Sex Moderates Associations Between Dimensions of Emotion Dysregulation and Problematic Cannabis Use

Emotion Regulation Moderates Associations between Discrimination and Cannabis Use Patterns among Sexual Minority Young Adult Women

Background

Sexual minority young adults (SMYAs) experience discrimination and have high cannabis use prevalence. Discrimination may be associated with cannabis use, including hazardous use and co-use with tobacco, depending on emotion regulation and gender.

Methods

Fall 2020 survey data assessed discrimination, use frequency of emotion regulation strategies (i.e., cognitive reappraisal, expressive suppression), current cannabis use, hazardous use, and cannabis-tobacco dual use among SMYAs (age 18-34) in 6 United States metropolitan areas (women: n=450, M age =24.1, SD=4.7, 69.6% bisexual, 18.2% lesbian/gay, 12.2% other; men: n=254, M age=24.7, SD=4.5, 33.5% bisexual, 54.3% gay, 12.2% other). Multivariable logistic regression examined the moderating roles of cognitive reappraisal and expressive suppression on associations of discrimination with cannabis use outcomes, stratified by gender and adjusted for age, race and ethnicity, and employment.

Results

Among SMYA women, 89.5% experienced any discrimination; 53.1% reported current cannabis use, of whom 49.4% and 47.7% reported hazardous use and cannabis-tobacco dual use, respectively. Adjusting for sociodemographics, experiencing greater discrimination was associated with greater odds of hazardous cannabis use (aOR=1.08, 95% CI [1.02, 1.15]) and cannabis-tobacco dual use (aOR=1.04, 95% CI [1.01, 1.08]) among SMYA women with greater use of expressive suppression. Among SMYA men, 83.9% experienced any discrimination; 49.2% reported current cannabis use, of whom 55.2% and 44.0% reported hazardous use and cannabis-tobacco dual use. Discrimination and emotion regulation were unrelated to cannabis use outcomes among men. Conclusions: Given high rates of discrimination experiences among SMYAs, emotion regulation skills training may empower SMYAs, particularly women, to cope with discrimination without using cannabis.

Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18-64 years

INTRODUCTION

Individuals with chronic pain often receive prescription opioid medication, and they may use cannabis to treat pain as well, although the risks of cannabis-opioid co-use are significant. This study aimed to investigate whether two transdiagnostic factors, emotion regulation and distress tolerance, had significant indirect effects in the relationship between pain and cannabis use in adults with chronic pain and an opioid prescription.

METHODS

Participants (n = 450; mean age = 38.6 ± 11.09) were recruited using Qualtrics panel service and were 75 % female and 79 % White, non-Hispanic. Participants completed a 30-minute self-report survey capturing three-month cannabis use, the Difficulties in Emotional Regulation Scale (DERS), and the Distress Tolerance Scale (DTS). The Graded Pain Scale (GCPS) assessed pain severity/intensity and disability. Analyses used the SPSS PROCESS macro, with both single (i.e., one transdiagnostic factor) and parallel indirect effects (i.e., both the DERS and DTS) examined.

RESULTS

There were statistically significant indirect effects for both the DERS and DTS in the relationship between pain intensity or disability and three-month cannabis use in single factor models. In the parallel indirect effect model, only the DERS was statistically significant (intensity indirect effect coefficient = 0.0195 % confidence interval [95 %CI] = 0.0065, 0.390; disability indirect effect coefficient = 0.0147, 95 %CI = 0.0055, 0.0274).

CONCLUSIONS

When examining parallel indirect effects, only emotional regulation and not distress tolerance mediated the relationship between chronic pain and cannabis use among those with an opioid prescription. Clinically, interventions aimed at improving emotional regulation in individuals with chronic pain can help limit cannabis and opioid co-use.