Prospective associations of behavioral economic demand for cannabis and alcohol with simultaneous cannabis and alcohol use among young adults.

Behavioral economic demand for cannabis and alcohol is robustly associated with cannabis use and alcohol use, respectively. However, few studies have examined the contributions of cannabis and alcohol demand to simultaneous cannabis and alcohol use, which is common among young adults. We examined prospective associations of cannabis demand and alcohol demand with propensity for simultaneous use (broadly defined as using both cannabis and alcohol in the same day) and with cannabis and alcohol consumption during simultaneous use days among young adults. Young adults reporting simultaneous use (N = 107) completed a Marijuana Purchase Task assessing cannabis demand and an Alcohol Purchase Task assessing alcohol demand. They then completed daily smartphone surveys over 21 days assessing cannabis and alcohol use. Multilevel models revealed that higher cannabis demand (i.e., higher Omax, Pmax, and intensity; lower elasticity) was uniquely associated with greater propensity for simultaneous use relative to nonuse. In addition, higher alcohol demand (lower elasticity) was uniquely associated with greater propensity for simultaneous use relative to cannabis-only use, and higher cannabis demand (higher break point and intensity, lower elasticity) was uniquely associated with greater propensity for simultaneous use relative to alcohol-only use. Furthermore, in models limited to simultaneous use days, greater cannabis demand (higher Omax, lower elasticity) and lower alcohol demand (higher elasticity) were uniquely associated with greater overall cannabis flower consumption, and higher alcohol demand (higher Omax, lower elasticity) was uniquely associated with greater overall alcohol consumption. Results suggest that individual differences in cannabis and alcohol demand may contribute to simultaneous cannabis and alcohol use behaviors in a substance-specific pattern. Furthermore, cannabis demand may more strongly drive the tendency to engage in simultaneous use (vs. nonuse) relative to alcohol demand. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychometric Validation of the Gambling Craving Scale in a Treatment-Seeking Sample.

The Gambling Craving Scale (GACS) is a multifaceted measure of gambling craving. Initial validation work by Young and Wohl (2009) in university student samples showed that the GACS had a three-factor structure capturing dimensions of Desire, Anticipation, and Relief. Despite its potential clinical utility as a measure of craving, the GACS has yet to be validated in people seeking treatment for gambling problems. Accordingly, we examined the psychometric properties in a sample of people (N = 209; Mage = 37.66; 62.2% female) participating in a randomized controlled trial testing a novel online treatment for problem gambling. We predicted the GACS would have a three-factor structure. In addition, we also examined measurement invariance across sex and problem gambling risk status. Finally, we assessed concurrent validity of the factors with other measures of problem gambling severity and involvement. Exploratory structural equation modeling findings supported a three-factor structure that was invariant across the groups tested. Each of the Desire, Anticipation, and Relief subscales were significant positive predictors of problem gambling severity and symptoms, and some form of gambling behaviour. Findings show the GACS is a promising scale to assess multidimensional craving experiences among people in treatment for gambling problems.

Interactive effects of alcohol and cannabis quantities in the prediction of same-day negative consequences among young adults.

BACKGROUND: Simultaneous alcohol and cannabis use is common, but observational studies examining negative consequences of simultaneous use have rarely considered dose-related interactions between alcohol and cannabis. This study examined interactions between quantities of cannabis and alcohol consumed in predicting negative consequences on simultaneous use days. METHODS: Young adults (N = 151; 64% female; 62% White) reporting recent simultaneous use and at least weekly alcohol and cannabis use completed 21 daily, smartphone-based surveys assessing previous day quantities of cannabis and alcohol used, types of cannabis used (flower, concentrates, edibles), and negative substance-related consequences. Multilevel models examined: (1) whether negative consequences differed within-person across simultaneous use days and single-substance use days; and (2) whether quantities of alcohol and cannabis consumed on simultaneous use days interacted, within-person, to predict negative consequences. We focused on quantities of cannabis flower (grams) in primary analyses and explored quantities of other forms of cannabis (concentrates, edibles) in supplementary analyses. RESULTS: Participants reported fewer negative consequences on alcohol-only (243 observations) and cannabis-only (713 observations) days than they did on simultaneous use days (429 observations). On simultaneous use days involving cannabis flower use (313 observations across 81 participants), the within-person association between number of standard drinks and negative consequences was weaker on days during which larger (vs. smaller) amounts of cannabis flower were consumed. Inspection of simple slopes revealed that decreased alcohol use was associated with less of a decline in negative consequences when combined with relatively greater amounts of cannabis flower. CONCLUSIONS: Although simultaneous use was associated with more negative consequences than alcohol-only and cannabis-only use, negative consequences on simultaneous use days varied as a function of the interaction between alcohol and cannabis quantities. As findings suggest that using larger amounts of cannabis may attenuate declines in negative consequences associated with lighter drinking, interventions for higher-risk simultaneous use patterns may benefit from a focus on quantities of both alcohol and cannabis.

How much THC is in that joint? A daily diary study of young adults' knowledge of the cannabinoid content of cannabis products.

OBJECTIVE: Many young adults report frequent cannabis use and are at risk for cannabis harms. Knowledge of the tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations of cannabis products may promote harm reduction, but few studies have characterized cannabinoid concentration knowledge in this population. This study used day-level data to examine predictors of cannabinoid concentration knowledge and associations of cannabinoid concentration knowledge with substance-related consequences among young adults. METHOD: Participants (N=131; mean age 22.11 years, 64.12% female) from a larger study of cannabis and alcohol co-use completed daily surveys over 21 days assessing knowledge of the cannabinoid concentrations of cannabis used, forms of cannabis used, motives for cannabis use (medicinal, nonmedicinal, both), and substance-related consequences. RESULTS: On average, participants reported at least some knowledge of the THC and CBD concentrations of their cannabis on a respective 48% and 32% of their cannabis days. Generalized linear mixed models revealed that participants with a greater propensity to use non-flower (relative to flower) cannabis products and to report medicinal (relative to exclusively non-medicinal) motives for cannabis use reported greater cannabinoid concentration knowledge overall across days, controlling for sociodemographic factors and level of cannabis involvement. Participants with greater overall cannabinoid concentration knowledge reported positive substance-related consequences more often. In addition, participants were more likely to report negative substance-related consequences on days during which cannabinoid concentrations were known versus unknown. CONCLUSIONS: Findings suggest that cannabinoid concentration knowledge may be higher among young adults who report primarily non-flower and medicinally-motivated cannabis use, although cannabinoid concentration knowledge, alone, may not protect against negative substance-related consequences at the day level.

Knowledge of Cannabinoid Content Among People Living with HIV Who Use Cannabis: a Daily Diary Study.

BACKGROUND: Many people living with HIV (PLWH) use cannabis for medicinal reasons. Patients' knowledge of the tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations of the cannabis products they use may be important in helping patients achieve symptom relief while guarding against potential risks of cannabis use. However, no studies have examined cannabinoid concentration knowledge among PLWH. METHOD: PLWH (N = 29; 76% men, mean age 47 years) reporting cannabis use for both medicinal and nonmedicinal reasons completed daily surveys over 14 days assessing cannabis products used, knowledge of cannabinoid concentrations of cannabis products used, cannabis use motives (medicinal, nonmedicinal, both), and positive and negative cannabis-related consequences. Across the 361 cannabis use days captured on the daily surveys, at least some knowledge of cannabinoid concentrations was reported on an average of 43.1% (for THC) and 26.6% (for CBD) of the days. RESULTS: Generalized linear mixed models revealed that participants were more likely to report knowing THC and CBD concentrations on days when they used non-flower forms of cannabis relative to days when they used cannabis flower only. Participants who used cannabis for medicinal reasons on a greater proportion of days had greater knowledge of cannabinoid concentration overall across days. Further, greater overall knowledge of cannabinoid concentrations was associated with fewer reported negative cannabis-related consequences. CONCLUSIONS: Findings suggest that among PLWH, knowledge of cannabinoid concentrations may be higher when using non-flower cannabis products and among those reporting primarily medicinal cannabis use. Moreover, knowledge of cannabinoid concentration may protect against negative cannabis-related consequences in this population.

Executive functions and behavioral economic demand for cannabis among young adults: Indirect associations with cannabis consumption and cannabis use disorder.

Behavioral economic demand for cannabis is robustly associated with cannabis consumption and cannabis use disorder (CUD). However, few studies have examined the processes underlying individual differences in the relative valuation of cannabis (i.e., demand). This study examined associations between executive functions and cannabis demand among young adults who use cannabis. We also examined indirect associations of executive functions with cannabis consumption and CUD symptoms through cannabis demand. Young adults (N = 113; 58.4% female; mean age 22 years) completed a Marijuana Purchase Task. Participants also completed cognitive tasks assessing executive functions (set shifting, inhibitory control, working memory) and semistructured interviews assessing past 90-day cannabis consumption (number of grams used) and number of CUD symptoms. Poorer inhibitory control was significantly associated with greater Omax (peak expenditure on cannabis) and greater intensity (cannabis consumption at zero cost). Poorer working memory was significantly associated with lower elasticity (sensitivity of consumption to escalating cost). Lower inhibitory control was indirectly associated with greater cannabis consumption and CUD symptoms through greater Omax and intensity, and poorer working memory was indirectly associated with greater cannabis consumption and CUD symptoms through reduced elasticity. This study provides novel evidence that executive functions are associated with individual differences in cannabis demand. Moreover, these results suggest that cannabis demand could be a mechanism linking poorer executive functioning with heavier cannabis use and CUD, which should be confirmed in future longitudinal studies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Dispositional and contextual correlates of in-play sports betting and related harms: A 2-week ecological momentary assessment study.

OBJECTIVE: In-play betting is a novel form of sports betting that allows players to make continuous bets during a game. The present study examined the dispositional and contextual correlates of in-play sports betting and related harms. METHOD: Participants were 84 individuals (73.81% men, Mage = 41.02) who engaged in in-play betting. Participants first completed an online questionnaire including measures of problem gambling severity, childhood trauma, impulsivity, and emotion dysregulation. Participants then completed a 14-day ecological momentary assessment (EMA) study involving completing brief surveys twice per day. EMA surveys assessed in-play betting behaviors, motives, contexts, and harms. RESULTS: A total of 1,365 EMA surveys were completed, of which 32.89% involved placing at least one in-play bet. A total of 77 (91.67%) participants placed at least one in-play bet during the study period. Participants reported greater in-play betting involvement (the number of bets placed, money spent) and an increased likelihood of experiencing in-play betting-related financial and relationship harms when using substances while betting and when motivated to place in-play bets by an interest in sports or to "be in the game." Participants, who used substances during a greater proportion of in-play betting occasions, who more frequently endorsed coping motives for in-play betting, and who exhibited elevated problem gambling severity, reported greater in-play betting involvement and the likelihood of experiencing in-play betting-related harms overall. CONCLUSIONS: Responsible gambling initiatives targeting contextual risk factors, such as using alcohol and cannabis while in-play betting, may help to reduce the intensity of in-play betting and its associated harms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Who makes in-play bets? Investigating the demographics, psychological characteristics, and gambling-related harms of in-play sports bettors.

Background and aims: Sports betting has increased markedly in recent years, in part due to legislative changes and the introduction of novel forms of sports betting (e.g., in-play betting). Some evidence suggests that in-play betting is more harmful than other types of sports betting (i.e., traditional and single-event). However, existing research on in-play sports betting has been limited in scope. To address this gap, the present study examined the extent to which demographic, psychological, and gambling-related constructs (e.g., harms) are endorsed by in-play sports bettors relative to single-event and traditional sports bettors. Methods: Sports bettors (N = 920) aged 18+ from Ontario, Canada completed an online survey containing self-report measures of demographic, psychological, and gambling-related variables. Participants were classified as either in-play (n = 223), single-event (n = 533), or traditional bettors (n = 164) based on their sports betting engagement. Results: In-play sports bettors reported higher problem gambling severity, endorsed greater gambling-related harms across several domains, and reported greater mental health and substance use difficulties compared to single-event and traditional sports bettors. There were generally no differences between single-event and traditional sports bettors. Discussion: Results provide empirical support for the potential harms associated with in-play sports betting and inform our understanding of who may be at risk for increased harms associated with in-play betting. Conclusions: Findings may be important for the development of public health and responsible gambling initiatives to reduce the potential harms of in-play betting, particularly as many jurisdictions globally move towards legalization of sports betting.

Characterizing heterogeneity among people who use cannabis for medicinal reasons: A latent class analysis of a nationally representative Canadian sample.

BACKGROUND: Many individuals who use cannabis report doing so for medicinal reasons. Few studies have explored heterogeneity within this population, which may be important to inform targeted interventions. This study used latent class analysis to identify subgroups of people who use cannabis for medicinal reasons and their sociodemographic and cannabis-risk-related correlates. METHOD: Data were drawn from the 2019 Canadian Alcohol and Drugs Survey, which is a representative survey of Canadians ages 15 years and older. Data from 814 individuals reporting past-year use of cannabis for medicinal or mixed medicinal and non-medicinal reasons were included. Latent class analysis was conducted with forms of cannabis used, cannabis use frequency, concurrent non-medicinal cannabis use, and the medical conditions and symptoms cannabis was used to manage as indicators. RESULTS: Four distinct latent classes of medicinal cannabis use were identified: a non-daily cannabis flower for mental health and sleep class (39.56% of the sample), a non-daily cannabis flower for pain class (26.41% of the sample), a non-daily cannabis oil for physical health class (20.15% of the sample), and a daily multi-form cannabis for mental health and non-medical reasons class (13.88% of the sample). Sociodemographic factors and risk level for cannabis-related harms were associated with latent class membership. CONCLUSIONS: Results of this study reveal considerable heterogeneity among people reporting medicinal cannabis use and suggest that the distinct patterns of cannabis use behaviors and motives observed may be important for understanding risk for cannabis-related harms in this population. Findings underscore a need for harm reduction interventions tailored toward specific patterns of medicinal cannabis use.

Daily associations between cannabis use and alcohol use among people who use cannabis for both medicinal and nonmedicinal reasons: Substitution or complementarity?

OBJECTIVE: People who use cannabis for medicinal (vs. nonmedicinal) reasons report greater cannabis use and lower alcohol use, which may reflect a cannabis-alcohol substitution effect in this population. However, it is unclear whether cannabis is used as a substitute or complement to alcohol at the day level among people who use cannabis for both medicinal and nonmedicinal reasons. This study used ecological momentary assessment to examine this question. METHOD: Participants (N = 66; 53.1% men; mean age 33 years) completed daily surveys assessing previous-day reasons for cannabis use (medicinal vs. nonmedicinal), cannabis consumption (both number of different types of cannabis used and grams of cannabis flower used), and number of standard drinks consumed. RESULTS: Multilevel models revealed that, in general, greater cannabis consumption on a given day was associated with greater same-day alcohol use. Further, days during which cannabis was used for medicinal (vs. exclusively nonmedicinal) reasons were associated with reduced consumption of both cannabis and alcohol. The day-level association between medicinal reasons for cannabis use and lower alcohol consumption was mediated by using fewer grams of cannabis on medicinal cannabis use days. CONCLUSIONS: Day-level cannabis-alcohol associations may be complementary rather than substitutive among people who use cannabis for both medicinal and nonmedicinal reasons, and lower (rather than greater) cannabis consumption on medicinal use days may explain the link between medicinal reasons for cannabis use and reduced alcohol use. Still, these individuals may use greater amounts of both cannabis and alcohol when using cannabis for exclusively nonmedicinal reasons. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The reliability of attentional biases for gambling-related images in free-viewing eye-tracking paradigms.

Attentional biases for gambling-related stimuli are a robust correlate of problem gambling. Free-viewing eye-tracking paradigms are considered the gold standard for measuring attentional bias in addiction research, but their reliability in measuring biases for gambling-related stimuli remains unclear. Using secondary data from two different free-viewing eye-tracking paradigms (two-image and four-image displays), this study examined the internal consistency of fixation indices in samples with varying degrees of gambling involvement and problem gambling risk. Cronbach's alpha, McDonald's omega, and split-half reliability coefficients were used to assess internal consistency of several fixation indices (total dwell time, total dwell time percent, total fixation count, time of first fixation) for gambling-related images, neutral images, and computed attentional bias difference scores. For both two- and four-image displays, internal consistency estimates for total dwell time, total dwell time percent, and total fixation count were good to excellent for gambling-related images, neutral images, and attentional bias scores. Only time of first fixation exhibited low internal consistency. These findings indicate that both two-image and four-image free-viewing eye-tracking paradigms can reliably measure attentional biases for gambling-related stimuli among participants reporting varying degrees of gambling involvement and problem gambling risk.

A Systematic Review of Eye-Tracking Studies of Gambling-Related Attentional Biases.

Previous research has identified attentional biases towards addiction-related stimuli, including gambling-related stimuli. Eye-tracking is considered the gold standard methodology for measuring attentional biases, yet no review to date has examined its use in measuring gambling-related attentional biases. This systematic review synthesized the literature using eye-tracking to examine attentional biases among people who gamble. We reviewed articles from Web of Science and PubMed that were published from 1990 to 2021. A total of 11 articles were included, with sample sizes ranging from 38 to 173 participants. Of these studies, seven examined attentional biases for gambling-related visual stimuli. These seven studies provided support that gambling can result in the development of an attentional bias for gambling-related stimuli. With respect to correlates of gambling-related attentional biases, there were mixed results. Some studies identified significant positive associations between gambling-related attentional biases and psychosocial variables, such as problem gambling severity, gambling expectancies, gambling cravings, gambling motives, depressive symptom severity, alcohol use severity, daily stress, affective impulsivity, and immersion. Four studies examined attentional biases for responsible gambling messaging and advertisements, finding that both people who do and do not gamble attend less to responsible gambling messaging compared to other types of information such as the betting odds. Research using eye-tracking to examine attentional biases among people who gamble is in its infancy. Yet, the preliminary results support the identification of attentional biases using the gold-standard methodology. Further studies are needed to examine the correlates and potential clinical utility of assessing gambling-related attentional biases using eye-tracking.

Return to school and mask-wearing in class during the COVID-19 pandemic: Student perspectives from a school simulation study.

Objectives: This study examined children's perspectives about returning to in-person school following lockdown due to the pandemic and about mask-wearing in class, as well as the mental health of children and parents during the pandemic. Methods: This cross-sectional study was part of a 2-day school simulation exercise that randomized students to different masking recommendations. Parent-report of mental health and post-simulation child-report of COVID-19-related anxiety and mask-wearing were analyzed using descriptive and multiple regression analyses. Semi-structured focus groups were conducted with older students to supplement questionnaire data. Results: Of 190 students in this study, 31% were in grade 4 or lower 95% looked forward to returning to in-person school. Greater child anxiety about COVID-19 was predicted by increased parent/caregiver anxiety (ß=0.67; P<0.001), and lower parental educational attainment (ß=1.86; P<0.002). Older students were more likely than younger students to report that mask-wearing interfered with their abilities to interact with peers (χ2(1)=31.16; P<0.001) and understand the teacher (χ2(1)=13.97; P<0.001). Students in the group that did not require masks were more likely than students in the masking group to report worries about contracting COVID-19 at school (χ2(1)=10.07; P<0.05), and anticipated difficulty wearing a mask (χ2(1)=18.95; P<0.001). Conclusions: For children anxious about COVID-19, parental anxiety and education about COVID-19 may be targets for intervention. Future research should examine the impact of prolonged implementation of public health mitigation strategies in school on academic achievement and children's mental health.