Poster #207 - Exploring Transactional Relations between Adolescent Marijuana use and Emotional Awareness over Time

• In Event: 1-005 - Poster Session 01
  In Poster Session: PS 01 Section - Social, Emotional, Personality

Integrative Statement

Considering the adverse effects of regular marijuana use in adolescence on key developmental outcomes, there is a need to better understand the mechanisms involved in marijuana use in adolescents. Low emotional awareness, a precursor to regulating emotions, is associated with adolescent marijuana use (Dorard et al., 2008). Despite their co-occurrence, the mechanism behind this relation remains unclear. One hypothesis is that adolescents who lack emotional awareness may have limited resources for overcoming negative feelings and use substances to regulate emotions (i.e., awareness->substance use; e.g., Hassler & Katz, 2010). Alternatively, substance use may result in poorer emotional awareness through cognitive impairment (i.e., substance use->awareness; e.g., Lynskey & Hall, 2000). An equally plausible explanation is that there are reciprocal relations between substance use and emotional awareness that interact over time. It is essential to understand directions of effects in order to improve treatment or prevention. However, to our knowledge, there has been no such investigation. The purpose of this study is to probe alternative theories of directions of effects to facilitate a more complete understanding of why adolescents use marijuana and the consequences of doing so.

The sample comprised 110 adolescents (ages 13-18; mean age=15.72; 43% female) who were engaged in outpatient substance use treatment. Participants were randomized to treatment as usual (n=49) or a family focused cognitive behavioral theory (CBT) intervention (n=61) targeting adolescent substance use. At baseline and 3-, 6-, and 12-month assessments, participants self-reported on marijuana use across the preceding 7 days using the Drug Use Questionnaire, as well as their difficulties in emotional awareness on the Difficulties in Emotion Regulation Scale. Higher scores reflect greater marijuana use and more difficulties in emotional awareness, respectively.

The present study utilized a cross-lagged path modeling design to test the fit of four alternative models and inform hypotheses about the longitudinal associations between emotional awareness and marijuana use over time (Arnett et al., 2012). Model 1 predicts that emotional awareness and marijuana use have bidirectional associations, with earlier emotional awareness predicting later marijuana use and vice versa. Model 2 predicts that marijuana use predicts later emotional awareness. Model 3 predicts that emotional awareness predicts later marijuana use. Finally, model 4 predicts that there are concurrent associations between emotional awareness and marijuana use, but no cross lagged association. Analyses controlled for treatment group and age.

Overall, mean levels of marijuana use increased over time. However, the family-focused CBT treatment group had lower marijuana use at month 3. Difficulties in emotional awareness was relatively stable over time, with a peak (i.e., most difficulties) at 6 months. Model fit comparisons revealed that model 3 (emotional awareness->marijuana use) fit the data best (Figure 1). There was a significant, modest cross-lagged effect from month 3 emotional awareness to month 6 marijuana use, indicating that lack of emotional awareness at 3 months was associated with increased marijuana use at 6 months. These findings support the notion that, in an at-risk adolescent sample, difficulties in emotional awareness are related to higher levels of subsequent substance use.

Authors

• Lauren Micalizzi, Brown University
  Presenting Author

• Leslie A. Brick, Brown University
  Non-Presenting Author

• Sarah Thomas, Brown University
  Non-Presenting Author

• Anthony Spirito, Brown University
  Non-Presenting Author