Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety

Blasi, Maria Di; Cavani, Paola; Pavia, Laura; Tosto, Crispino; Grutta, Sabina La; Baido, Rosa Lo; Giordano, Cecilia; Schimmenti, Adriano

doi:10.3389/fpsyt.2017.00249

Cited by 6 publications

(5 citation statements)

References 59 publications

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“…There is limited and mixed evidence to support social anxiety as a direct predictor of CRNCs. 57 , 58 Social anxiety may moderate the association between social norms and cannabis use problems, 59 and one study reported social anxiety was indirectly associated with cannabis-related problems through solitary use frequency. 60 Social anxiety was also associated with CRNCs via underutilization of protective behavioral strategies (ie, planned behaviors to decrease the use of cannabis) and serial effects with cannabis use frequency and peak quantity 61 as well as the effect on negative and positive affect and sequential effects on frequency of use and problems.…”

Section: Resultsmentioning

confidence: 99%

“…68 Several cross-sectional studies described an association between higher scores on self-reported impulsivity measures and the experiences of CRNCs. 44,57,[69][70][71] Sensation seekingthe trait of seeking novel and intense experiences-was also significantly associated with CRNCs 45,70,72 with one exception, a significant, negative association to CRNCs among persons with relatively low use of protective behavioral strategies (ie, acting as a mediator for the risk and protective factors of cannabis consequences). 73 There were no longitudinal studies investigating this relationship identified in our search.…”

Section: Intrapersonal Influencesmentioning

confidence: 98%

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A Scoping Review of Risk and Protective Factors for Negative Cannabis Use Consequences

et al. 2023

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Objective: Numerous reviews have examined risk and protective factors for alcohol-related negative consequences, but no equivalent review of risk and protective factors exists for cannabis-related negative consequences (CRNCs)-a gap filled by the present study. This scoping review examined survey-based research of risk and protective factors for CRNCs such as neglecting responsibilities, blacking out, or needing more cannabis. Methods: Three databases (PubMed, PsycINFO, and Google Scholar) were searched for peer-reviewed manuscripts published between January 1, 1990, and December 31, 2021. A qualitative synthesis was performed using the matrix method and the results were organized using the socioecological model as a framework. Results: Eighty-three studies were included in the review. There was considerable variation in measures and operationalizations of CRNCs across studies. Risk factors were identified in the intrapersonal (depression, social anxiety, PTSD, impulsivity, sensation seeking, motives, expectancies), interpersonal/community (trauma, victimization, family and peer substance use, social norms), and social/policy (education, employment, community attachment, legalization, availability of substances) domains of influence. Protective behavioral strategies were a robust protective factor for CRNCs. Males consistently reported more CRNCs than females, but there were no differences observed across race. Conclusions: Future research should identify person- and product-specific patterns of CRNCs to refine theoretical models of cannabis misuse and addiction. Public health interventions to reduce the risk of negative consequences from cannabis should consider utilizing multilevel interventions to attenuate the cumulative risk from a combination of psychological, contextual, and social influences.

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Section: Resultsmentioning

confidence: 99%

Section: Intrapersonal Influencesmentioning

confidence: 98%

A Scoping Review of Risk and Protective Factors for Negative Cannabis Use Consequences

et al. 2023

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“…Mammen et al 14 and Hill 12 echoed this result in that cannabis use was often linked with individuals with substance use disorders, which in turn frequently results in higher anxiety levels. For the remaining studies identified, the level of anxiety level reduction/increase was difficult to quantify as every study used a different standard of measuring anxiety (not the GAD-7) 9 , 18 , 36 or utilized primarily surveys/databases to measure anxiety. 13 , 20 , 25 , 37 , 38 Collectively, these data are in contrast to our findings where the vast majority of patients did not show any worsening in their GAD-7 scores or anxiety classification over time.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, other studies, such as Gobbi et al, 16 report that cannabis use is significantly associated with a higher risk for depression, anxiety, and suicide in young adults. However, the majority of former studies are limited due to the following: studies focus on how cannabis increases anxiety levels 12,14,17 rather than how cannabis could potentially improve anxiety 18,19 ; few accurately differentiate cannabis prescribed medically versus non-medical use 13,20 ; studies are typically age-specific with small cohort sample sizes 3,16,[21][22][23][24] ; and the studies primarily measure anxiety and concomitant use of cannabis in the context of other illegal substance use (not medical cannabis use). 25,26 Despite the evidence on its well-validated measure for anxiety, few studies [27][28][29] have directly utilized the generalized anxiety disorder 7-item (GAD-7) 30 questionnaire as a method of measuring anxiety levels in association with cannabis use.…”

Section: Introductionmentioning

confidence: 99%

Generalized Anxiety Disorder 7-Item (GAD-7) Scores in Medically Authorized Cannabis Patients—Ontario and Alberta, Canada

et al. 2021

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Objectives Despite increasing rates of legalization of medical cannabis worldwide, the current evidence available on its effect on mental health outcomes including anxiety is of mixed results. This study assesses the effect of medical cannabis on generalized anxiety disorder 7-item (GAD-7) scores in adult patients between 2014 and 2019 in Ontario and Alberta, Canada. Methods An observational cohort study of adults authorized to use medical cannabis. The GAD-7 was administered at the time of the first visit to the clinic and subsequently over the follow-up time period of up to 3.2 years. Overall changes in GAD-7 scores were computed (mean change) and categorized as: no change (<1 point); improvement; or worsening—over time. Results A total of 37,303 patients had initial GAD-7 scores recorded and 5,075 (13.6%) patients had subsequent GAD-7 follow-up scores. The average age was 54.2 years (SD 15.7 years), 46.0% were male, and 45.6% noted anxiety symptoms at the baseline. Average GAD-7 scores were 9.11 (SD 6.6) at the baseline and after an average of 282 days of follow-up (SD 264) the average final GAD-7 score recorded was 9.04 (SD 6.6): mean change −0.23 (95% CI, −0.28 to −0.17, t[5,074]: −8.19, p-value <0.001). A total of 4,607 patients (90.8%) had no change in GAD-7 score from their initial to final follow-up, 188 (3.7%) had a clinically significant decrease, and 64 (1.3%) noted a clinically significant increase in their GAD-7 scores. Conclusions Overall, there was a statistically significant decrease in GAD-7 scores over time (in particular, in the 6–12-month period). However, this change did not meet the threshold to be considered clinically significant. Thus, we did not detect clinical improvements or detriment in GAD-7 scores in medically authorized cannabis patients. However, future well-controlled clinical trials are needed to fully examine risks or benefits associated with using medical cannabis to treat anxiety conditions.

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“…This lack of consensus of cannabis use for anxiety may also be attributed to the inconsistent nature of the current available literature. Previous studies either tend to strongly focus on the negative effects of cannabis and anxiety (rather than searching for how cannabis may improve anxiety) [ 15 – 18 ], consist of age-specific and small cohort sizes [ 13 , 19 – 23 ], did not differentiate cannabis from other illicit substances [ 24 , 25 ], or cannot accurately distinguish cannabis for medical purposes versus recreational where non-medical use which often occur in the context of other drug use [ 26 , 27 ]. Consequently, the current clinical practice guidelines for medical cannabis for Canadian physicians do not support its use for anxiety and other mental health conditions [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Benzodiazepine use in medical cannabis authorization adult patients from 2013 to 2021: Alberta, Canada

Dubois,

Fernandes,

Lin

et al. 2024

BMC Public Health

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Background Benzodiazepines are a class of medications that are being frequently prescribed in Canada but carry significant risk of harm. There has been increasing clinical interest on the potential “sparing effects” of medical cannabis as one strategy to reduce benzodiazepine use. The objective of this study as to examine the association of medical cannabis authorization with benzodiazepine usage between 2013 and 2021 in Alberta, Canada. Methods A propensity score matched cohort study with patients on regular benzodiazepine treatment authorized to use medical cannabis compared to controls who do not have authorization for medical cannabis. A total of 9690 medically authorized cannabis patients were matched to controls. To assess the effect of medical cannabis use on daily average diazepam equivalence (DDE), interrupted time series (ITS) analysis was used to assess the change in the trend of DDE in the 12 months before and 12 months after the authorization of medical cannabis. Results Over the follow-up period after medical cannabis authorization, there was no overall change in the DDE use in authorized medical cannabis patients compared to matched controls (− 0.08 DDE, 95% CI: − 0.41 to 0.24). Likewise, the sensitivity analysis showed that, among patients consuming ≤5 mg baseline DDE, there was no change immediately after medical cannabis authorization compared to controls (level change, − 0.04 DDE, 95% CI: − 0.12 to 0.03) per patient as well as in the month-to-month trend change (0.002 DDE, 95% CI: − 0.009 to 0.12) per patient was noted. Conclusions This short-term study found that medical cannabis authorization had minimal effects on benzodiazepine use. Our findings may contribute ongoing evidence for clinicians regarding the potential impact of medical cannabis to reduce benzodiazepine use. Highlights • Medical cannabis authorization had little to no effect on benzodiazepine usage among patients prescribed regular benzodiazepine treatment in Alberta, Canada. • Further clinical research is needed to investigate the potential impact of medical cannabis as an alternative to benzodiazepine medication.

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Mediating Effects of Global Negative Effect Expectancies on the Association between Problematic Cannabis Use and Social Anxiety

Cited by 6 publications

References 59 publications

A Scoping Review of Risk and Protective Factors for Negative Cannabis Use Consequences

A Scoping Review of Risk and Protective Factors for Negative Cannabis Use Consequences

Generalized Anxiety Disorder 7-Item (GAD-7) Scores in Medically Authorized Cannabis Patients—Ontario and Alberta, Canada

Benzodiazepine use in medical cannabis authorization adult patients from 2013 to 2021: Alberta, Canada

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