Efficiently Quantifying Egocentric Social Network Cannabis Use: Initial Psychometric Validation of the Brief Cannabis Social Density Assessment.

OBJECTIVE: Social environment is a key determinant of substance use, but cannabis-related social network analysis is not common, in part due to the assessment burden of comprehensive egocentric social network analysis. METHOD: The current pre-registered secondary analysis assessed the psychometric properties (i.e., convergent, criterion-related, incremental validity) of the Brief Cannabis Social Density Assessment (B-CaSDA) in a cross-sectional sample of adults who use cannabis (N = 310) using a survey-based design. The B-CaSDA assesses the quantity and frequency of cannabis use for the respondent's four closest (non-parent) relationships. RESULTS: Cannabis use severity was elevated for each additional person who used cannabis at all or daily in the individual's social network. B-CaSDA indices (i.e., frequency, quantity, total score) were positively correlated with cannabis consumption, cannabis use severity indicators, and established risk factors for harmful cannabis use. B-CaSDA indices also discriminated between those above and below a clinical cutoff on the Cannabis Use Disorder Identification Test - Revised (CUDIT-R). Finally, in omnibus models that included common risk factors for cannabis use severity, the B-CaSDA quantity index contributed additional variance when predicting CUDIT-R total score, and B-CaSDA frequency contributed additional variance in predicting the CUDIT-R quantity-frequency subscale. CONCLUSIONS: The results suggest that the B-CaSDA has the potential to expand social network research on cannabis use and misuse by increasing its assessment feasibility in diverse designs.

Development and Initial Validation of a Momentary Cannabis Craving Scale Within a Homogeneous Sample of U.S. Emerging Adults.

Given the popularity and ease of single-item craving assessments, we developed a multi-item measure and compared it to common single-item assessments in an ecological momentary assessment (EMA) context. Two weeks of EMA data were collected from 48 emerging adults (56.25% female, 85.42% White) who frequently used cannabis. Eight craving items were administered, and multilevel factor analyses were used to identify the best fitting model. The resulting scale's factors represented purposefulness/general desire and emotionality/negative affect craving. Convergent validity was examined using measures of craving, cannabis use disorder symptoms, frequency of use, cannabis cue reactivity, cannabis use, negative affect, and impulsivity. The scale factors were associated with cue-reactivity craving, negative affect, impulsivity, and subfactors of existing craving measures. For researchers interested in using a single item to capture craving, one item performed particularly well. However, the new scale may provide a more nuanced assessment of mechanisms underlying craving.

Identifying brief intervention factors to improve cannabis related outcomes in adolescents and young adults: A systematic review of sample characteristics and intervention components.

INTRODUCTION: Prior systematic and meta-analytic reviews observed mixed evidence for the efficacy of cannabis brief interventions (BIs). Inconsistent support for cannabis BIs may be the result of intersecting methodological factors, including intervention structure and content, participant eligibility criteria, and outcome assessment measures. The current systematic review of cannabis BI studies narratively synthesizes these data to guide intervention development decision-making in future cannabis BI studies (PROSPERO CRD42022285990). METHODS: We searched PubMed/MEDLINE, PsycINFO, and CINAHL databases in January 2022 and again in June 2023 to capture newly published studies. Studies were included if they were a randomized trial, enrolled adolescents (13-17) and/or young adults (18-30), specified cannabis use and/or problems inclusion criteria, and evaluated a cannabis BI (defined as ≤4 sessions). We extracted and synthesized data on intervention characteristics (e.g., components, length/duration, modality), cannabis inclusion criteria and recruitment setting, baseline cannabis use descriptives and treatment-seeking status, and outcome assessment measures to discern if/how they may intersect to determine intervention efficacy. The Cochrane Risk of Bias Tool 2 assessed study quality. RESULTS: Our search resulted in a final sample of 25 study records including 4094 participants. Recruitment setting seemed to provide an influential backdrop for how well inclusion criteria determined baseline cannabis use level, as well as for the type/length of the BI evaluated. Motivational interviewing (MI) and personalized feedback (PF) were the most frequently used BI components overall; however, some differences were observed in the proportion of BIs with reported intervention effects using MI vs. PF. Frequency of use days was the most commonly used outcome measure, although this may not be the most sensitive measure for assessing cannabis BI efficacy. CONCLUSIONS: Our systematic review indicates that cannabis BI studies require greater precision in their design, giving special attention to matching the content and structure of the BI to the needs of the target population and selecting outcomes commensurate to the goals of the BI and the target population to more accurately reflect the efficacy of the BI. However, consistent with prior reviews, all included studies demonstrated at least some concerns for risk of bias, and most were at high risk.

Sex differences in the relationship between cannabis use motives and cannabis craving in daily life in emerging adults.

OBJECTIVE: Cannabis use motives and craving are associated with increased risk for cannabis-related problems and are ideal targets for prevention and early intervention. Patterns of motives and craving reactivity to cannabis cues differ by sex; however, few studies closely examine the relationship between motives and craving and how it may differ by valence (±) across men and women. METHOD: The present study used Cue Reactivity Ecological Momentary Assessment to assess reward (+) and relief (-) craving four semirandom times per day for 2 weeks in a sample of 63 emerging adults (age 18-21; 54% cisgender women; 85.7% White) who frequently use cannabis (≥ 3 times per week). We assessed craving before and after exposure to brief neutral or cannabis image cues and examined within- and between-participant effects of cue type, motives, sex/gender, and their interactions, on postcue cannabis craving. RESULTS: Regardless of cue type, women with high coping motives (-) reported less postcue relief (-) craving, and men with high enhancement motives (+) reported more postcue reward (+) craving. High enhancement motives (+), regardless of sex/gender, were associated with elevated relief (-) craving reactivity to cannabis cues, and women with high coping motives (-) reported elevated reward (+) craving reactivity to cannabis cues. CONCLUSIONS: Sex/gender differences in the relationships between cannabis motives and craving reactivity indicate the value of a more targeted examination of valence (±) of craving experiences in addition to motives for use. Higher levels of precision may better inform interventions for emerging adults at risk for experiencing cannabis-related problems. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Role of Emotion Differentiation in the Association Between Momentary Affect and Tobacco/Nicotine Craving in Young Adults.

INTRODUCTION: Tobacco/nicotine use is commonly initiated during adolescence or young adulthood, which increases the likelihood of continued use into adulthood and related adverse health outcomes. Despite interest in cessation, achieving and maintaining abstinence is difficult among this population. Cravings are often a barrier to abstinence, which have been associated with intensity of affect at the moment level. Emotion differentiation involves the ability to distinguish between discrete emotion states, and previous work suggests it may moderate the effect of momentary affect on craving, which has never been explored among young adults who are smoking or vaping nicotine. AIMS AND METHODS: In a sample of young adults (N = 37, observations = 2020, ages 18-25, 51% female, and 78% white) interested in quitting smoking or vaping, we used real-time, naturalistic data capture via mobile phones to examine the interaction of momentary affect and trait emotion differentiation on nicotine craving. Participants were prompted with four surveys per day for 35 days and asked to make a 48-h quit attempt on day 7. RESULTS: Multilevel models showed moments of higher-than-average momentary negative affect (NA; b = 0.39, p < .001), and positive affect (PA; b = 0.26, p = .001) were associated with greater levels of craving. NA emotion differentiation significantly moderated the associations between PA and craving (b = -0.63, p = .031) and NA and craving (b = -0.67, p = .003). CONCLUSIONS: Findings from this exploratory analysis suggest that for young adults engaging in a nicotine quit attempt, greater ability to differentiate NA weakens the momentary association between intense affect and craving. IMPLICATIONS: Results of this study show that the ability to differentiate between discrete emotional experiences may protect young adults against nicotine craving during moments of intense affective experience. These preliminary findings suggest that emotion differentiation, a modifiable construct, could be an important treatment target for individuals engaged in treatment for nicotine dependence.

A randomized pilot trial of a mobile delivered brief motivational interviewing and behavioral economic alcohol intervention for emerging adults.

OBJECTIVE: Mobile health (mHealth) interventions show potential to broaden the reach of efficacious alcohol brief motivational interventions (BMIs). However, efficacy is mixed and may be limited by low participant attention and engagement. The present study examined the feasibility, acceptability, and preliminary efficacy of a live text-message delivered BMI in a pilot randomized clinical trial. METHOD: Participants were 66 college students (63.6% women; 61.9% White; Mage = 19.95, SD = 1.66) reporting an average of 11.88 (SD = 8.74) drinks per week, 4.42 (SD = 3.59) heavy drinking episodes (HDEs), and 8.44 (SD = 5.62) alcohol-related problems in the past month. Participants were randomized to receive either (a) education or (b) an alcohol BMI plus behavioral economic substance-free activity session (SFAS), each followed by 4 weeks of mini sessions. All sessions were administered via live text-message. Participants completed assessments postintervention (after the 4th mini session) and at 3-month follow-up. RESULTS: 90.9% completed both initial full-length sessions and at least two of the four mini sessions with 87.9% retention at 3-month follow-up. Participants found the interventions useful, interesting, relevant, and effective, with no between-group differences. There were no statistically significant group differences in drinks per week or alcohol-related problems at follow-up, but BMI + SFAS participants reported fewer past-month HDEs than those who received education. CONCLUSIONS: Live text-messaging to deliver the BMI + SFAS is feasible and well-received. The preliminary efficacy results should be interpreted cautiously due to the small sample size but support further investigation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effects of social context and opportunity cost on the behavioral economic value of cannabis.

OBJECTIVE: Behavioral economics suggest that cannabis reinforcing value (cannabis demand) may be influenced by external, contextual factors such as the social reward that might accompany cannabis use and the presence of opportunity costs (e.g., a next-day responsibility that cannabis use might adversely impact). The present study examined the effect of social context and opportunity cost on cannabis demand and explored whether relations were moderated by cannabis use severity. METHOD: Adults with past-week cannabis use recruited from Amazon's Mechanical Turk (N = 310; 53.5% female, 79.4% White) completed four purchase tasks, in which participants reported how much cannabis they would purchase across escalating prices, to index cannabis demand under varying contexts: (a) solitary, typical responsibilities; (b) social, typical responsibilities; (c) solitary, substantial responsibilities; and (d) social, substantial responsibilities. RESULTS: The presence of peers significantly increased demand intensity (consumption at zero price) and Omax (maximum expenditure) relative to the solitary conditions. Substantial responsibilities significantly decreased intensity, breakpoint (price at which consumption is fully suppressed), and Pmax (price at which maximum expenditure occurs) and increased elasticity (greater price sensitivity). Demand was most inelastic in the social, typical responsibilities condition relative to other conditions. Cannabis use severity was associated with less elastic demand in the solitary, typical responsibilities condition. Those with higher cannabis use severity reported larger differences in demand intensity and Omax between solitary and social conditions, and in demand elasticity between typical and substantial responsibility conditions. CONCLUSIONS: Results are consistent with previous research illustrating social and opportunity costs as determinants of cannabis use behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sex and Gender Differences in Simultaneous Alcohol and Cannabis Use: a Narrative Review.

Purpose of Review: The aim is to review recent literature on sex and gender differences in patterns of use, motives, pharmacological effects, and consequences of simultaneous alcohol and cannabis use (SAC). Recent Findings: Men engage in SAC more frequently than women. Women may have more substance-specific motives for use, while men tend to consistently endorse social/enhancement motives for both alcohol and cannabis. Regarding pharmacological effects, women experience the same subjective effects as men do at lower levels of use, with some evidence that women modulate cannabis use during simultaneous use episodes to avoid greater subjective intoxication. Finally, women appear more vulnerable to experiencing a range of positive and negative consequences from SAC relative to men. Summary: Research has identified several important sex/gender differences in SAC and its correlates and consequences. However, research has primarily focused on white and cisgender populations, with a need for more research among racial/ethnic and gender minorities.

Distress tolerance and reactivity to negative affective cues in naturalistic environments of cannabis-using emerging adults.

BACKGROUND: Distress tolerance (DT) has been implicated as an important factor in the experience of negative affect (NA) and cannabis craving. However, previous research is limited by its use of laboratory paradigms that may not replicate in naturalistic settings. The current study examined how DT influenced reactivity to NA cues in daily life in a sample of frequent (≥3 times per week) cannabis-using emerging adults (age 18-21). METHODS: Using cue-reactivity ecological momentary assessment (CREMA), 63 (54 % female; 85.7 % white; Mage = 19.62) participants reported on their cannabis craving and affect (sadness, relaxation) four semi-random times per day for two weeks (56 possible CREMA sessions/participant). We assessed affect and cannabis craving before and after exposure to neutral and NA cues. Multilevel modeling was used to examine within- and between-participant effects of cues, DT, and sex, as well as within- and between-participant average pre-cue affect and craving, on post-cue affect and craving. RESULTS: NA cues consistently predicted higher-than-normal post-cue sadness and lower relaxation, but not greater-than-normal post-cue craving. Cue type interacted with sex and DT to predict post-cue sadness, but not craving. Female participants and those reporting low DT reported higher sadness following NA cues compared to males and those with high DT, respectively. CONCLUSIONS: Frequent cannabis-using emerging adults differed in affect, but not cannabis craving, reactivity to NA cues as a function of sex and DT. Our results were partially consistent with prior human laboratory and CREMA research finding greater reactivity to NA cues among females and individuals with low DT.

Change in alcohol demand following a brief intervention predicts change in alcohol use: A latent growth curve analysis.

BACKGROUND: The association between behavioral economic demand and various alcohol use outcomes is well established. However, few studies have examined whether changes in demand occur following a brief alcohol intervention (BAI), and whether this change predicts alcohol outcomes over the long term. METHODS: Parallel process piecewise latent growth curve models were examined in a sample of 393 heavy drinking emerging adults (60.8% women; 85.2% white; Mage  = 18.77). In these models, two linear slopes represented rates of change in alcohol use, heavy drinking episodes, alcohol-related problems, and demand (intensity and highest expenditure across all price points or Omax ) from baseline to 1 month (slope 1) and 1 month to 16 months (slope 2). Mediation analyses were conducted to estimate the effect of a BAI on 16-month alcohol outcomes through slope 1 demand. RESULTS: A two-session BAI predicted significant reductions in all five outcomes from baseline to 1-month follow-up. Although no further reduction was observed from the 1-month to the 16-month follow-up, there was no regression to baseline levels. Slope 1 demand intensity, but not Omax , significantly mediated the association between BAI and both outcomes-heavy drinking episodes (Est. = -0.23, SE = 0.08, p < 0.01) and alcohol-related problems (Est. = -0.15, SE = 0.07, p < 0.05)-at the 16-month follow-up. CONCLUSIONS: Reducing high valuation of alcohol among heavy drinking emerging adults within the first month following BAI is critical for the long-term efficacy of the intervention. A two-session BAI was associated with enduring reductions in alcohol demand, and the change in demand intensity, but not Omax , was associated with sustained reductions in heavy drinking and alcohol-related problems.

Beyond BASICS: A scoping review of novel intervention content to enhance the efficacy of brief alcohol interventions for emerging adults.

OBJECTIVE: Brief motivational interventions (BMIs) that include personalized drinking feedback delivered in a motivational interviewing (MI) style have demonstrated reductions in drinking across numerous clinical trials with emerging adults (EAs) ages 18-25. However, effect sizes for these BMIs are generally small to moderate and drinking reductions are often not maintained beyond short-term follow-ups. Additionally, EAs may be more interested in approaches that highlight wellness, mood enhancement, or goal pursuit rather than programs focused exclusively on reducing alcohol-related risk. Thus, there is a need to evaluate novel intervention content as an alternative or supplement to BMIs in this high-risk population. METHOD: This scoping review examined studies of novel intervention elements to reduce alcohol consumption among EAs. Eligible studies were published in peer-reviewed journals in English from January 2015 to September 2021 and evaluated novel brief interventions, operationalized as one to five sessions focused on alcohol-related outcomes with key content beyond what has typically been included in alcohol BMIs. Results were categorized as additions to BMIs or stand-alone interventions and were synthesized within these categories by theoretical approach. RESULTS: Although standard in-person BMIs have the greatest empirical support, there are a variety of alternative intervention approaches that might enhance health and wellness and that can be feasibly integrated with BMIs or offered as an appealing "gateway" to increase help-seeking among EAs who drink alcohol. CONCLUSIONS: More research is needed to empirically evaluate both the relative efficacy of supplements and stand-alone alternatives to BMI among higher risk EAs and their potential for widespread dissemination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).