Ecological Momentary Assessment of Cannabis Use and Affect Among Adolescents Following Psychiatric Discharge

Overview

Journal J Stud Alcohol Drugs

Specialty Psychiatry

Date 2023 Feb 17

PMID 36799676

Authors

Leslie A Brick

Julia A Gajewski-Nemes

Marisa E Marraccini

Shaquanna Brown

Michael Armey

Nicole R Nugent

Affiliations

Soon will be listed here.

Abstract

Objective: Affect regulation is central to multiple theoretical models that explain cannabis use (CU) behavior. However, much of the research has been conducted with adults, leaving unanswered questions about the nature of associations among adolescents, especially those with affective disorders. Using clinical interviews and ecological momentary assessment (EMA), we assessed rates of adolescent CU and momentary associations with affect following psychiatric discharge among youth hospitalized for suicidal thoughts and behaviors.

Method: Participants were 13- to 18-year-olds ( = 62; 64.5% female) recruited from an inpatient psychiatric hospital who reported having ever used cannabis. Participants completed clinical interviews during hospitalization. EMA was conducted for 21 days upon discharge.

Results: Concurrent use of other drugs was associated with greater odds of CU (odds ratio = 27.63). Momentary CU was associated with higher levels of positive affect and lower levels of anger/irritability, but not with negative affect. The effect of momentary CU on positive affect was greater among youth with a diagnosis of posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD).

Conclusions: Findings suggest that adolescents may use cannabis to enhance positive emotion, especially those with PTSD/GAD. Results highlight the importance of tailored interventions that focus on providing alternative and adaptive methods to enhance positive affect.

References

E Blevins C, Walker D, Stephens R, Banes K, Roffman R . Changing social norms: The impact of normative feedback included in motivational enhancement therapy on cannabis outcomes among heavy-using adolescents. Addict Behav. 2017; 76:270-274. PMC: 5614893. DOI: 10.1016/j.addbeh.2017.08.030. View

Nugent N, Armey M, Boker S, Brick L, Knopik V, McGeary J . Adolescents hospitalised for suicidality: biomarkers, social and affective predictors: a cohort study. BMJ Open. 2022; 12(10):e056063. PMC: 9535190. DOI: 10.1136/bmjopen-2021-056063. View

Hyman S, Sinha R . Stress-related factors in cannabis use and misuse: implications for prevention and treatment. J Subst Abuse Treat. 2008; 36(4):400-13. PMC: 2696937. DOI: 10.1016/j.jsat.2008.08.005. View

Chen C, Wagner F, Anthony J . Marijuana use and the risk of Major Depressive Episode. Epidemiological evidence from the United States National Comorbidity Survey. Soc Psychiatry Psychiatr Epidemiol. 2002; 37(5):199-206. DOI: 10.1007/s00127-002-0541-z. View

Meier M, Caspi A, Cerda M, Hancox R, Harrington H, Houts R . Associations Between Cannabis Use and Physical Health Problems in Early Midlife: A Longitudinal Comparison of Persistent Cannabis vs Tobacco Users. JAMA Psychiatry. 2016; 73(7):731-40. PMC: 4936934. DOI: 10.1001/jamapsychiatry.2016.0637. View

Padovano H, Miranda R . Subjective cannabis effects as part of a developing disorder in adolescents and emerging adults. J Abnorm Psychol. 2018; 127(3):282-293. PMC: 5912694. DOI: 10.1037/abn0000342. View

Sideli L, Trotta G, Spinazzola E, La Cascia C, Di Forti M . Adverse effects of heavy cannabis use: even plants can harm the brain. Pain. 2020; 162(Suppl 1):S97-S104. PMC: 8216111. DOI: 10.1097/j.pain.0000000000001963. View

Wu L, Gersing K, Burchett B, Woody G, Blazer D . Substance use disorders and comorbid Axis I and II psychiatric disorders among young psychiatric patients: findings from a large electronic health records database. J Psychiatr Res. 2011; 45(11):1453-62. PMC: 3196279. DOI: 10.1016/j.jpsychires.2011.06.012. View

Kedzior K, Laeber L . A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population--a meta-analysis of 31 studies. BMC Psychiatry. 2014; 14:136. PMC: 4032500. DOI: 10.1186/1471-244X-14-136. View

10.

Meier M, Caspi A, Ambler A, Harrington H, Houts R, Keefe R . Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci U S A. 2012; 109(40):E2657-64. PMC: 3479587. DOI: 10.1073/pnas.1206820109. View

11.

Tyler E, Jones S, Black N, Carter L, Barrowclough C . The relationship between bipolar disorder and cannabis use in daily life: an experience sampling study. PLoS One. 2015; 10(3):e0118916. PMC: 4349825. DOI: 10.1371/journal.pone.0118916. View

12.

Koob G, Le Moal M . Drug addiction, dysregulation of reward, and allostasis. Neuropsychopharmacology. 2000; 24(2):97-129. DOI: 10.1016/S0893-133X(00)00195-0. View

13.

Clarke M, Coughlan H, Harley M, Connor D, Power E, Lynch F . The impact of adolescent cannabis use, mood disorder and lack of education on attempted suicide in young adulthood. World Psychiatry. 2014; 13(3):322-3. PMC: 4219077. DOI: 10.1002/wps.20170. View

14.

Bresin K, Mekawi Y . Do marijuana use motives matter? Meta-analytic associations with marijuana use frequency and problems. Addict Behav. 2019; 99:106102. DOI: 10.1016/j.addbeh.2019.106102. View

15.

Gruber S, Sagar K, Dahlgren M, Olson D, Centorrino F, Lukas S . Marijuana impacts mood in bipolar disorder: a pilot study. Ment Health Subst Use. 2022; 5(3):228-239. PMC: 9016723. DOI: 10.1080/17523281.2012.659751. View

16.

Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P . Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997; 36(7):980-8. DOI: 10.1097/00004583-199707000-00021. View

17.

Cheung J, Mann R, Ialomiteanu A, Stoduto G, Chan V, Ala-Leppilampi K . Anxiety and mood disorders and cannabis use. Am J Drug Alcohol Abuse. 2010; 36(2):118-22. DOI: 10.3109/00952991003713784. View

18.

Wycoff A, Metrik J, Trull T . Affect and cannabis use in daily life: a review and recommendations for future research. Drug Alcohol Depend. 2018; 191:223-233. PMC: 6201696. DOI: 10.1016/j.drugalcdep.2018.07.001. View

19.

Swift W, Coffey C, Carlin J, Degenhardt L, Patton G . Adolescent cannabis users at 24 years: trajectories to regular weekly use and dependence in young adulthood. Addiction. 2008; 103(8):1361-70. DOI: 10.1111/j.1360-0443.2008.02246.x. View

20.

Cougle J, Bonn-Miller M, Vujanovic A, Zvolensky M, Hawkins K . Posttraumatic stress disorder and cannabis use in a nationally representative sample. Psychol Addict Behav. 2011; 25(3):554-8. DOI: 10.1037/a0023076. View