The Medical Cannabis Expectancy Questionnaire: Adult Medical Marijuana Users’ Expectancies Associated with Combustible, Vaporized, and Edible Cannabis Use for Medical Purposes

Abstract

Measures of medical cannabis (MC) use are lacking. This study details the development and psychometric evaluation of The Medical Cannabis Expectancy Questionnaire (MCEQ), a novel measure of positive and negative expectations associated with using combustible, vaporizable, and edible MC. 333 adult MC users completed a 30-minute online survey in Spring 2017 (64.0% female, 82.3% White, mean age 32.77[±10.19] years). Participants reported on demographics, product preference, MCEs, frequency of MC use, quality of life, and negative cannabis use consequences. Psychometric analyses included evaluations of latent factor structure, measurement invariance, between-groups differences in MCEs, and test-criterion relationships with MC outcomes. The 27-item MCEQ evidenced a 2-factor structure (positive/negative). MCEs were scalar invariant by product type, sex, and reasons for MC use (medical only vs medical/recreational). Participants held more positive MCEs for combustibles than for vaporizables or edibles and more negative MCEs for combustibles and edibles than for vaporizables. MCEs did not differ by sex. Participants who also used cannabis recreationally reported stronger positive MCEs for all MC products. MCEs also differed by product preference. Additionally, preference for and more positive MCEs associated with using a specific product were associated with more frequent use of that product. Positive MCEs for all products also were associated with increased quality of life, but these relationships failed to reach statistical significance after accounting for covariates. Finally, negative MCEs for combustibles and edibles were associated with more negative consequences. The MCEQ is the first psychometrically promising measure of MC expectancies, and it uniquely distinguishes among expectations associated with using combustible, vaporizable, and edible MC. As MC use continues to proliferate, having measures dedicated to MC (versus recreational cannabis) may better inform research and clinical efforts. Further, differentiating between product types is important given established differences among them (e.g., duration of effect onset).

The Anticipated Effects of Cannabis Scale (AECS): Initial development and validation of an affect- and valence-based expectancy measure.

“…First, “pain relief” did not make it past the EFA stage. Pain relief is a popular and known cannabis effect for individuals using medical marijuana, and “pain relief” is one of the highest loading positive expectancy items on the MCEQ (Morean & Butler, 2019). Because the majority of participants in our study were young adults, who may not be using for medicinal, pain reducing purposes, item endorsement was low.…”

“…Further, we did not examine whether the factor structure of the AECS differed across cannabis product types (e.g., flower, concentrates, edibles) or methods of cannabis administration (e.g., smoke, vape, edible). Some research has suggested that product type or method of administration might impact cannabis effects (Cavazos-Rehg et al, 2018; Morean & Butler, 2019; Spindle et al, 2018). Therefore, future research might consider testing measurement invariance of the AECS across type of cannabis and method of administration.…”

“…In fact, most MEEQ subscales measure inherently low arousal effects, except for some items on the social/sexual facilitation and perceptual/cognitive enhancement subscales (both positive). In addition, the measure also asks solely about expectancies for smoked marijuana, which refers to the flower of the cannabis plant, failing to capture expected effects associated with a variety of more potent cannabis products (e.g., concentrates) and administration modes (e.g., edibles; e.g., Jones et al, 2018; Meier, 2017; Meier et al, 2019; Morean & Butler, 2019; Schauer et al, 2020). Although the B-MEEQ is a brief instrument at six items, it has notoriously poor internal consistency (e.g., Torrealday et al, 2008; Brackenbury et al, 2016) and uses quadruple barreled items (e.g., “marijuana makes it harder to think and do things; harder to concentrate or understand; slows you down when you move”).…”

Overbaked: assessing and predicting acute adverse reactions to Cannabis

“…There has been some indication that there are individual differences in the chronic psychophysiological effects of cannabis (Atakan et al 2013;Volkow et al 2014). For instance, past research has established that psychotic symptoms (Atakan et al 2013), coping-related motives for cannabis use (e.g., Moitra et al 2015;Spradlin and Cuttler 2019), and adolescent-onset cannabis use (Volkow et al 2014) predict negative consequences associated with chronic cannabis use. This suggests that some cannabis users may be more prone to experience negative side effects of chronic cannabis use (e.g., impaired cognitive functioning, cannabis abuse/addiction, and increased risk of mental illness).…”

The Cannabis Effects Expectancy Questionnaire–Medical (CEEQ-M): Preliminary psychometric properties and longitudinal validation within a clinical trial.

“…One instrument has been developed to address this need: the Medical Cannabis Expectancy Questionnaire (MCEQ; Morean & Butler, 2019). The MCEQ comprises 27 binary yes/no items that represent two factors corresponding to positive (e.g., symptom relief) and negative (e.g., side effects) cannabis expectancies.…”