Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories?

Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = .36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = .19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.

Do we really need two sessions?: The use of a structured interview as a trauma cue reactivity paradigm

OBJECTIVES

Derived from classical conditioning theory and rooted in motivational mechanisms, cue reactivity paradigms (CRPs) are used in addictions research to measure participants' propensities for substance-relevant responses (e.g., craving) during exposure to substance-relevant cues (e.g., drug paraphernalia). CRPs are also useful in PTSD-addiction comorbidity research, allowing the study of affective and substance-relevant responses to trauma cues. However, studies using traditional CRPs are time-consuming with high attrition rates due to repeat testing. Thus, we sought to test whether a single session semi-structured trauma interview could serve as a CRP in terms of eliciting theorized cue exposure effects on craving and affect measures.

METHOD

Fifty regular cannabis users with trauma histories provided detailed descriptions of their most traumatic lifetime experience, and a neutral experience, according to an established interview protocol. Linear mixed models examined the effect of cue type (trauma vs. neutral) on affective and craving responses.

RESULTS

As hypothesized, the trauma interview elicited significantly greater cannabis craving (and alcohol craving among the drinkers), and, greater negative affect among those with more severe PTSD symptoms, compared to the neutral interview.

CONCLUSION

Results suggest an established semi-structured interview may function effectively as a CRP for use in trauma and addictions research.

Changes in Youth Mental Health, Psychological Wellbeing, and Substance Use During the COVID-19 Pandemic: A Rapid Review

Since the onset of the COVID-19 pandemic, researchers around the world have made efforts to assess its impact on youth mental health; however, the breadth of this topic has impeded a clear assessment of pandemic outcomes. This study aimed to address this gap by reviewing changes in youth (age ≤ 25) mental health, psychological wellbeing, substance use, and the use or delivery of relevant services during the pandemic. PubMed and Embase were searched in May 2021 to conduct a rapid review of the literature. The results encompass 156 primary publications and are reported using a narrative synthesis. Studies of mental health (n = 122) and psychological wellbeing (n = 28) generally indicated poor outcomes in many settings. Publications regarding substance use (n = 41) noted overall declines or unchanged patterns. Studies of service delivery (n = 12) indicated a generally positive reception for helplines and telehealth, although some youth experienced difficulties accessing services. The findings indicate negative impacts of the pandemic on youth mental health, with mixed results for substance use. Services must support marginalized youth who lack access to telehealth.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40894-022-00185-6.

Sex differences in maladaptive emotional and behavioral responses to COVID-19: What is the role of personality?

Males are more non-adherent to public health measures for containing COVID-19 while females experience more COVID-19-related distress. Personality traits may influence both non-adherence and distress. We examined sensation seeking (SS), anxiety sensitivity (AS), impulsivity, and hopelessness as traits potentially associated with non-adherence and distress in response to COVID-19. Furthermore, we sought to understand if known sex differences in SS (male > female) and AS (female > male) may explain sex differences on these two COVID-19 outcomes. In the first month of the pandemic, 400 adults (mean age = 32.16 years; 45.3%F) completed the Substance Use Risk Profile Scale to assess personality. Degree of adherence to public health recommendations and COVID-19-related distress were also measured. Male sex was indirectly related to poorer adherence to stay-at-home advisories via SS, and female sex was indirectly related to higher COVID-19 distress via AS. Personality-targeted interventions may help reduce non-adherence and COVID-19 distress, potentially reducing sex differences.