Phillips Kristina T, Prince Mark A, Phillips Michael M, Lalonde Trent L, Stein Michael D
Center for Integrated Health Care Research (CIHR), Kaiser Permanente Hawai'i, 501 Alakawa St., Suite 201, Honolulu, HI 96817.
Department of Psychology, 1876 Campus Delivery, Colorado State University, Fort Collins, CO 80523.
Cannabis. 2022 Feb 2;5(1):42-58. doi: 10.26828/cannabis/2022.01.005. Epub 2021 Dec 17.
Using ecological momentary assessment (EMA), we assessed momentary patterns of alcohol and cannabis co-use in college students and whether state-level and baseline reports of anxiety varied based on type of substance(s) consumed. Students (=109) reporting regular cannabis use completed a baseline assessment and two-week signal-contingent EMA, with three random prompts/day. At each EMA instance, we categorized instances of substance "usage" as: 1) no use, 2) cannabis-only, 3) alcohol-only, or 4) co-use of alcohol and cannabis (i.e., reports of alcohol and cannabis use within the same prompt). Using temporal sequenced data, we explored how state-level anxiety varied before and after usage type using multiple multilevel structural equation models (MSEMs) and whether baseline factors (general anxiety, social anxiety, and sex) influenced the relation between usage type and state-level anxiety. Participants were 63.3% White, 58.7% female, used cannabis near-daily, and commonly reported co-use. Models examining whether usage type predicted subsequent state-level anxiety were predominantly significant, with the majority of relationships being more pronounced for participants with higher baseline general anxiety. In examining whether momentary state-level anxiety predicted usage type, in instances when participants reported higher levels of momentary anxiety, they were more likely to report no use compared to co-use and cannabis-only, with sex moderating some of the relationships. Social anxiety did not moderate any of the within-person associations between state-level anxiety and usage type. This study provides preliminary evidence that report of momentary anxiety varies based on substance type. Future research is needed to establish co-use related synergistic effects and correlates.
我们采用生态瞬时评估（EMA）方法，评估了大学生酒精和大麻同时使用的瞬时模式，以及焦虑的状态报告和基线报告是否因所消费物质的类型而异。报告经常使用大麻的学生（=109人）完成了基线评估和为期两周的信号触发式EMA，每天有三次随机提示。在每个EMA实例中，我们将物质“使用”情况分为：1）未使用，2）仅使用大麻，3）仅使用酒精，或4）酒精和大麻同时使用（即在同一提示中报告酒精和大麻的使用情况）。利用时间序列数据，我们使用多个多层次结构方程模型（MSEM）探讨了使用类型前后状态焦虑如何变化，以及基线因素（一般焦虑、社交焦虑和性别）是否影响使用类型与状态焦虑之间的关系。参与者中63.3%为白人，58.7%为女性，几乎每天都使用大麻，且普遍报告同时使用。检验使用类型是否预测后续状态焦虑的模型大多具有显著性，对于基线一般焦虑较高的参与者，大多数关系更为明显。在检验瞬时状态焦虑是否预测使用类型时，当参与者报告较高水平的瞬时焦虑时，与同时使用和仅使用大麻相比，他们更有可能报告未使用，性别对部分关系有调节作用。社交焦虑并未调节状态焦虑与使用类型之间的任何个体内关联。本研究提供了初步证据，表明瞬时焦虑报告因物质类型而异。需要进一步的研究来确定同时使用相关的协同效应及其相关因素。
