Abstract
BackgroundTo goal of this study was to better understand mechanisms underlying associations between Major Depressive Disorder (MDD) and marijuana use and problems. Specifically, it was hypothesized that negative urgency (NU), the tendency to act rashly while experiencing negative mood states, would uniquely (compared to other impulsivity traits: positive urgency, sensation seeking, premeditation, and perseverance) account for the relationship between MDD and marijuana use and problems.MethodsData were collected from a sample (N = 357) of veterans (M age = 33.63) recruited from a Veterans Affairs hospital who used marijuana at least once in their lifetime. Participants completed the SCID-NP to assess MDD, a marijuana problems scale, a Time-Line Follow-back to assess six-month marijuana use, and the UPPS-P Impulsive Behavior Scale for impulsivity.ResultsPath analysis was conducted using bootstrapped (k = 20,000) and bias-corrected 95% confidence intervals (CIs) to estimate mediation (indirect) effects, controlling for age, sex, and race. Analyses revealed a significant direct effect of MDD on NU and NU on marijuana problems. Regarding mediational analyses, there was a significant indirect effect of MDD on marijuana problems via NU. The direct effect of MDD on marijuana problems was reduced, but remained significant, suggesting partial mediation. No other impulsivity scales accounted for the relationship between MDD and marijuana problems. In predicting marijuana use, there were no significant indirect effects for any impulsivity traits, including NU, despite significant bivariate associations between use and NU and MDD.ConclusionsResults suggest that high levels of NU may partially explain associations between MDD and marijuana problems, but not marijuana use. No other facets of impulsivity accounted for the relationship between MDD and marijuana use or problems, underscoring the specificity of NU as a putative mechanism and the importance of assessing NU in treatment settings.
Highlights
To goal of this study was to better understand mechanisms underlying associations between Major Depressive Disorder (MDD) and marijuana use and problems
MDD was positively associated with marijuana use and marijuana problems
Marijuana problems were positively associated with negative urgency (NU), positive urgency (PU), and lack of perseverance (PS)
Summary
To goal of this study was to better understand mechanisms underlying associations between Major Depressive Disorder (MDD) and marijuana use and problems. In the wake of these rapid social and legal changes, epidemiological research reveals that past-year cannabis use disorder (CUD) rates have increased in the general population [2] and have more than doubled in the past decade among military veterans [3]. Cross-sectional between-subject [5, 17] and prospective within-subject [18] empirical research in support of this theory suggests that greater intensity of negative affect associated with MDD leads to increased marijuana use to in order to cope with negative emotions. Coping-oriented use of substances has been shown to worsen affective symptoms of depression and to increase substance misuse [19, 20]
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