Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, United States; Harvard Medical School, Boston, MA, United States.
Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, United States.
Addict Behav. 2019 Jun;93:212-218. doi: 10.1016/j.addbeh.2019.01.029. Epub 2019 Jan 23.
Correlates of cannabis use and dependence among young adults have been widely studied. However, it is not known which factors are most strongly associated with severity of cannabis use dependence (CUD) severity. Identification of the salient correlates of CUD severity will be of increasing clinical significance as use becomes more socially normative.
This study used a data-driven, hypothesis-free approach to examine the most robust correlates of CUD severity among a sample of 76 young adults (ages 18 to 25 years) who used cannabis at least weekly. Seventy-one candidate variables were examined for association with CUD severity. These included demographic variables, self-reported and psychodiagnostic assessments of mood and anxiety, self-reported measures of personality, cannabis and other substance use characteristics, and objective and subjective measures of cognition.
Of the 71 candidate variables considered, 27 were associated with CUD severity on a univariate level at a p-value ≤.20. Correlates of CUD severity in the multivariable model using stepwise selection were: more frequent cannabis use in the past 90 days, greater expectancies that cannabis causes cognitive and behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on a test of sustained attention. Internal validation tests support high prediction accuracy of all variables in the multivariable model, except for lower reaction time variability.
Cannabis use frequency, beliefs about use, perceived cognitive abilities, and anxiety are robustly associated with CUD severity in young adult, regular cannabis users, and may be important in guiding prevention and treatment efforts.
年轻人中与大麻使用和依赖相关的因素已得到广泛研究。然而，目前尚不清楚哪些因素与大麻使用依赖（CUD）严重程度的相关性最强。随着大麻使用变得更加普遍，确定 CUD 严重程度的显著相关因素将具有越来越重要的临床意义。
本研究使用一种数据驱动、无假设的方法，在一个每周至少使用大麻的 76 名年轻成年人（年龄在 18 至 25 岁之间）样本中，检查与 CUD 严重程度最相关的因素。共检查了 71 个候选变量与 CUD 严重程度的关联。这些变量包括人口统计学变量、情绪和焦虑的自我报告和心理诊断评估、自我报告的人格测量、大麻和其他物质使用特征以及认知的客观和主观测量。
在所考虑的 71 个候选变量中，有 27 个在单变量水平上与 CUD 严重程度相关，p 值≤.20。使用逐步选择的多变量模型中与 CUD 严重程度相关的因素包括：过去 90 天内更频繁地使用大麻、更大的期望大麻会导致认知和行为障碍、更大的自我报告元认知缺陷、更大的焦虑以及在注意力持续测试中反应时变异性更低。内部验证测试支持多变量模型中所有变量的高预测准确性，除了反应时变异性较低之外。
大麻使用频率、对使用的信念、感知认知能力和焦虑与年轻成年人中 CUD 严重程度高度相关，可能对指导预防和治疗工作很重要。
