Targeting Perceived Risk Through an Online Personalized Feedback Intervention for Cannabis-Using College Students

Although online personalized feedback interventions (PFIs) that include personalized normative feedback (PNF) have been found to reduce drinking in college populations (for review, see Miller et al., 2013), there is little evidence to support that similar PFIs reduce risky cannabis use in college students (e.g., Elliott, Carey, & Vanable, 2014). The present study sought to examine perceived risk, a leading indicator of cannabis use (Bachman, Johnston, & O\u27Malley, 1998), as a potential intervention target for online cannabis PFIs. Undergraduate students who reported current (past-month) cannabis use and experiencing at least one past three-month cannabis use-related problem were randomly assigned to receive a feedback control condition (n = 102) or PFI (n = 102). Condition was not related follow-up perceived risk or to any follow-up outcomes (i.e., use frequency, use-related problems, problem-related distress). Follow-up perceived risk or norms did not mediate the relationship between condition and outcomes. Gender moderated the relationship between condition and follow-up problems, such that males in the PFI condition reported greater problems than males in the feedback control condition and females in the PFI condition reported fewer problems than females in the feedback control condition. Baseline problem distress moderated the relationship between condition and follow-up problems, such that those with high distress in the PFI condition reported fewer problems at follow-up than in the feedback control condition. Results suggest that perceived risk of cannabis may not be readily modified via a one-session online intervention. Cannabis PFIs may be efficacious for reducing cannabis use-related problems among females (but not males) and those with high problem distress. Novel PFI components must be considered to increase the efficacy of brief, online interventions for cannabis-using college students, especially among male cannabis users

The daily association between affect and alcohol use: a meta-analysis of individual participant data

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.The present study was funded by the Canadian Institutes of Health Research Grant MOP-115104 (Roisin M. O’Connor), Canadian Institutes of Health Research Grant MSH-122803 (Roisin M. O’Connor), John A. Hartford Foundation Grant (Paul Sacco), Loyola University Chicago Research Support Grant (Tracy De Hart), National Institute for Occupational Safety and Health Grant T03OH008435 (Cynthia Mohr), National Institutes of Health (NIH) Grant F31AA023447 (Ryan W. Carpenter), NIH Grant R01AA025936 (Kasey G. Creswell), NIH Grant R01AA025969 (Catharine E. Fairbairn), NIH Grant R21AA024156 (Anne M. Fairlie), NIH Grant F31AA024372 (Fallon Goodman), NIH Grant R01DA047247 (Kevin M. King), NIH Grant K01AA026854 (Ashley N. Linden-Carmichael), NIH Grant K01AA022938 (Jennifer E. Merrill), NIH Grant K23AA024808 (Hayley Treloar Padovano), NIH Grant P60AA11998 (Timothy Trull), NIH Grant MH69472 (Timothy Trull), NIH Grant K01DA035153 (Nisha Gottfredson), NIH Grant P50DA039838 (Ashley N. Linden-Carmichael), NIH Grant K01DA047417 (David M. Lydon-Staley), NIH Grant T32DA037183 (M. Kushner), NIH Grant R21DA038163 (A. Moore), NIH Grant K12DA000167 (M. Potenza, Stephanie S. O’Malley), NIH Grant R01AA025451 (Bruce Bartholow, Thomas M. Piasecki), NIH Grant P50AA03510 (V. Hesselbrock), NIH Grant K01AA13938 (Kristina M. Jackson), NIH Grant K02AA028832 (Kevin M. King), NIH Grant T32AA007455 (M. Larimer), NIH Grant R01AA025037 (Christine M. Lee, M. Patrick), NIH Grant R01AA025611 (Melissa Lewis), NIH Grant R01AA007850 (Robert Miranda), NIH Grant R21AA017273 (Robert Miranda), NIH Grant R03AA014598 (Cynthia Mohr), NIH Grant R29AA09917 (Cynthia Mohr), NIH Grant T32AA07290 (Cynthia Mohr), NIH Grant P01AA019072 (P. Monti), NIH Grant R01AA015553 (J. Morgenstern), NIH Grant R01AA020077 (J. Morgenstern), NIH Grant R21AA017135 (J. Morgenstern), NIH Grant R01AA016621 (Stephanie S. O’Malley), NIH Grant K99AA029459 (Marilyn Piccirillo), NIH Grant F31AA022227 (Nichole Scaglione), NIH Grant R21AA018336 (Katie Witkiewitz), Portuguese State Budget Foundation for Science and Technology Grant UIDB/PSI/01662/2020 (Teresa Freire), University of Washington Population Health COVID-19 Rapid Response Grant (J. Kanter, Adam M. Kuczynski), U.S. Department of Defense Grant W81XWH-13-2-0020 (Cynthia Mohr), SANPSY Laboratory Core Support Grant CNRS USR 3413 (Marc Auriacombe), Social Sciences and Humanities Research Council of Canada Grant (N. Galambos), and Social Sciences and Humanities Research Council of Canada Grant (Andrea L. Howard)

Development and Initial Psychometric Properties of the Cannabidiol Outcome Expectancies Questionnaire (CBD-OEQ)

In the United States, a growing number of adults are using products containing cannabidiol (CBD), a non-psychoactive cannabinoid marketed as a treatment for a large number of medical and mental health conditions, despite limited support for the efficacy of CBD for these conditions. Identification of CBD-related outcome expectancies (i.e., beliefs concerning the anticipated effects of using CBD) could be useful in understanding the etiology and maintenance of CBD use. Although there are several measures of cannabis outcome expectancies, no known CBD-specific outcome expectancy measure exists. The current study used a three phase, mixed methods approach to develop and test the initial psychometric properties of the Cannabidiol Outcome Expectancy Questionnaire (CBD-OEQ). In Phase I, an initial item pool was generated via individual interviews. In Phase II, the initial item pool was expanded via literature search and evaluated by a review panel. In Phase III, the final pool of 133 items was administered to a sample of 600 adults who endorsed having heard of or used CBD products. The CBD-OEQ assessed both probability ratings (i.e., likelihood of an expectancy occurring) and desirability ratings (i.e., how desirable an expectancy is). Phase III factor analyses supported a 60-item, six-factor structure (i.e., positive mood, global negative effects, pain relief, sleep, harm reduction, and no effect). Tests of the psychometric properties provide initial support for internal consistency and convergent, discriminant, and incremental validity of the CBD-OEQ subscales. Desirability ratings explained minimal additional variance in CBD variables for most subscales but moderated the relationship between probability ratings and CBD variables for the Global Negative Effects and No Effect subscales. The newly developed CBD-OEQ could help identify current non-users who are at risk for initiating CBD use and current users who are at risk for engaging in frequent or heavy CBD use

Online personalized feedback intervention for cannabis-using college students reduces cannabis-related problems among women

There is growing evidence that college cannabis use is associated with use-related problems, yet efforts to reduce cannabis-related problems via online personalized feedback interventions (PFIs) have had limited success in significantly reducing risky cannabis use among college students. However, men and women may respond differently to such interventions and failure to examine effects of gender may obfuscate intervention effects. Thus, the current study tested intervention effects (moderated by gender) of an online, university-specific PFI for high-risk cannabis users (i.e., past-month cannabis users with at least one recent cannabis-related problem) who were randomly assigned to an online PFI (n = 102) or an online personalized normative feedback-only condition (PNF-only; n = 102). Gender moderated the relationship between condition and one-month follow-up problems, such that women in the PFI condition reported fewer cannabis-related problems at follow-up than women in the PNF-only condition. Men in the PFI condition did not significantly differ from men in the PNF-only condition on use-related problems at follow-up. Cannabis PFIs may be efficacious for reducing cannabis use-related problems among undergraduate women (but not men) and women may benefit from online interventions that include problem-focused components

Sexual minority women and Cannabis use: The serial impact of PTSD symptom severity and coping motives

Sexual minority women (SMW) report greater rates of cannabis use. Posttraumatic stress disorder (PTSD) symptom severity is related to greater cannabis use among SMW, and it is theorized that this is due to SMW using cannabis in an attempt to manage negative affectivity associated with PTSD symptoms. However, this is the first known study to test this hypothesis. Among undergraduate women who endorsed lifetime cannabis use (N = 439, 10.5% self-identified SMW), SMW reported greater rates of cannabis use, more frequent cannabis use, greater coping-motivated use, and greater PTSD symptom severity than heterosexual women. Serial mediation analyses revealed that SMW reported more frequent cannabis use via the serial effect of PTSD symptom severity and coping-motivated cannabis use. Given the high rates of trauma exposure and cannabis use among SMW, findings suggest that SMW could benefit from exposure-based interventions in addition to cognitive behavioral skills that would teach them more adaptive strategies to manage negative affect associated with trauma exposure and PTSD symptoms

Cannabis-Related Impairment and Social Anxiety: The Role of Use to Manage Negative and Positive Affect in Social Situations

: Individuals with elevated social anxiety are thought to be at high risk for developing cannabis-related problems because they use cannabis to cope with anxiety-provoking social situations. Social anxiety is unique among the anxiety conditions in that it is characterized by both elevated negative affect (NA) and lower positive affect (PA). Yet it is unclear whether persons with elevated social anxiety use cannabis to decrease their NA or to increase their PA. : This study examined the role of PA and NA (including cannabis use to increase PA and to decrease NA in social situations) on cannabis use frequency and related problems among current (past three-month) cannabis users ( = 278). : Social anxiety was significantly correlated with NA, PA, cannabis use to decrease NA, and use to increase PA. Serial mediation analyses tested the paths between social anxiety, affect, use to manage affect, typical cannabis use frequency, and cannabis use-related problems. Contrary to prediction, social anxiety was not indirectly related to use frequency or related problems via NA or PA generally. Rather, social anxiety was indirectly related to cannabis problems via the serial effect of use to cope with NA and typical use frequency and via the serial effect of use to increase PA and typical use frequency. : Social anxiety may be associated with using cannabis to decrease NA and increase PA specifically in social situations, which increases cannabis use frequency and thus, problem risk