From Adverse Childhood Experiences to Problematic Marijuana Use: Examining the Role of Distress Tolerance and Coping Motives on Negative Marijuana Use Consequences

Abstract

Background: Problematic marijuana use is highly prevalent globally, particularly in young adults, with marijuana use disorder affecting 5.8%, or 2.0 million, of young adults (ages 18 – 25) in the United States alone (SAMHSA, 2020). Previous research has reported a significant association between Adverse Childhood Experiences (ACEs) and later marijuana use (Scheidell et al., 2018). Though existing research reports an association between exposure to ACEs and marijuana use outcomes, the underlying mechanisms that could explain these associations are unclear. In previous research, general drug use coping motives have been shown to significantly mediate the relationship between childhood emotional, physical, and sexual abuse and later drug use problems (Hogarth et al., 2019). Other research has suggested that the factors like distress tolerance, typically negatively associated with childhood trauma (Robinson et al., 2021) and maladaptive coping strategies (Zvolensky et al., 2010), can also play a role in specifically predicting future problematic marijuana use (Buckner et al., 2018). Objective: The present study aimed to probe this relationship by exploring the associations between ACEs, distress tolerance, marijuana use coping motives, and negative marijuana-related consequences. Specifically, we hypothesized that greater experiences of ACEs would relate to more negative marijuana-related consequences via lower distress tolerance and higher coping motives. Method: Participants were 752 marijuana-using (i.e., used marijuana in the past month) U.S. college students (66.0% female) who completed an online survey including measures of basic marijuana use patterns, marijuana use consequences (Brief Marijuana Consequences Questionnaire (MACQ); Simons et al., 2012), marijuana use motivations (Marijuana Motives Questionnaire (MMQ); Simons et al., 1998), ACEs (Adverse Childhood Experiences International Questionnaire (ACE-IQ); WHO, 2018), and distress tolerance (Distress Tolerance Scale, Simons et al., 2005). To address study aims, path analysis was performed within the whole sample to test the serial unique associations between ACEs → distress tolerance → using marijuana to cope → negative marijuana-related consequences. Results: Within our analytic sample, we found that only marijuana coping motives uniquely indirectly influenced the relationship between ACEs and negative marijuana-related consequences (indirect β = .079, 99% CIs = .042, .121). Distress tolerance did not significantly uniquely indirectly influence the relationship between ACEs and negative marijuana-related consequences. However, a significant double-mediation effect was found illustrating that a higher endorsement of ACEs was associated with lower distress tolerance, which in turn was associated with higher using marijuana to cope motives, which in turn was associated with more negative marijuana-related consequences (indirect β = .011, 99% CIs = .002, .026). Conclusions: These findings provide support for the relevance of distress tolerance and coping motives as potential factors in linking ACEs to problematic marijuana use among college students. Our preliminary findings encourage further exploration of these associations in longitudinal or experimental studies. Further these results lend support to the therapeutic targeting of distress tolerance and using marijuana to cope to mitigate harms stemming from ACEs and its impact on problematic marijuana use.