The Role of Safety Behaviors in the Relationship between Social Anxiety and Marijuana Use Problems

The Influence of Anxiety and Avoidant Coping on Probable Cannabis Use Disorder

Objective

Individuals with anxiety frequently use cannabis to cope and are at greater risk for developing probable cannabis use disorder (CUD). Previous literature suggests avoidant coping styles are associated with higher anxiety levels and risk for problematic cannabis use, while action-oriented coping is associated with lower anxiety and problematic cannabis use. No studies have examined whether anxiety and action-oriented coping or avoidant coping interact to influence risk for CUD, which was the aim of the present study.

Method

College students were recruited as part of a cross-sectional study on cannabis use. Participants (N = 371; 72.2% female) completed the Depression Anxiety and Stress Subscale (DASS-21), Cannabis Use Disorder Identification Test-Revised (CUDIT-R), and the Brief-COPE (B-COPE).

Results

The data were analyzed using logistic moderation analysis. After controlling for gender, anxiety was a positive significant predictor of probable CUD, but action-oriented coping and avoidant coping were not. The interaction between anxiety and avoidant coping on probable CUD was significant, indicating that participants with high avoidant coping (regardless of high or low anxiety) and those with high anxiety (even with low avoidant coping) were more likely to have probable CUD than those with both low anxiety and low avoidant coping. No significant interaction was observed with action-oriented coping.

Conclusions

Results suggest that avoidant coping, but not action-oriented coping, influences the relationship between anxiety and risk for probable CUD. Findings emphasize the importance of targeting both anxiety and avoidant coping when considering risk for probable CUD.

Prevalence and correlates of cannabis use among individuals with DSM-5 social anxiety disorder: Findings from a nationally representative sample

Cannabis use disorder (CUD) and frequency of use are highly related to social anxiety disorder (SAD). With updates to diagnostic criteria of psychiatric disorders and recent changes in cannabis laws, the present study sought to explore the relationships between cannabis use, CUD, and social anxiety in a large nationally representative sample of individuals with lifetime (N = 1255) and past-year SAD (N = 980). Notably, we found that at the symptom level, at least weekly cannabis use was significantly related to fear or avoidance of social situations interfering with relationships in both samples. Weekly + cannabis use and CUD were significantly associated with lifetime SAD symptom severity, but only weekly + cannabis use was related to SAD severity in the past-year sample. We also found that weekly + cannabis use but not CUD was related to greater odds of seeking treatment for SAD and suicide attempt history. Overall, these data provide an updated examination of cannabis use and SAD using DSM-5 criteria and a large nationally representative sample and also highlight the importance of weekly + cannabis use as a marker of severity and suicide risk in individuals with SAD.

A Scoping Review of Risk and Protective Factors for Negative Cannabis Use Consequences

Objective

Numerous reviews have examined risk and protective factors for alcohol-related negative consequences, but no equivalent review of risk and protective factors exists for cannabis-related negative consequences (CRNCs)-a gap filled by the present study. This scoping review examined survey-based research of risk and protective factors for CRNCs such as neglecting responsibilities, blacking out, or needing more cannabis.

Methods

Three databases (PubMed, PsycINFO, and Google Scholar) were searched for peer-reviewed manuscripts published between January 1, 1990, and December 31, 2021. A qualitative synthesis was performed using the matrix method and the results were organized using the socioecological model as a framework.

Results

Eighty-three studies were included in the review. There was considerable variation in measures and operationalizations of CRNCs across studies. Risk factors were identified in the intrapersonal (depression, social anxiety, PTSD, impulsivity, sensation seeking, motives, expectancies), interpersonal/community (trauma, victimization, family and peer substance use, social norms), and social/policy (education, employment, community attachment, legalization, availability of substances) domains of influence. Protective behavioral strategies were a robust protective factor for CRNCs. Males consistently reported more CRNCs than females, but there were no differences observed across race.

Conclusions

Future research should identify person- and product-specific patterns of CRNCs to refine theoretical models of cannabis misuse and addiction. Public health interventions to reduce the risk of negative consequences from cannabis should consider utilizing multilevel interventions to attenuate the cumulative risk from a combination of psychological, contextual, and social influences.

Anxiety as a Moderator of the Relationship Between Deviant Peer Association and Substance Use: Does the Specific Dimension of Anxiety Matter?

Deviant peer association has been identified as a risk factor for substance use. Anxiety has been examined as a moderator of this relationship in a limited capacity. Despite this, investigations of specific dimensions of anxiety as moderators of this relationship remain understudied. This study examined three dimensions of anxiety as moderators: physiological anxiety, worry/oversensitivity anxiety, and social concerns/concentration anxiety. The Pathways to Desistance data were used in analyses. Ordered logistic regression models were used to assess relationships of interest for three substance use outcomes: heavy episodic drinking, marijuana use, and cigarette use. Findings indicated that social concerns/concentration anxiety moderated the relationship between deviant peer association and marijuana use, but, contrary to predictions, a protective effect at higher levels of this form of anxiety was observed. Worry/oversensitivity anxiety also appeared to exert a significant and negative direct effect on all three substance use outcomes. Implications are discussed.