Examination of Rumination's Mediating Role in the Relation Between Distal Personality Predictors, Cannabis Coping Motives, and Negative Cannabis-Related Consequences.

Objective: Perseverative cognitive processes, such as rumination, may indirectly influence effects of personality traits on cannabis use and related problems. Understanding relations among personality, rumination, and cannabis use motives may lead to better understanding of problematic cannabis use. The present study examined personality traits' influence on negative cannabis-related consequences via rumination and cannabis use coping motives. Methods: We tested a sequential path model across two independent samples such that the model was tested in one sample and replicated in the second sample. Participants were U.S. undergraduate students from multiple universities who reported using cannabis at least once in the prior thirty days. Results: Results partially supported hypotheses such negative urgency and distress tolerance were indirectly related to negative cannabis-related consequences via rumination and coping motives. Specifically, higher negative urgency and lower distress tolerance were related to higher rumination. Higher rumination was related to higher coping motives; which in turn was related to more negative cannabis-related consequences. Results indicate that rumination is a risk factor belying associations between personality and cannabis use to cope and negative consequences of use. Conclusions: Implementing techniques that attenuate rumination for individuals high in negative urgency or low in distress tolerance may reduce or prevent problematic cannabis and unintended outcomes.

Development and Validation of the Positive Outcomes of Cannabis Use Scale (POCUS) Among Predominantly White Adults in the United States.

Operant conditioning and social learning theories suggest that positive cannabis use-related outcomes are a primary contributor to maintained use and risk for dependence. However, currently there does not exist a reliable, validated measure of positive cannabis-related outcomes. This study sought to develop and psychometrically evaluate the Positive Outcomes of Cannabis Use Scale (POCUS). We collected three samples, college students (N = 883), community adults (N = 214), and college students (N = 615), of predominantly White adults in the United States who completed an online survey. Exploratory and confirmatory factor analyses evaluated scale structure and identified four factors: social enhancement, mood enhancement, cognitive enhancement, and sexual enhancement. Positive outcomes were positively associated with recent use, controlling for expectancies and negative outcomes. Positive outcomes were also differentiated from positive expectancies and more influential in predicting typical use frequency. Findings indicate that the POCUS is psychometrically sound and clinically useful for measuring positive cannabis use-related outcomes among predominantly White adults in the United States.

Alcohol First, Cannabis Last: Identification of an Especially Risky Use Pattern among Individuals Who Co-Use Alcohol and Cannabis.

Background: Alcohol and cannabis co-use is common and confers increased risk for potential harms, such as negative consequences and substance dependence. The existing evidence suggests that factors such as dose of delta-9-tetrahydrocannabinol (THC) consumed and order of use of each substance (i.e., using alcohol or cannabis first or last when co-using) may impact co-use outcomes. Existing co-use research has focused primarily on college-samples or young adults, and few studies have explored these nuanced relations among community samples. Methods: We examined survey data from 87 community members (mean age 32.9 years, 49.4% female) recruited from legal market cannabis dispensaries. Using a combination of regression techniques (i.e., OLS, negative binomial, censor-inflated) we modeled relations among co-use ordering patterns, THC dose and cannabis outcomes as well as interactions with sex assigned at birth and age. Results: Individuals who endorsed co-use reported significantly higher CUDIT scores than those who had never co-used (p < 0.01). Using alcohol first and cannabis last (a pattern we refer to as "AFCL") was more common among females than males (p < 0.01). In the context of typical substance use weeks, more frequently engaging in the AFCL pattern was associated with significantly higher CUDIT scores (p < 0.001) and negatively predicted positive consequences (p < 0.001). Other patterns predicted higher CUDIT scores during heavy use weeks. Conclusions: Results indicate that co-use ordering patterns are related to substance use outcomes. Further research leveraging within-subjects, longitudinal designs is needed to test causal relations between these variables.

Results of a randomized controlled trial of the cannabis eCHECKUP TO GO personalized normative feedback intervention on reducing cannabis use, cannabis consequences, and descriptive norms.

BACKGROUND: The prevalence of cannabis use disorder and its negative consequences among young adults has highlighted the need for prevention and early intervention programs. However, low treatment prevalence persists due to factors such as lack of perceived need, concerns about stigma, and limited access to treatment. To address these barriers, web-based cannabis interventions have been developed, but their efficacy remain limited. This study aims to evaluate the cross-site efficacy of the Cannabis eCHECKUP TO GO program, a web-based Personalized Normative Feedback and Protective Behavioral Strategies intervention for reducing cannabis use frequency and consequences in college students with willingness to change. METHODS: Participants were 781 students from three universities (two in Canada, one in the US) who reported using cannabis in the past month and expressed interest in reducing or engaging in safer cannabis use. The study randomly assigned them to either an experimental group that received personalized normative feedback or a control group that received information on healthy stress management. The study collected follow-up data 4 weeks after the initial intervention and measured participants' frequency of cannabis use, number of cannabis consequences, descriptive and injunctive norms at both time points. RESULTS: The results showed no significant reductions in cannabis use or negative consequences of use. However, students who received personalized normative feedback experienced a significant reduction in descriptive norms related to cannabis use, to be more in line with actual use. CONCLUSION: This study suggests that more targeted interventions may be necessary for university students who are already using and seeking help to reduce their use.

Early Birds and Night Owls: Distinguishing Profiles of Cannabis Use Habits by Use Times with Latent Class Analysis.

Background: Understanding, predicting, and reducing the harms associated with cannabis use is an important field of study. Timing (i.e., hour of day and day of week) of substance use is an established risk factor of severity of dependence. However, there has been little attention paid to morning use of cannabis and its associations with negative consequences. Objectives: The goal of the present study was to examine whether distinct classifications of cannabis use habits exist based on timing, and whether these classifications differ on cannabis use indicators, motives for using cannabis, use of protective behavioral strategies, and cannabis-related negative outcomes. Methods: Latent class analyses were conducted on four independent samples of college student cannabis users (Project MOST 1, N=2,056; Project MOST 2, N=1846; Project PSST, N=1,971; Project CABS, N=1,122). Results: Results determined that a 5-class solution best fit the data within each independent sample consisting of the classes: (1) "Daily-morning use",(2) "Daily-non-morning use", (3) "Weekend-morning use", (4) "Weekend-night use", and (5) "Weekend-evening use." Classes endorsing daily and/or morning use reported greater use, negative consequences and motives, while those endorsing weekend and/or non-morning use reported the most adaptive outcomes (i.e., reduced frequency/quantity of use, fewer consequences experienced, and fewer cannabis use disorder symptoms endorsed). Conclusions: Recreational daily use as well as morning use may be associated with greater negative consequences, and there is evidence that most college students who use cannabis do avoid these types of use. The results of the present study offer evidence that timing of cannabis use may be a pertinent factor in determining harms associated with use.

Pot at the End of the Rainbow: Cannabis Use Among Sexual Minorities.

Introduction: Gay, lesbian, and bisexual individuals (i.e., sexual minorities) use cannabis more frequently than heterosexuals; however, little research has directly compared sexual minorities' patterns of cannabis use (e.g., quantity, age of onset, forms of cannabis used) with heterosexuals. Some research has identified motivations for cannabis use in sexual minorities, but much of this research has been qualitative and/or narrow in scope (e.g., focused on sexual motivations). To the best of our knowledge, no previous research has used a validated measure to examine motives for cannabis use among sexual minorities. Additionally, cannabis use is known to be associated with mental health symptoms, but little research has examined relationships between cannabis use and mental health in this population. Materials and Methods: Data analyses were performed on archival survey data collected from 10 undergraduate psychology subject pools across the United States (N=4,669) as a part of Project ART (Addictions Research Team). Participants indicated their sexual orientation using a 5-point scale, and responses were used to classify participants into three groups: the majority of the sample (n=3,483) were classified into the heterosexual group, about one quarter were classified into the bisexual group (n=1,081), and a small number were classified into the gay group (n=105). Results: The bisexual group was more likely to report using cannabis. They also reported using cannabis more frequently, were more likely to report use of all product types (i.e., flower, concentrates, and edibles), and reported more severe symptoms of cannabis use disorder (CUD) than the heterosexual group. The bisexual group also reported higher levels of coping and enhancement motives for using cannabis and reported higher levels of all measured mental health symptoms (e.g., depression, suicidality, generalized anxiety, and social anxiety) compared with the heterosexual group. Conclusions: Increased frequency of cannabis use, use of a broad range of different products, and use of cannabis to cope with mental health concerns may be placing bisexual individuals at greater risk of CUD. Findings from this study can be used to guide future research and help target mental health interventions among bisexual individuals.

An investigation of the effects of sensation seeking and impulsivity on extreme sport participation and injury using path analysis.

OBJECTIVE: Extreme sport participation and injury rates have increased in recent decades. This study aimed to investigate sub-dimensions of impulsivity and sensation seeking that contribute to participation and injury risk in extreme sports. PARTICIPANTS: Data included cross-sectional survey responses from 7,109 college students (Mage = 19.68, SD = 2.31). METHODS: This study utilized path analysis to investigate sub-dimensions of sensation seeking and impulsivity as predictors of extreme sport participation and injury across 3 models. RESULTS: Results of the final model identify risk seeking and lack of perseverance as the two strongest predictors of extreme sports injury, risk seeking, experience seeking, and lack of premeditation as the strongest positive predictors of extreme sports participation, and lack of perseverance as the strongest negative predictor of extreme sports participation. CONCLUSIONS: These results will contribute to targeted prevention and intervention efforts for extreme sports injury among young adults based on identified individual personality factors.

Personality and emotion dysregulation profiles predict differential engagement in a wide range of health-risk behaviors.

OBJECTIVE: Health-risk behaviors have an unclear etiology and college students have elevated risk for engagement. Emotion dysregulation and several personality dimensions have been implicated in health-risk behaviors, but these constructs have rarely been studied together. Further, it is unknown if different types of health-risk behaviors have distinct etiologies. PARTICIPANTS: 2077 college students completed a cross-sectional survey. METHODS: Latent profile analysis discerned classes of participants from emotion dysregulation and personality dimensions. Differential engagement in self-injury, suicidality, disordered eating, substance misuse, and unprotected sex was evaluated across classes. RESULTS: Three classes were identified, which were primarily distinguished by emotion dysregulation, urgency, and neuroticism. Health-risk behaviors generally increased across classes with increasing emotion-related constructs. Self-injury and suicidality demonstrated different patterns than other health-risk behaviors. CONCLUSIONS: Results elucidate heterogeneity in health-risk behavior engagement. Focusing on emotional difficulties may be more important for reducing self-injury and suicidality than disordered eating, substance misuse, and risky sex.

Associations between alcohol and cannabis use order, frequency, quantity, and consequences in a college sample of individuals who co-use alcohol and cannabis.

BACKGROUND AND OBJECTIVES: Using both alcohol and cannabis (either at the same time or at different times) is common among college students, and is called "co-use." Using these substances simultaneously, such that their effects overlap, is thought to be an especially risky co-use pattern. Gaining a better understanding of how co-use patterns relate to substance use and consequences could aid prevention and intervention efforts. METHODS: We examined college students (N = 401) who reported using both alcohol and cannabis at least once in the past 30 days. Path analysis was used to explore relations among co-use patterns (number of days in a typical week that participants used both alcohol and cannabis; the number of days using alcohol first, cannabis first, alcohol last, and cannabis last; the number of days of simultaneous use), past-30-day alcohol and cannabis consequences, use frequency, and typical quantities used. RESULTS: Each additional day of using alcohol first was associated with fewer past-30-day cannabis consequences. Each additional day of using cannabis first was associated with fewer alcohol-related consequences. Each additional day of using alcohol and cannabis on the same day and each additional day of simultaneous use were both associated with less cannabis used and alcohol consumed in a typical week. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This study is among the first to identify associations between alcohol and cannabis order and outcomes (i.e., consequences and consumption). Results suggest that modifying which substance is used first on a given day could be a practical intervention strategy for individuals who co-use alcohol and cannabis.

Protocol for a mobile laboratory study of co-administration of cannabis concentrates with a standard alcohol dose in humans.

Cannabis is commonly used among people who drink alcohol, yet evidence on acute effects of co-use is conflicting. Two important variables that may influence the effects of cannabis and alcohol are cannabinoid content (i.e., the ratio of cannabidiol [CBD] and 9-tetrahydrocannabinol [THC]) as well as the order of use (i.e., cannabis before alcohol vs. alcohol before cannabis). Research is mixed regarding the acute imapct of cannabis on alcohol consumption and intoxication, with some studies suggesting additive effects of alcohol and cannabis, and others demonstrating negligible effects of combining these substances. Further complicating this, high-THC-content cannabis concentrates are increasingly popular on the legal-market, but to our knowledge, no studies have explored concentrate and alcohol co-use. In addition to cannabinoid content, order of use may influence intoxication and other acute effects, but is also understudied. Co-use studies typically administer a fixed dose of alcohol before cannabis, and there is a lack of data on the acute effects of cannabis before alcohol. Thus, there is a need for experimental co-use studies exploring the impact of cannabinoid content (particularly of highly potent cannabis concentrates) and order effects on intoxication. This study uses a federally-compliant mobile laboratory procedure to explore the effects of co-administration of legal-market cannabis concentrates with a moderate alcohol dose (.8g/kg) in a sample of community participants who regularly use alcohol and cannabis. The study will also explore alcohol and cannabis order effects (cannabis before alcohol vs. alcohol before cannabis). Outcomes are objective intoxication (measured using blood cannabinoid level, heart rate, psychomotor performance and breath alcohol level [BrAC]) and subjective intoxication (assessed via self-report measures). Overall, this study may influence harm-reduction recommendations for individuals who drink alcohol and use cannabis.

Meaning in Life Moderates Relations between Personality and Temperament and Nonsuicidal Self-Injury in Hospitalized Adolescents.

Previous research indicates that sensation seeking, emotion dysregulation, and impulsivity are predictive of non-suicidal self-injury (NSSI). A body of research supports that meaning in life predicts improved mental health and well-being, including fewer suicidal thoughts and attempts, yet no research has examined the moderating effects of meaning in life on the relations between personality and temperament and NSSI. Given the growing incidence rates of NSSI among adolescents and the potential lifelong consequences of NSSI, it is imperative to better understand the factors that reduce the rates at which adolescents in a clinical sample engage in NSSI. The present study investigates if the protective factors of meaning in life moderate the relation between personality and temperament variables and NSSI among 126 adolescents (71% female, Mage = 16.1, SD = 1.1, range 13-18, 80% White) residing in an inpatient psychiatric hospital who endorsed NSSI in the last 12 months. Results from hurdle modeling indicate that two subtypes of meaning in life, presence of meaning in life and search for meaning of life, may serve as robust protective factors against engagement in NSSI among a clinical sample of adolescents. Additionally, results suggest that search for meaning, but not presence of meaning in life, variables moderate the relations between personality and temperament and NSSI. Results provide evidence that meaning in life is an understudied variable of importance in understanding how to prevent or treat NSSI. It also underscores the need to develop, refine, and test meaning-making interventions.

The Relation Between Impulsivity and Estimation of Marijuana Weight.

Until recently, marijuana research has often relied on self-reported frequency of use (e.g., days used per month). These estimations may oversimplify use at times, as they can only infer the quantity that one uses, rather than directly measure it. While some studies have estimated quantity (e.g., number of joints, grams), research has supported that user estimates of marijuana weight are often inaccurate and overestimate the true quantity. Since weight misestimation varies by participant, it may be important to identify individual difference factors (e.g., personality) that influence weight estimation. One such factor may be impulsivity, as it is known to relate to other marijuana-use measures (e.g., frequency, consequences). However, research has yet to examine the specific relation between impulsivity and misestimation of marijuana weights. The present study investigated impulsivity as a predictor of marijuana quantity estimation, using objectively weighed quantity data. We hypothesized that impulsivity facets would relate to marijuana quantity misestimation. We asked attendees at a marijuana- related event to roll a joint or pack a bowl, and then take, among a battery of measures, the SUPPS-P Impulsive Behavior Scale. We found that negative urgency, positive urgency, and lack of perseverance were not significantly associated with misestimation, while lack of premeditation was significantly negatively related to misestimation. Findings indicated that individuals who lacked in premeditation made more accurate quantity estimates than those higher in premeditation. Future directions should investigate the relation between impulsivity, marijuana intoxication, and marijuana quantity estimation.

Does Accessibility of Cannabis Mediate the Relation Between Method of Acquisition and Cannabis Use Frequency among Adolescents?

Cannabis use frequency among adolescents is associated with negative outcomes. Two variables associated with cannabis use frequency are method of acquisition and accessibility of cannabis. Prior research on the relation between methods of acquisition and cannabis use frequency is sparse. Differences in cannabis use in states in which the sale of recreational cannabis is legal (recreational states) compared to states in which it is not warrants research on how adolescents acquire cannabis in recreational states, and how easy it is for them to do so. The primary way in which adolescents acquire cannabis and the ease by which they can acquire cannabis may be associated with cannabis use frequency via specific interactions. We hypothesized that primarily acquiring cannabis from a store would be positively associated with cannabis use frequency when compared to other primary methods of acquisition, and that accessibility would meditate relations between primary method of acquisition and cannabis use frequency. This study used data from high school students who completed the 2019 Healthy Kids Colorado Survey (HKCS) who reported using cannabis in the past 30 days. Results indicated that primary method of acquisition was significantly differentially associated with 30-day cannabis use frequency, with participants who reported buying cannabis at a store reporting significantly higher 30-day cannabis use frequency than any other method of acquisition. Ease of accessibility was not significantly associated with 30-day cannabis use frequency and did not significantly mediate the relation between primary method of acquisition and 30-day cannabis use frequency. Results of the current study indicate that the ways in which adolescents acquire cannabis are associated with how often they use it. Further, the positive relation between primarily acquiring cannabis at stores and frequency of use provide evidence that access to stores may be a risk factor for cannabis use frequency among adolescents.

Personality Predictors of Sports-Related Concussion Incidence: Analysis of Data From a Large, Heterogeneous Undergraduate Sample.

OBJECTIVE: Studies investigating the associations between personality and sports-related concussion are limited. The current study aimed to address this gap by examining whether specific personality dimensions predicted self-reported sports-related concussion outcomes. DESIGN: This study included 1141 undergraduate students ( Mage = 19.47, SD = 2.14, female = 64.5%) who completed a battery of online personality measures and self-reported sports-related concussion items. The self-reported sports-related concussion outcomes included a single diagnosed sports-related concussion incident (i.e., "diagnosed sports-related concussion incidence") and incidents of multiple diagnosed sports-related concussions (i.e., "multiple diagnosed sports-related concussion incidents"). Analyses included splitting data randomly into training and validation data sets. Multivariate logistic regression models were then fit to each data set to determine predictors of sports-related concussion. RESULTS: In both training and validation data sets, extraversion and experience seeking were found to be positively and most strongly associated with both sports-related concussion outcomes, whereas motor inhibition was found to be negatively associated with both outcomes. Additional personality dimensions showed differential relations with each sports-related concussion outcome. CONCLUSIONS: The current study highlights the importance of considering personality dimensions in the context of self-reported sports-related concussion outcomes, as there are differential relations between personality dimensions and these outcomes. Thus, prevention efforts for sports-related concussion may benefit from evaluating additional athlete factors, like personality traits.

Personality Predictors of Time to Return to Play After Sports-Related Concussion: Analysis of Survey Data From an Undergraduate Sample.

OBJECTIVE: This study aimed to address a gap in concussion literature by investigating the relation between personality and return to play. It is important to know that earlier return to play places individuals at higher risk of sustaining a new concussion after an initial concussion. DESIGN: Participants were undergraduate students recruited from psychology courses in 2019 who reported medically confirmed sports-related concussion and medically advised return to play (N = 202). Participants completed an online battery in a supervised laboratory setting that included self-report survey measures, concussion history items, and behavioral impulsivity tasks. Kaplan-Meier analysis and Cox proportional hazards models were used to analyze time to return to play after participants' first reported sports-related concussion. RESULTS: Results showed that one subdimension of sensation seeking, experience seeking, and two subdimensions of self-reported impulsivity, attentional and motor impulsivity, were positively associated with earlier return to play after a sports-related concussion. In contrast, higher levels of conscientiousness were associated with later return to play. CONCLUSIONS: Despite a heterogeneous sample, significant relations were found between timing of return to play and sensation seeking, impulsivity, and conscientiousness. Because earlier return to play can heighten the risk of sustaining a new concussion after an initial concussion, it is important to identify characteristics-such as personality traits-that influence individuals' return-to-play behaviors. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Distinguish between personality traits that resulted in earlier versus later return to play in this sample; (2) Describe why certain personality traits might be related to an earlier or later return-to-play timeline; and (3) List practical ways that these study results could be used to reduce adverse outcomes related to early return to play. LEVEL: Advanced. ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Personality Disorders, Risky Behaviors, and Adversity: The Moderating Role of Resilience.

Individuals with personality disorders (PDs) comprise 30% to 40% of individuals receiving mental health treatment. Treatment of PDs is exceedingly difficult; therefore, research has focused on PD etiology and preventative factors. One known influence on PD etiology is adverse childhood experiences (ACEs). ACEs are associated with increased prevalence of several health risk behaviors (HRBs), including engagement in substance use, criminal, and risky sexual behavior. One protective factor, childhood resiliency, predicts lower prevalence of PDs and engagement in HRBs. We hypothesized that increased prevalence of ACEs would predict higher levels of PD symptoms and HRBs engagement. Furthermore, we predicted that childhood resiliency would moderate the relation between ACEs, PD symptoms, and HRBs. In the present study, students (N = 531) completed the Adverse Childhood Experiences survey, the Self-Administered - Standardized Assessment of Personality Abbreviated Scale, and the Childhood Youth and Resiliency Measure-28. They also responded to questions about substance use, criminal, and sexual behavior which were used to define a latent HRB variable. Structural equation modeling was conducted to examine study hypotheses. As hypothesized, we found positive relations between ACEs, PD symptoms, and our HRB latent variable. Childhood resiliency moderated both ACE and PD symptom paths. At lower levels of reported ACEs, individuals high in childhood resiliency reported fewer PD symptoms and HRBs than individuals low in childhood resiliency. At high levels of ACEs, childhood resiliency did not serve as a protective factor. Additionally, study findings suggest that childhood resiliency factors are integral for protecting against the development of these disorders.

Assessing invariance of cannabis use motives by veteran status and binary gender identity among college students.

Student service members/veterans (SSM/V) are distinct from non-veteran students in a variety of ways, including in their cannabis use patterns and potentially their motives for cannabis use. Additionally, previous research has shown that men and women endorse different motives for their cannabis use. The present study was designed to assess whether a popular measure of cannabis use motives is invariant across veteran status and gender identity. Based on previous research, we hypothesized that cannabis motives would show invariance across SSM/V men, SSM/V women, non-veteran men, and non-veteran women (n = 1,011, SSM/V = 553) among those who indicated using cannabis at least once in their lifetime. Results from the four-group invariance testing procedure revealed metric invariance. This suggests that while the factor structure and factor loadings are invariant, there are differences at the intercept level for cannabis motives across groups. The same items load onto the same latent constructs and the strength of the items loading onto the latent factors was also the same across groups. The demonstrated invariance has implications for use in SSM/V and non-veteran clients. As this scale is brief, it could easily be used as a screening tool or used to guide intervention content.

Investigating sensation seeking as a predictor of false identification attainment and associated risks among a college student sample.

BACKGROUND: To date, few studies have included false identification (fake ID) use as a specific health risk behavior despite the fact that research has established a link between fake ID attainment and problematic alcohol use in a college student sample. The present study investigated the role of risk seeking, a facet of sensation seeking, in fake ID attainment, and the relation between fake ID attainment and risk seeking in predicting problematic drinking. METHODS: Data were collected using a cross-sectional survey battery from a sample of college students at a large, Colorado university. Analyses included penalized likelihood and negative binomial regression models. RESULTS: and Conclusions: Risk seeking positively predicted fake ID attainment. Additionally, a negative binomial hurdle model established that, controlling for 30-day alcohol use, both fake ID attainment and risk seeking predicted being drunk in the past 30 days. The role of risk seeking and fake ID attainment in problematic drinking outcomes is important to consider for informing prevention and intervention efforts in a college student population.

Young adult use, dual use, and simultaneous use of alcohol and marijuana: An examination of differences across use status on marijuana use context, rates, and consequences.

Objective: Co-use of alcohol and marijuana has increased among college students, though comparisons among simultaneous (i.e., use of both substances such that effects overlap), dual (i.e., use of both substances within a similar time period but without overlapping effects), and marijuana-only use are limited. This study aimed to understand differences between simultaneous, dual, and marijuana-only users on marijuana use rates, consequences, and context of use in a multi-university study. Method: College students (N = 4,764; Mage = 19.9 years) who were mainly female (70.6%) and White (67.9%) completed an online survey. The Marijuana Use Grid captured marijuana use quantity/frequency, and the Brief Marijuana Consequences Questionnaire and the Cannabis Use Disorders Identification Test-Revised assessed problem use. Location, method of consumption, and social context of use also were assessed. Results: Fifty-five percent of the sample endorsed lifetime use of alcohol and marijuana. Of these students, 36.1% endorsed past-month simultaneous use, 10.8% endorsed past-month dual use, and 6.4% endorsed past-month marijuana-only use. Simultaneous users reported more marijuana use and problems than dual users. Marijuana-only users did not differ from simultaneous users on marijuana use indices, though they reported greater use than dual users as well. Simultaneous users used marijuana in plant form, at parties, and with unknown others a greater percentage of the time than dual users, while dual users used edibles and ingested marijuana a greater percentage of the time. Conclusions: Given their greater levels of marijuana use and marijuana-related problems, screening and interventions for simultaneous alcohol-marijuana use are needed in college students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Moderated Mediation of the eCHECKUP TO GO College Student Cannabis Use Intervention.

Background: Cannabis use rates are rising among college students, creating a need for effective and accessible intervention options. One such intervention, the Marijuana eCHECKUP TO GO (eCTG) program, has relatively few studies investigating mechanisms of change and related outcomes. This intervention provides users with personalized normative feedback to adjust user's normative perceptions and use patterns. The current study tested moderated mediation of program effects between the eCTG intervention condition and a healthy stress management (HSM) control condition in a college student sample of near-daily cannabis users. Protective behavioral strategies (PBS) were measured among the eCTG conditionMethods: Data were analyzed from a sample of 227 students who were randomly assigned to the eCTG intervention condition or HSM control condition. Change in cannabis use frequency was measured by re-administering the baseline survey at a six-week follow-up. Multi-group moderated mediation path analysis tested the effects of the eCTG intervention on change in cannabis use frequency through PBS, descriptive norms, and injunctive norms, with multi-group categories defined by sex.Results: Direct effects indicated the intervention predicted reduced descriptive norm perceptions and cannabis use frequency. An indirect effect was found for the intervention condition on reducing cannabis use frequency through change in descriptive norms in males. Similarly, an indirect effect was seen for intervention condition on reducing cannabis use frequency through change in injunctive norms for females.Conclusions: Findings suggest changes in descriptive norms played a sex-specific mediating role in the mechanisms of change for the eCTG intervention on reductions in cannabis use frequency.