographic data and cannabis use frequency, as well as post-traumatic stress disorder symptoms (PCL-5), depression symptoms (Centre for Epidemiological Studies Depression Scale), trait and state anxiety (State-Trait Anxiety Inventory), and cannabis use motives [Comprehensive Marijuana Motives Questionnaire (CMMQ)] were collected. The Chi-square and independent-sample t-tests were used for the comparison of categorical variables and normally distributed continuous variables. Data were analyzed using analyses of variance (ANOVAs) and t-tests. Statistical significance was considered where the value of p was <0.05. The survey was completed by 161 participants. Medical cannabis users were older, consumed cannabis more often, had a higher "Sleep" motive on the CMMQ, and had a higher prevalence in self-reporting current diagnoses of neurological problems, mood disorders, and anxiety disorders (p < 0.05). Recreational cannabis users had higher scores on several motives for use (e.g., "Enjoyment," "Coping," "Experimentation," "Boredom," and "Celebration") and higher state anxiety scores (p < 0.05). The most common motives for cannabis use in both groups were "Enjoyment," "Low Risk," and "Sleep." There were no differences between groups in gender, "Low-Risk" motive, post-traumatic stress disorder symptoms, depression scores, trait anxiety scores, self-reported prevalence of substance use-related disorders, and past consumption of alcohol, tobacco, or caffeine (p > 0.05). The current study not only demonstrates a difference in age and motivations for cannabis consumption between recreational and medical cannabis users but also shows areas of potential overlap, including mental health outcomes, past substance use, and gender. These UK-specific findings indicate that recreational cannabis users experience higher state anxiety, highlighting the need for further evaluation of potential anxiogenic/anxiolytic properties of cannabis. These findings demonstrate the importance of researching individual differences in cannabis users and hold significant implications for future research, clinical practice, and legislation.
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Affiliation(s)
- Beata Ciesluk
- Division of Psychology, School of Education and Social Sciences, University of the West of Scotland, Paisley, United Kingdom
| | - Simon Erridge
- Medical Cannabis Research Group, Imperial College London, London, United Kingdom
- Sapphire Medical Clinics, London, United Kingdom
| | - Mikael H. Sodergren
- Medical Cannabis Research Group, Imperial College London, London, United Kingdom
- Sapphire Medical Clinics, London, United Kingdom
- Curaleaf International, London, United Kingdom
| | - Lucy J. Troup
- Division of Psychology, School of Education and Social Sciences, University of the West of Scotland, Paisley, United Kingdom
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3
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Tuvel AL, Winiger EA, Ross JM. A Review of the Effects of Adolescent Cannabis Use on Physical Health. Psychiatr Clin North Am 2023; 46:719-739. [PMID: 37879834 DOI: 10.1016/j.psc.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
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Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
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4
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Goodhines PA, Rathod K. Substance use and sleep health in young adults: Implications for integrated treatment and harm reduction. Sleep Med Rev 2023; 70:101811. [PMID: 37423096 DOI: 10.1016/j.smrv.2023.101811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023]
Abstract
In their systematic review and meta-analysis, Meneo and colleagues document distinct substance-sleep effects reported by young adults (ages 18-30) across multidimensional sleep health and different substances used in the naturalistic environment, including alarming rates of self-medication for sleep aid. Key innovations of Meneo et al.'s review include (a) a multidimensional approach to defining sleep health and (b) robust inclusion of various substances commonly used in young adults. Although future research will be essential to clarifying transdiagnostic risk mechanisms, interplay of co-used substances, and the role of expectancies in risk processes, the developing literature reviewed herein may inform much-needed clinical recommendations. This work by Meneo et al should prompt an emphasis on approaching young adult substance use and self-medication through a harm reduction lens, highlighting recommendations for integrated behavioral sleep treatment tailored to stage of change using motivational interviewing.
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5
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Amaral C, Carvalho C, Scaranelo A, Chapman K, Chatkin J, Ferreira I. Cannabis and sleep disorders: not ready for prime time? A qualitative scoping review. J Clin Sleep Med 2023; 19:975-990. [PMID: 36692176 PMCID: PMC10152356 DOI: 10.5664/jcsm.10428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 01/25/2023]
Abstract
STUDY OBJECTIVES To perform a qualitative scoping literature review for studies involving the effects of cannabis on sleep and sleep disorders. METHODS Two electronic databases, MEDLINE and EMBASE, searched for comprehensive published abstracted studies that involved human participants. Inclusion criteria were article of any type, published in English, a target population of cannabis users, and reported data on cannabis effect on sleep and sleep disorders. The Joanna Briggs Institute's (JBI) approach was elected as the methodology framework guidance in the scoping review process. RESULTS A total of 40 unique publications were found. The majority (82.5%) were from the Americas with 60% published in the last decade. Of the 40 studies, only 25% were randomized control trials, and the sleep outcome measurements were similar and comparable in only 20%. Cannabis users studied were reported either 73% frequent users or 27% sporadic users. The utilization of cannabis showed improved sleep (21%), worse sleep (48%), mixed results (14%), or no impact at all (17%) in the studies published in the last 5 decades. CONCLUSIONS Our findings summarize the lack of robust evidence to support the use of cannabis for sleep disorders. The varied cannabis user-related characteristics may account for the inconsistent results identified. Further studies assessing cannabis and sleep are needed to discern what works in what context, how it works, and for whom. CITATION Amaral C, Carvalho C, Scaranelo A, Chapman K, Chatkin J, Ferreira I. Cannabis and sleep disorders: not ready for prime time? A qualitative scoping review. J Clin Sleep Med. 2023;19(5):975-990.
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Affiliation(s)
- Caio Amaral
- Department of Medicine, University Centre of the Americas, São Paulo, São Paulo, Brazil
| | - Carolina Carvalho
- KITE-Toronto Rehabilitation Institute, University Health Network and Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Anabel Scaranelo
- Medical Imaging Department, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth Chapman
- Department of Medicine, Respiratory Division, University of Toronto, Toronto, Ontario, Canada
- Asthma & Airway Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Jose Chatkin
- Division of Respiratory Diseases, School of Medicine Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ivone Ferreira
- Department of Medicine, Respiratory Division, University of Toronto, Toronto, Ontario, Canada
- Asthma & Airway Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, Respiratory Division of McMaster University, Hamilton, Ontario, Canada
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6
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Livingston NR, Hetelekides E, Bravo AJ, Looby A. Negative Affect Regulation and Marijuana Use in College Students: Evaluating the Mediating Roles of Coping and Sleep Motives. J Psychoactive Drugs 2023; 55:203-212. [PMID: 35341474 PMCID: PMC9512938 DOI: 10.1080/02791072.2022.2054747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 10/18/2022]
Abstract
Negative affect regulation models suggest that marijuana may be used to reduce negative affect. Extant research has provided support for these models, indicating that specific motives for marijuana use, particularly coping motives (i.e., using to alleviate negative affects), mediate relations between affective vulnerabilities and marijuana outcomes. However, sleep motives (i.e., using to promote sleep) have been neglected from such models, despite their theoretical relevance. The present study tested two multiple mediation models in a large sample of marijuana-using college students (N = 1,453) to evaluate the indirect effects of coping and sleep motives in paths from depressive and anxiety symptoms to marijuana outcomes (use, consequences, and cannabis use disorder [CUD] symptoms). Both coping and sleep motives mediated the effects of depressive/anxiety symptoms on each marijuana variable. Moreover, significant double mediated effects were found, such that higher affective symptoms were associated with greater motives; which were associated with more marijuana use; which was related to more negative consequences and CUD symptoms. The findings provide support for sleep motives as a relevant pathway between affective vulnerabilities and marijuana outcomes. Additional research is needed to evaluate the potential benefits of interventions targeting specific marijuana motives.
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Affiliation(s)
| | | | - Adrian J. Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, VA USA
| | - Alison Looby
- Department of Psychology, University of Wyoming, Laramie, WY USA
| | - Stimulant Norms and Prevalence (SNAP) Study Team
- This project was completed by the Stimulant Norms and Prevalence Study (SNAP) Team, which includes the following investigators (in alphabetical order): Adrian J. Bravo, William & Mary (Co-PI); Bradley T. Conner, Colorado State University; Mitch Earleywine, University at Albany, State University of New York; James Henson, Old Dominion University; Alison Looby, University of Wyoming (Co-PI); Mark A. Prince, Colorado State University; Ty Schepis, Texas State University; Margo Villarosa-Hurlocker, University of New Mexico
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7
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Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
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Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
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8
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Winiger EA, Ma M, Brooks-Russell A. Novel Methods of Cannabis Use and Lower Sleep Duration Among High School Students. CANNABIS (ALBUQUERQUE, N.M.) 2022; 5:66-73. [PMID: 37287665 PMCID: PMC10212238 DOI: 10.26828/cannabis/2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background The general use of cannabis in adolescence is associated with various sleep deficits. While traditional smoking remains the most common form of cannabis consumption amongst adolescents, novel methods of administration are becoming more popular and available due to legalization. The association of these novel methods of use with sleep in adolescence has yet to be studied and research is needed to inform public health initiatives. Methods High school (9th-12th grade) students from the Healthy Kids Colorado Survey with current cannabis use (n= 4,637) reported on numerous demographic variables, method of cannabis use (flower, edibles, dabs, and vaporizers) and average sleep duration on weeknights. Logistic regression assessed the relationship between novel methods of use (edibles, dabs, and vaporizers) and sleep duration in comparison to cannabis flower. Results Use of any edible, dab, or vaporizer product in the past 30-days was associated with being male and current tobacco use. Reporting a novel method of use as the most common mode of cannabis use was associated with current tobacco use and higher mothers' education. Students who used any novel method products in the past 30 days or reported these products as the usual mode of cannabis use, were more likely to sleep 7 hours or fewer a night. Conclusions Novel methods of cannabis administration such as edibles, dabs, and vaporizers are associated with getting less sleep than recommended (7 or less hours), in comparison to those who smoked flower. Sleep outcomes should be a focus of study for novel cannabis products amongst high school adolescents.
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Affiliation(s)
- Evan A. Winiger
- Department of Psychiatry, University of Colorado
Anschutz Medical Campus, Aurora
| | - Ming Ma
- Colorado School of Public Health, Department of
Community and Behavioral Health, University of Colorado Anschutz Medical Campus,
Aurora
| | - Ashley Brooks-Russell
- Colorado School of Public Health, Department of
Community and Behavioral Health, University of Colorado Anschutz Medical Campus,
Aurora
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9
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Hatoum AS, Winiger EA, Morrison CL, Johnson EC, Agrawal A. Characterisation of the genetic relationship between the domains of sleep and circadian-related behaviours with substance use phenotypes. Addict Biol 2022; 27:e13184. [PMID: 35754104 PMCID: PMC10038127 DOI: 10.1111/adb.13184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/20/2022] [Accepted: 05/07/2022] [Indexed: 12/14/2022]
Abstract
Sleep problems and substance use frequently co-occur. While substance use can result in specific sleep deficits, genetic pleiotropy could explain part of the relationship between sleep and substance use and use disorders. Here we use the largest publicly available genome-wide summary statistics of substance use behaviours (N = 79,729-632,802) and sleep/activity phenotypes to date (N = 85,502-449,734) to (1) assess the genetic overlap between substance use behaviours and both sleep and circadian-related activity measures, (2) estimate clusters from genetic correlations and (3) test processes of causality versus genetic pleiotropy. We found 31 genetic correlations between substance use and sleep/activity after Bonferroni correction. These patterns of overlap were represented by two genetic clusters: (1) tobacco use severity (age of first regular tobacco use and smoking cessation) and sleep health (sleep duration, sleep efficiency and chronotype) and (2) substance consumption/problematic use (drinks per day and cigarettes per day, cannabis use disorder, opioid use disorder and problematic alcohol use) and sleep problems (insomnia, self-reported short sleep duration, increased number of sleep episodes, increased sleep duration variability and diurnal inactivity) and measures of circadian-related activity (L5, M10 and sleep midpoint). Latent causal variable analyses determined that horizontal pleiotropy (rather than genetic causality) underlies a majority of the associations between substance use and sleep/circadian related measures, except one plausible genetically causal relationship for opioid use disorder on self-reported long sleep duration. Results show that shared genetics are likely a mechanism that is at least partly responsible for the overlap between sleep and substance use traits.
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Affiliation(s)
- Alexander S. Hatoum
- Washington University School of Medicine, Department of Psychiatry, Saint Louis, USA
| | - Evan A. Winiger
- Department of Psychiatry, University of Colorado School of Medicine, Denver, USA
| | - Claire L. Morrison
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado
| | - Emma C. Johnson
- Washington University School of Medicine, Department of Psychiatry, Saint Louis, USA
| | - Arpana Agrawal
- Washington University School of Medicine, Department of Psychiatry, Saint Louis, USA
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10
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Cousin L, Roucoux G, Petit AS, Baumann-Coblentz L, Torrente OR, Cannafarina A, Chassany O, Duracinsky M, Carrieri P. Perceived stigma, substance use and self-medication in night-shift healthcare workers: a qualitative study. BMC Health Serv Res 2022; 22:698. [PMID: 35610623 PMCID: PMC9128768 DOI: 10.1186/s12913-022-08018-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Many risk factors related to altered circadian rhythms impact the health of night-shift hospital workers (NSHW), resulting in mental and somatic disorders. Easy access to psychoactive substances (PS) may facilitate addictive behaviors in NSHW. They are also exposed to a stressful work environment, which may further affect sleep quality. This study aimed to explore the link between sleep deprivation, work-related psychosocial stress and psychoactive substance use as a self-medication response in NSHW. Methods Qualitative study to verify the plausibility of the self-medication theory applied to addictive behaviors. Semi-structured interviews (N = 18 NSHW) and thematic analysis, following consolidated criteria for reporting qualitative research recommendations. Results Stigma against NSHW was a primary element of a stressful work environment. The stressful and stigmatizing environment, together with night-shift work, further affected NSHW sleep and their mental and physical health. The use of PS appeared to be for self-medication, encouraged by social and professional environments, source(s) of stress, discrimination, and isolation. The work environment, through aggravated sleep disorders, led NSHW to use non-prescribed sleeping pills. Alcohol after work and smoking were used as a social break but also as a means to reduce stress. Conclusion Anti-stigma interventions in the healthcare setting and screening of mental/somatic disorders in NSHW can help reduce harmful self-medication behaviors and improve hospital care in the COVID-19 era. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08018-x.
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Affiliation(s)
- Lorraine Cousin
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France. .,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France. .,Groupe de Recherche en Psychologie Sociale (UR GRePS), Université Lyon 2, Bron, France.
| | - Guillaume Roucoux
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Anne Sophie Petit
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Groupe de Recherche en Psychologie Sociale (UR GRePS), Université Lyon 2, Bron, France
| | | | - Olivia Rousset Torrente
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Adriano Cannafarina
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de La Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Patient-Reported Outcomes Unit (PROQOL), UMRS 1123, Université Paris Cité, INSERM, F-75004, Paris, France.,Département de Médecine Interne Et d'immunologie Clinique, Hôpital Bicêtre, AP-HP, 94275, Kremlin Bicêtre, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale, ISSPAM, Marseille, France
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11
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Cousin L, Di Beo V, Marcellin F, Coscas S, Mahé V, Chavignaud I, Rousset Torrente O, Chassany O, Duracinsky M, Carrieri MP. Use of psychoactive substances by night-shift hospital healthcare workers during the first wave of the COVID-19 pandemic: a cross-sectional study based in Parisian public hospitals (ALADDIN). BMJ Open 2022; 12:e055699. [PMID: 35246420 PMCID: PMC8918090 DOI: 10.1136/bmjopen-2021-055699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/14/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the prevalence of psychoactive substance (PAS) use in night-shift healthcare workers (NSHW) during France's first COVID-19 wave (March-May 2020). DESIGN Observational cross-sectional online survey. SETTING 39 public hospitals in the Assitance Publique des Hôpitaux de Paris (AP-HP) network in the Parisian area. PARTICIPANTS A total of 1238 nurses, assistant nurses, X-ray technicians, managers, lab technicians, midwives and childcare assistants working at night or alternating between days and nights answered the questionnaire. INTERVENTION Online survey. OUTCOME MEASURES PAS use prevalence after weighting data for sex, age and profession using calibration on margins, in order to be representative of all AP-HP NSHW. We used the Fagerström scale and the Alcohol Use Disorders Identification Test Concise to assess PAS use. RESULTS The weighted estimated prevalences of daily smoking, alcohol drinking and tranquilliser use in participating NSHW were 21.4, 1.3 and 2.4%, respectively. Twelve per cent (11.7%) of our study sample used opioids. During the first COVID-19 wave, PAS use remained stable except for tobacco use, with 8.6% of participants reporting an increase. Previous 3-month prevalences of tranquilliser and opioid use were significantly higher than in the general population. CONCLUSION Daily smoking (especially in younger men) and tranquilliser and opioid use were highly prevalent in NSHW in the AP-HP network during France's first COVID-19 wave. Specific interventions for quitting smoking and addressing determinants of tranquilliser and opioid use in NSHW need to be developed and evaluated to improve quality of life in these essential, underdiagnosed and undertreated health personnel.
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Affiliation(s)
- Lorraine Cousin
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Vincent Di Beo
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Fabienne Marcellin
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
| | - Sarah Coscas
- Mission FIDES, AP-HP, hôpital Paul Brousse, Villejuif, Assistance Publique - Hopitaux de Paris, Paris, France
- UR psychiatrie-comorbidités-addictions (PSYCOMadd), Assistance Publique - Hopitaux de Paris, Villejuif, France
| | - Véronique Mahé
- Service de santé au travail, hôpitaux Lariboisière-Fernand Widal, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Isabelle Chavignaud
- Mission FIDES, AP-HP, hôpital Paul Brousse, Villejuif, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Olivia Rousset Torrente
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
| | - Olivier Chassany
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
| | - Martin Duracinsky
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), F-75004, Assistance Publique - Hopitaux de Paris, Paris, France
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, INSERM, F-75004, Université de Paris, Paris, France
- Département de médecine interne et d'immunologie clinique, Assistance Publique - Hopitaux de Paris, Kremlin Bicêtre, France
| | - Maria Patrizia Carrieri
- Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, Aix-Marseille Université, Marseille, France
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12
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Hicks TA, Chartier KG, Buckley TD, Reese D, Working Group TSFS, Vassileva J, Dick DM, Amstadter AB, Peterson RE, Moreno O. Divergent changes: abstinence and higher-frequency substance use increase among racial/ethnic minority young adults during the COVID-19 global pandemic. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:88-99. [PMID: 35007453 DOI: 10.1080/00952990.2021.1995401] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Identifying factors influencing substance use among racial/ethnic minorities (REM) is important given the disproportionate impact of the COVID-19 pandemic on this population. OBJECTIVES We examined factors in four domains and hypothesized that poor mental health, negative coping behaviors, negative environmental aspects, and belonging to more vulnerable social groups would be associated with increased substance use during the pandemic. METHODS Multiple regression was applied to longitudinal data from a college sample assessed prior (fall 2017 to spring 2019) and during (spring 2020) the pandemic (n= 323; 81.5% cisgender women; 34.5% African-American, 36.1% Asian-American, 15.5% Hispanic/Latinx, 11.8% multi-racial) to identify factors predicting current alcohol, cannabis, and nicotine use frequency (spring 2020) and change in frequency of use between springs 2019 and 2020. RESULTS While infrequent substance use (monthly or less) decreased during the pandemic, abstinence rates increased (alcohol 39%; cannabis 18%; nicotine 18%) and higher-frequency alcohol use increased (207%-1600% 2-3 times+/week) compared to spring 2019. The strongest protective factor was change in living situation during the pandemic, associated with lower current alcohol and cannabis use. Risk factors included a history of trouble with police and impulsivity since the pandemic, both associated with higher current and increased alcohol and cannabis use. REM did not differ on most factors and the outcomes. However, a higher percentage of Asian-Americans than other REM reported living situation changes. CONCLUSION Substance use rates diverged during the pandemic, with both increased abstinence and higher-frequency use, attributed mostly to mental health and environmental domain factors with few REM differences.
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Affiliation(s)
- Terrell A Hicks
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Karen G Chartier
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Tommy D Buckley
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
| | - Diamond Reese
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Jasmin Vassileva
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Roseann E Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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13
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Altman BR, Mian MN, Ueno LF, Earleywine M. Expectancies about the effects of cannabidiol products on anxiety symptoms. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.2006341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Brianna R. Altman
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Maha N. Mian
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Luna F. Ueno
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
| | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, Albany, New York, USA
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14
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Abstract
BACKGROUND Despite tetrahydrocannabinol (THC)'s reputation for creating dramatic effects at high doses, empirical work rarely addresses cannabis's impact on subjective responses common to the tryptamine psychedelics. We focused on these effects because they have preceded and covaried with the therapeutic impact of psilocybin in previous work. AIMS The current study examined if self-reported responses to cannabis products might parallel those found in clinical trials of psilocybin administration. We also investigated if measures of demographics and cannabis use might correlate with these responses. METHODS Participants reported the subjective effect of their highest THC experience using 27 items that assess oceanic boundlessness, a correlate of mystical experiences. They also answered infrequency items and questions on demographics and cannabis consumption. RESULTS In an effort to address concerns about replication, we divided respondents who passed infrequency items into two random samples. Self-reported "breakthrough" experiences were significantly greater than zero but significantly lower than those reported in randomized clinical trials of psilocybin (17-19% vs. 59%). Total scores covaried with perceived dosages of THC, but only in one sample. Heavier users of cannabis reported lower scores. CONCLUSIONS Self-report data suggest that high doses of cannabis can create subjective effects comparable to those identified in trials of psilocybin that precede relief from cancer-related distress, treatment-resistant depression, alcohol problems, and cigarette dependence. Given the disparate mechanisms of action, comparing THC-induced to psilocybin-induced effects might improve our understanding of the mechanisms underlying subjective experiences. This work might also support the development of a cannabis-assisted psychotherapy comparable to psilocybin-assisted psychotherapy.
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Affiliation(s)
- Mitch Earleywine
- Department of Psychology, University at Albany, SUNY, Albany, USA
| | - Luna F Ueno
- Department of Psychology, University at Albany, SUNY, Albany, USA
| | - Maha N Mian
- Department of Psychology, University at Albany, SUNY, Albany, USA
| | - Brianna R Altman
- Department of Psychology, University at Albany, SUNY, Albany, USA
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15
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Edwards D, Filbey FM. Are Sweet Dreams Made of These? Understanding the Relationship Between Sleep and Cannabis Use. Cannabis Cannabinoid Res 2021; 6:462-473. [PMID: 34143657 DOI: 10.1089/can.2020.0174] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: There is widespread literature on the interaction between cannabis use and sleep, yet the mechanisms that underlie this relationship are not well understood. Several factors lead to inconsistencies in this relationship suggesting a nuanced interaction between cannabis and sleep. An important question that remains to be addressed is the temporal relationship between disrupted sleep and cannabis use. This literature review summarizes the existing literature on the association between disrupted sleep and cannabis toward the goal of addressing the question of the chronology of these reported effects. Materials and Methods: We conducted a review of the literature using PubMed to summarize current knowledge on the association between cannabis use and sleep in humans. Results: We identified 31 studies on the association of cannabis use and sleep. The findings from these studies were mixed. Cannabis was associated with a variety of impacts on sleep ranging from beneficial effects, such as reduced sleep-onset latency, to negative outcomes, such as reduced sleep duration and suppressed rapid eye movement oscillations. The chronology of the interaction of cannabis and sleep was unclear, although much of the current literature focus on factors that modulate how cannabis impairs sleep after initial use. Conclusion: There was sufficient evidence to suggest that cannabis use alters circadian rhythms, and hence, negatively impacts sleep. The current literature is largely from studies utilizing self-report measures of sleep; thus, objective measures of sleep are needed. In addition, although there were no empirical studies on the temporal relationship between cannabis use and sleep, the majority of the literature focused on characterizing sleep impairment after cannabis use.
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Affiliation(s)
- Dalton Edwards
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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16
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Mian MN, Altman BR, Luba R, Ueno LF, Dalal D, Earleywine M. Factor analysis of a short form of the Protective Behavioral Strategies for Marijuana scale. Addict Behav 2021; 117:106852. [PMID: 33581678 DOI: 10.1016/j.addbeh.2021.106852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/13/2020] [Accepted: 01/27/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The Protective Behavioral Strategies for Marijuana Scale (PBSM), a 17-item scale targeting strategies for mitigating the negative consequences of cannabis use, highlights a range of behaviors that can reduce harm beyond straightforward decreases in quantity or frequency. The 17-item scale's factor structure remains under-examined but could reveal meaningful distinctions among strategies. This study aimed to confirm the factor structure of the short form of the PBSM. METHODS This study recruited cannabis-using undergraduates (N = 454,Mage = 19.6, 68.8% female, 39% White), who reported using cannabis approximately 2.3 days per week with mild cannabis-related consequences (CAPQ; M = 9.74). RESULTS A confirmatory factor analysis demonstrated poor fit for the one-factor model of the PBSM, prompting an exploratory factor analysis. Analyses revealed two internally reliable factors: a "Quantity" factor, strategies specific to mitigating overuse and limiting amounts consumed and an "Context" factor loosely related to troubles with others. This two-factor model accounted for over half of the total variance; invariance testing indicated reduced fit as models became more restrictive. Though each of the factors covaried negatively with both days of use and problems, Context had a stronger relation to both variables compared to Quantity. Only Context predicted fewer cannabis problems and use. CONCLUSIONS The two-factor solution suggests further work on the psychometric properties of the scale could provide heuristic information to allow for more nuanced approaches in clinical and research settings. Theoretically, each factor might have novel links to some constructs but not others in ways that could assist harm-reduction strategies and treatment.
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Affiliation(s)
- Maha N Mian
- Department of Psychology, University at Albany, State University of New York, USA.
| | - Brianna R Altman
- Department of Psychology, University at Albany, State University of New York, USA
| | - Rachel Luba
- Department of Psychology, University at Albany, State University of New York, USA
| | - Luna F Ueno
- Department of Psychology, University at Albany, State University of New York, USA
| | - Dev Dalal
- Department of Psychology, University at Albany, State University of New York, USA
| | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, USA
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17
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Mahoney CJ, Ahmed RM, Huynh W, Tu S, Rohrer JD, Bedlack RS, Hardiman O, Kiernan MC. Pathophysiology and Treatment of Non-motor Dysfunction in Amyotrophic Lateral Sclerosis. CNS Drugs 2021; 35:483-505. [PMID: 33993457 DOI: 10.1007/s40263-021-00820-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 12/21/2022]
Abstract
Amyotrophic lateral sclerosis is a progressive and fatal neurodegenerative disease typically presenting with bulbar or limb weakness. There is increasing evidence that amyotrophic lateral sclerosis is a multisystem disease with early and frequent impacts on cognition, behaviour, sleep, pain and fatigue. Dysfunction of normal physiological and metabolic processes also appears common. Evidence from pre-symptomatic studies and large epidemiological cohorts examining risk factors for the future development of amyotrophic lateral sclerosis have reported a high prevalence of changes in behaviour and mental health before the emergence of motor weakness. This suggests that changes beyond the motor system are underway at an early stage with dysfunction across brain networks regulating a variety of cognitive, behavioural and other homeostatic processes. The full impact of non-motor dysfunction continues to be established but there is now sufficient evidence that the presence of non-motor symptoms impacts overall survival in amyotrophic lateral sclerosis, and with up to 80% reporting non-motor symptoms, there is an urgent need to develop more robust therapeutic approaches. This review provides a contemporary overview of the pathobiology of non-motor dysfunction, offering readers a practical approach with regard to assessment and management. We review the current evidence for pharmacological and non-pharmacological treatment of non-motor dysfunction in amyotrophic lateral sclerosis and highlight the need to further integrate non-motor dysfunction as an important outcome measure for future clinical trial design.
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Affiliation(s)
- Colin J Mahoney
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia.
| | - Rebekah M Ahmed
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - William Huynh
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia
| | - Sicong Tu
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Richard S Bedlack
- Department of Neurology, Duke University Hospital, Durham, North Carolina, USA
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Matthew C Kiernan
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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18
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Altman BR, Mian MN, Dalal D, Ueno LF, Luba R, Slavin MN, Earleywine M. Gender-based differential item functioning in the Cannabis-Associated Problems Questionnaire: A replication and extension. Addict Behav 2021; 112:106658. [PMID: 32987304 PMCID: PMC7810355 DOI: 10.1016/j.addbeh.2020.106658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Gender bias in measures of cannabis problems may differentially affect how men and women endorse items. This gender invariance might mask, exaggerate, or otherwise obscure true distinctions in experiences of cannabis consequences. METHODS The Cannabis-Associated Problems Questionnaire (CAPQ), a measure of interpersonal deficits, occupational impairment, psychological issues, and physical side effects related to cannabis use, contained items with gender-based differential item functioning (DIF) in previous work-a finding we aim to replicate and extend (Lavender, Looby, & Earleywine, 2008). RESULTS In a sample of 4053 cannabis users, gender differences were apparent in global scores on the CAPQ. A DIF analysis revealed two gender-biased items, including one identified previously. Removal of these items did not significantly alter the scale's relation to cannabis use. Gender differences on the CAPQ persisted after removal of the two problematic items, indicating true gender differences still exist in men and women's experiences of cannabis-related consequences. Gender appeared to significantly contribute to scores on the full CAPQ and the short-form of the CAPQ with biased item removed, even after controlling for indices of cannabis use. CONCLUSIONS These findings suggest that the CAPQ evidences less gender bias than previously thought, perhaps due to diminishing gender-based stereotypes. Future work might opt to use the short form of the CAPQ to minimize gender-based DIF. In addition, potential biases in measures of substance use problems deserve more attention.
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Affiliation(s)
- Brianna R Altman
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Maha N Mian
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Dev Dalal
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Luna F Ueno
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Rachel Luba
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | | | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
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19
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Earleywine M, Denson TF, Altman BR. Replicating the Dimensional Structure of Cannabis Problems: A Taxometric Analysis. Subst Use Misuse 2021; 56:81-86. [PMID: 33143496 DOI: 10.1080/10826084.2020.1840589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study employed taxometric procedures to replicate a previous report of the dimensional structure of problems related to cannabis consumption. Method: Over 4,000 cannabis users completed an assessment of psychological, social, occupational, and physical harms (the Marijuana Problems Scale). Three taxometric procedures (MAMBAC, MAXEIG, and L-Mode) compared the current data to simulations with a base rate of problematic cannabis use derived from representative, large-scale data estimates. Results: All three procedures confirmed the continuous, dimensional nature of these cannabis problems and suggested no underlying taxon or category. Conclusions: Psychopathological disorders, including some substance use problems, have fit categorical models suggesting that they differ in kind (rather than intensity) from the behavior of the rest of the population. Cannabis problems, however, appeared to lie along a continuum with other forms of use. Given heightened awareness for the necessity of replication and a changing legal landscape for cannabis, a second look at the dimensionality of these problems seemed warranted. New data with a larger sample and different indices of problematic use confirmed the dimensionality of cannabis problems. This replication can inform predictions about the etiology, prevention, and treatment of cannabis use disorder. Researchers should expect cannabis problems to range along a continuum without categorical distinctions. Dividing users into groups of problematic and non-problematic users likely sacrifices meaningful variance. Harm reduction strategies likely can benefit all users rather than a targeted taxon with troubles. In addition, interventions will likely progress by small, incremental steps rather than dramatic, categorical jumps in progress.
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Affiliation(s)
- Mitch Earleywine
- Department of Psychology, University at Albany, Albany, New York, USA
| | - Thomas F Denson
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Brianna R Altman
- Department of Psychology, University at Albany, Albany, New York, USA
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20
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Winiger EA, Hitchcock LN, Bryan AD, Cinnamon Bidwell L. Cannabis use and sleep: Expectations, outcomes, and the role of age. Addict Behav 2021; 112:106642. [PMID: 32949837 PMCID: PMC7572650 DOI: 10.1016/j.addbeh.2020.106642] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVES Determine relationship between cannabis use with 1) expectations of cannabis being a sleep aid, 2) subjective sleep outcomes, and 3) the influence of age on these relationships. METHODS In 152 moderate cannabis users with a wide age range (67% female, mean age = 31.45, SD = 12.96, age range = 21-70; mean days of cannabis use in prior two weeks = 5.54, SD = 5.25) we examined the influence of cannabis use history and behaviors on expectations of cannabis being a sleep aid and sleep outcomes via the Pittsburgh Sleep Quality Index (PSQI). Moderation analysis examined the role of age in the relationship between cannabis use and sleep outcomes. RESULTS Endorsing current cannabis use and more days of cannabis use were associated with increased expectations that cannabis use improves sleep (all β > 0.03, p < 0.04). Frequency of recent use and reported average THC or CBD concentration were largely not associated with sleep outcomes. However, endorsing current cannabis use was associated with worse subjective sleep quality (β = 1.34, p = 0.02) and increased frequency of consuming edibles was associated with worse subjective sleep efficiency (β = 0.03, p = 0.04), lower sleep duration (β = 0.03, p = 0.01), and higher global PSQI scores (worse overall sleep) (β = 0.10, p = 0.01). Additionally, age had a moderating influence on the relationship between increased self-reported concentration of CBD and both better sleep duration and sleep quality (both p < 0.03). While the main effects of cannabis use on sleep outcomes did not survive multiple comparisons correction test (all p adj > 0.34), the adjusted p values for the main effects of cannabis behaviors/history on expectations of cannabis as a sleep aid (p adj = 0.07-0.09) and the main effects of CBD concentration on sleep duration (p adj = 0.08), as well as the interaction terms of CBD and age for that model (p adj = 0.07), were trending. CONCLUSION Cannabis users have increased expectations of cannabis being a sleep aid, but few associations existed between cannabis use and sleep outcomes. The two exceptions were endorsing any cannabis use and frequency of edible use. Additionally, age may be an important moderator of the potential positive influence CBD concentration can have on sleep.
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Affiliation(s)
- Evan A Winiger
- Institute for Behavioral Genetics, University of Colorado, Boulder. East Campus, 1480 30(th) Street, Boulder, CO 80309, United States; Department of Psychology and Neuroscience, University of Colorado, Boulder, Muenzinger Psychology Building, 1905 Colorado Ave, Boulder, CO 80309, United States.
| | - Leah N Hitchcock
- Institute of Cognitive Science, University of Colorado, Boulder.Center for Innovation and Creativity, 1777 E Exposition Drive, Boulder, CO 80301, United States
| | - Angela D Bryan
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Muenzinger Psychology Building, 1905 Colorado Ave, Boulder, CO 80309, United States; Institute of Cognitive Science, University of Colorado, Boulder.Center for Innovation and Creativity, 1777 E Exposition Drive, Boulder, CO 80301, United States
| | - L Cinnamon Bidwell
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Muenzinger Psychology Building, 1905 Colorado Ave, Boulder, CO 80309, United States; Institute of Cognitive Science, University of Colorado, Boulder.Center for Innovation and Creativity, 1777 E Exposition Drive, Boulder, CO 80301, United States
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21
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Altman BR, Mian MN, Ueno LF, Earleywine M. Examining and validating the factor structure of the cannabis-associated problems questionnaire. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1821807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Brianna R. Altman
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Maha N. Mian
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Luna F. Ueno
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Mitch Earleywine
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
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22
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Goodhines PA, LaRowe LR, Gellis LA, Ditre JW, Park A. Sleep-Related Cannabis Expectancy Questionnaire (SR-CEQ): Initial Development among College Students. J Psychoactive Drugs 2020; 52:401-411. [PMID: 32772641 DOI: 10.1080/02791072.2020.1800151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A growing body of literature demonstrates that cannabis is commonly used to aid sleep. Consistent with social cognitive theory, there is a vast literature documenting the role of outcome expectancies in the initiation, progression, and maintenance of cannabis use. Despite the readily endorsed belief that cannabis will help improve sleep, sleep-related expectancies have not been included in widely used cannabis expectancy measures. This study aimed to develop and provide preliminary psychometric evaluation of the Sleep-Related Cannabis Expectancy Questionnaire (SR-CEQ). Cross-sectional data were drawn from N= 166 college students (M age = 18.83 [SD = 1.06; range: 18-24], 34% male, 71% White). Students completed an online survey including demographics and the 12-item SR-CEQ. Exploratory Factor Analysis identified two factors representing Negative Sleep-Related Cannabis Expectancies and Positive Sleep-Related Cannabis Expectancies. Confirmatory Factor Analysis demonstrated adequate fit of the two-factor measurement model to observed data (SRMR = 0.08). Students endorsed greater positive (versus negative) sleep-related cannabis expectancies on average, and male students reported significantly greater negative expectancies (but not positive expectancies) compared to female students. The SR-CEQ is the first cannabis expectancy assessment tool specific to sleep-related cannabis outcomes. Ongoing psychometric validation of the SR-CEQ is needed to assess convergent/predictive validity and replicate findings among relevant clinical samples.
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Affiliation(s)
| | - Lisa R LaRowe
- Department of Psychology, Syracuse University , Syracuse, NY, USA
| | - Les A Gellis
- Department of Psychology, Syracuse University , Syracuse, NY, USA
| | - Joseph W Ditre
- Department of Psychology, Syracuse University , Syracuse, NY, USA
| | - Aesoon Park
- Department of Psychology, Syracuse University , Syracuse, NY, USA
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