Do Cannabis Use Motives Mediate the Relationship between PTSD Symptoms and Cannabis Craving to Trauma Cues?

Kyra N Farrelly, P. Romero-Sanchiz, I. Mahu, S. Barrett, Pamela Collins, Daniel Rasic, Sherry Stewart
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Abstract

Cannabis use is common in individuals with posttraumatic stress disorder (PTSD). The PTSD-cannabis relationship is important as cannabis use can worsen PTSD outcomes. Cannabis use motives are a useful construct for understanding the PTSD-cannabis relationship. Frequent pairing of a trauma cue with substance use to cope can lead to conditioned substance craving. The extant research has not yet examined potential mechanisms to explain this effect. We recruited 51 cannabis users with a trauma history for a cannabis cue-reactivity study to examine coping motives as a potential mediator of the hypothesized relationship between PTSD symptoms and cannabis craving to trauma cues. Participants first completed a validated cannabis use motives measure. They were then exposed to a personalized audio and visual cue based on their trauma experience and reported on their cannabis craving immediately following using a standardized measure. Coping motives were contrasted with enhancement motives as the mediator. Results supported our first hypothesis: PTSD symptoms were associated with increased cannabis craving following personal trauma cue exposure. However, our second hypothesis of an indirect effect through coping motives was not supported. We did find an independent main effect of coping motives on cannabis craving triggered by trauma cue exposure. The lack of an interaction between PTSD symptoms and coping motives on trauma-cue induced craving is potentially due to other factors we did not examine that help strengthen the relationship (e.g., sleep). These findings have important clinical implications for targeting both PTSD symptoms and coping motives to prevent the development of conditioned cannabis craving to trauma reminders.
大麻使用动机是否介导创伤后应激障碍症状与大麻渴望对创伤线索的关系?
大麻在创伤后应激障碍(PTSD)患者中很常见。创伤后应激障碍与大麻的关系很重要,因为大麻的使用会使创伤后应激障碍的结果恶化。大麻使用动机是理解创伤后应激障碍与大麻关系的一个有用的结构。频繁地将创伤线索与物质使用相结合会导致条件性物质渴望。现有的研究还没有检验解释这种效应的潜在机制。我们招募了51名有创伤史的大麻使用者进行大麻线索反应性研究,以检验应对动机是否可能是创伤后应激障碍症状与大麻对创伤线索的渴望之间假设关系的中介。参与者首先完成了一项有效的大麻使用动机测量。然后,根据他们的创伤经历,他们接触到个性化的音频和视觉提示,并在使用标准化测量后立即报告他们对大麻的渴望。以应对动机和增强动机为中介。结果支持了我们的第一个假设:创伤后应激障碍症状与个人创伤线索暴露后大麻渴望增加有关。然而,我们的第二个假设,通过应对动机的间接影响是不支持的。我们确实发现应对动机对创伤线索暴露引发的大麻渴望有独立的主要影响。创伤后应激障碍症状和应对动机之间缺乏相互作用,这可能是由于我们没有研究的其他有助于加强这种关系的因素(例如睡眠)。这些发现对于针对创伤后应激障碍症状和应对动机,防止对创伤提醒的条件性大麻渴望的发展具有重要的临床意义。
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