Anxiety Sensitivity and Distress Intolerance as Predictors of Cannabis Dependence Symptoms, Problems, and Craving: The Mediating Role of Coping Motives

Abstract

ABSTRACT. Objective:The tendency to react with fear to anxietyrelated sensations (anxiety sensitivity) and the inability to tolerate distressing psychological or physiological states (distress intolerance) are implicated in the comorbidity between affective psychopathology and cannabis use disorders. Emotionally vulnerable cannabis users may be particularly apt to use cannabis to cope with distress, which may both lead to and maintain its problematic use (e.g., dependence, craving). The current study tested a comprehensive model of anxiety sensitivity and distress intolerance as predictors of the number of cannabis dependence symptoms and problems, and severity of cannabis craving following deprivation from cannabis, and the mediating role of cannabis coping motives. Method: Participants (n = 103; mean age = 21.2 years, SD = 4.3; 35.9% female) were non-treatment-seeking frequent cannabis users.Data were cross-sectional in nature. Anxiety sensitivity was assessed via self-report, and distress intolerance was assessed via both self-report and breath-holding duration. Results: Greater perceived distress intolerance, but not breath-holding duration or anxiety sensitivity, was associated with a greater number of cannabis dependence symptoms and problems and elevated cannabis craving. These relations were mediated by cannabis coping motives. Conclusions: Findings provide specificity for the etiologic mechanisms related to emotional vulnerability and maintenance of cannabis problems. Perceived distress intolerance appears to be uniquely related to maladaptive coping motives for cannabis use, which could be meaningfully targeted in interventions for emotionally vulnerable cannabis users. (J. Stud. Alcohol Drugs, 77, 889-897, 2016)

Distress intolerance moderation of motivated attention to cannabis and negative stimuli after induced stress among cannabis users: an ERP study

“…; Farris et al . ). Somewhat consistent with predictions, cannabis cue‐elicited modulation of the LPP during acute stress was significantly related to three indices of cannabis problem severity among high DI users, although these effects were generally limited to the later time windows, and the relationship with the MPS was not robust to outlier exclusion.…”

“…Recent studies have demonstrated that high distress intolerance (DI), an individual difference reflective of the ability to tolerate and effectively manage negative affect, is linked with CUD indices in regular users (Bujarski, Norberg & Copeland ; Farris et al . ). Further, these associations appear to be partially mediated by increased coping motives for cannabis use (i.e.…”

How does anxiety sensitivity increase risk of chronic medical conditions?

“…Two cross‐sectional studies examining the link between AS and alcohol‐related outcomes among adult smokers and people living with HIV/AIDS, respectively, found that difficulties with emotion regulation mediated the relationship between AS and hazardous drinking (Paulus, Jardin, et al., ; Paulus et al., ), suggesting the potential additional role of maladaptive regulation of negative affect in the link between AS and alcohol use in these medical populations. There is also some evidence of a link between AS and increased cannabis use (Paulus, Manning, Hogan, & Zvolensky, ) and increased coping and conformity motives for use (Bonn‐Miller, Zvolensky, & Bernstein, ; Zvolensky, Marshall, et al., ), although a recent cross‐sectional study found that lower distress tolerance was associated with increased cannabis dependence symptoms and stronger coping motives, whereas AS was not (Farris, Metrik, Bonn‐Miller, Kahler, & Zvolensky, ). Further, individuals with high AS demonstrate a propensity to use alcohol and tobacco specifically to cope with distress (e.g., Brown, Kahler, Zvolensky, Lejuez, & Ramsey, ; Woicik et al., ), again suggesting that tension reduction is a primary motivation for their substance use, as McNally () suggested.…”

A Pilot Randomized Controlled Trial of Dialectical Behavior Therapy (DBT) for Craving and Cessation in Marijuana Use Disorder Patients: Feasibility, Acceptability, and Appropriateness

“…Therefore, by increasing craving, they no longer consume Marijuana immediately. Similarly, with other DBT components, they learn reinforcement management and problem-solving skills that they can help MUD patients to reduce Marijuana consumption (20,22,24,27,28).…”