Implicit Associations and Explicit Expectancies toward Cannabis in Heavy Cannabis Users and Controls

Esther M Beraha,Reinout W Wiers,Elisa Hermanides,Janna Cousijn,Anna E Goudriaan

doi:10.3389/fpsyt.2013.00059

Abstract

Cognitive biases, including implicit memory associations are thought to play an important role in the development of addictive behaviors. The aim of the present study was to investigate implicit affective memory associations in heavy cannabis users. Implicit positive-arousal, sedation, and negative associations toward cannabis were measured with three Single Category Implicit Association Tests (SC-IAT’s) and compared between 59 heavy cannabis users and 89 controls. Moreover, we investigated the relationship between these implicit affective associations and explicit expectancies, subjective craving, cannabis use, and cannabis related problems. Results show that heavy cannabis users had stronger implicit positive-arousal associations but weaker implicit negative associations toward cannabis compared to controls. Moreover, heavy cannabis users had stronger sedation but weaker negative explicit expectancies toward cannabis compared to controls. Within heavy cannabis users, more cannabis use was associated with stronger implicit negative associations whereas more cannabis use related problems was associated with stronger explicit negative expectancies, decreasing the overall difference on negative associations between cannabis users and controls. No other associations were observed between implicit associations, explicit expectancies, measures of cannabis use, cannabis use related problems, or subjective craving. These findings indicate that, in contrast to other substances of abuse like alcohol and tobacco, the relationship between implicit associations and cannabis use appears to be weak in heavy cannabis users.

Highlights

Cannabis is the most widely used illegal substance in most countries and treatment demands for cannabis dependence directly follow demands for alcohol and opiates (Degenhardt et al, 2008; UNODC, 2009)
One control was discarded as outlier because the Implicit associations (IAT) score was above four standard deviations (SD) from the group mean
Cannabis Use Disorder Identification Test (CUDIT) scores (t 148 = 17.73, p < 0.001) and craving were higher in the heavy cannabis users compared to controls

Summary

Introduction

Cannabis is the most widely used illegal substance in most countries and treatment demands for cannabis dependence directly follow demands for alcohol and opiates (Degenhardt et al, 2008; UNODC, 2009). Prior studies showed that substance-related cues automatically capture attention (i.e., attentional bias; e.g., Field, 2005; Mogg et al, 2005), elicit approach tendencies (i.e., approach bias; e.g., Field, 2005; Mogg et al, 2005; Wiers et al, 2009), and activate implicit memory associations in heavy substance users (e.g., Wiers et al, 2002; Field et al, 2004) These so called “cognitive biases” are thought to be relatively automatically triggered, the may reach awareness (for reviews, see McCusker, 2001; Wiers et al, 2007a). Cognitive biases have been found to predict relapse in cigarette smokers (Waters et al, 2003; Kahler et al, 2007), heroin dependent individuals (Marissen et al, 2006; Marhe et al, 2013), and alcohol dependent individuals (Cox et al, 2002)

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