(PS1-26) Expansion and Coping Motives Mediate Relations Between Psychological Distress and Cannabis Use

Data from the National Survey on Drug Use and Health show that cannabis users experiencing psychological distress are at greater risk of developing cannabis use disorder (Choi et al., 2023). CBT therapists can help patients reduce risk for cannabis use disorder by helping them understand their motives for using cannabis in response to distress. Research has investigated at least five motives for cannabis use: coping (reduce negative affect), conformity (avoid rejection), social (engage with peers), enhancement (increase positive affect), and expansion (gain new perceptual experiences or insights) (Simons et al., 1998). Coping motives are a robust predictor of cannabis use in response to distress (Johnson et al., 2015). Conceivably, additional motives may mediate relations between distress and cannabis use (e.g., conformity in response to perceived rejection). To determine if additional motives warrant attention in CBT with cannabis users, we estimated a mediation model testing relations between distress, the five cannabis motives, and cannabis use frequency.

Participants were 246 undergraduate college student cannabis users from a large Northeastern university (M_age = 20.71, SD = 3.05; 66.3% cisgender women; 51.2% white) who provided data for a survey on health behaviors. A parallel mediation model was tested in PROCESS (Hayes, 2023). Psychological distress (Kessler 6; Kessler et al., 2003); coping, conformity, social, enhancement, and expansion motives, (Marijuana Motives Questionnaire; Simons et al., 1998); and cannabis use frequency were included as predictor, mediating, and outcome variables, respectively. In this initial model, a significant indirect effect and multiple other indirect effects trended toward statistical significance, but statistical power was low given the number of parameters. Therefore, we tested a second model with two mediators that were correlated with distress and use. This model was significant and explained 22% of the variance in participants’ cannabis use in response to distress; F_{(3, 242)} = 23.172, p < .001, R² = .223. Standardized bootstrap results revealed significant and positive indirect effects of distress on cannabis use via coping motives (β = .06, 95% CI [.01, .12]) and expansion motives (β = .08, 95% CI [.03, .14]). The direct effect was non-significant.

We hope these findings help CBT therapists expand their conceptualization of distressed patients’ cannabis use. In this sample, emerging adults who were distressed used cannabis to cope but also for expansion, e.g., to increase openness and awareness, gain new insights, and engage in self-exploration. Using cannabis for expansion in response to distress may not necessarily be maladaptive, especially considering the emerging field of psychedelic assisted psychotherapy, in which expansion is a purported mechanism of change (Johnson et al., 2019). Future research can investigate under what conditions using cannabis for expansion in response to distress is maladaptive and whether it is associated with increased cannabis problems. CBT therapists will benefit from helping cannabis-using patients to acknowledge expansion motives and determine their adaptiveness and by intervening if these motives appear to promote harmful use.