Matthew Tyler Boden

Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users.

Abstract Objectives: Little research has investigated the demographic and symptom profile of medical cannabis users in states in the USA that have legalized cannabis use. Methods: In the present cross-sectional study, we investigated the demographic profile of 217 adults currently receiving medical cannabis, as well as differences in problematic use and perceived helpfulness in terms of (i) symptoms of psychological disorders and pain, and (ii) motives for use. Results: Findings indicated that medical cannabis users (i) use and perceive cannabis to be beneficial for multiple conditions, some for which cannabis is not specifically prescribed or allowed at the state level; and (ii) report similar rates of disordered use as compared with population estimates among regular users. Furthermore, problematic cannabis use was predicted by several symptoms of psychological disorders (e.g. depression) and a variety of use motives (e.g. coping), while cannabis was reported as particularly helpful among those with several psychological symptoms (e.g. traumatic intrusions), as well as those reporting use for social anxiety reasons. Conclusions: Results are discussed in terms of future directions for research given the current debates regarding legalization of cannabis for medical purposes and, more generally, the lack of empirical data to inform such debates.

Posttraumatic Stress, Difficulties in Emotion Regulation, and Coping-Oriented Marijuana Use

In an effort to better understand factors that may explain prior findings of a positive relation between posttraumatic stress symptom severity and coping-oriented marijuana use motivation, the present study tested whether the association between posttraumatic stress symptom severity and marijuana use coping motives is mediated by difficulties in emotion regulation. Participants were 79 (39 women; M age = 22.29 years, SD = 6.99) community-recruited adults who reported (1) lifetime exposure to at least one posttraumatic stress disorder Criterion A traumatic event and (2) marijuana use in the past 30 days. Results indicated that difficulties in emotion regulation, as indexed by the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004), fully mediated the association between posttraumatic stress symptom severity and marijuana use coping motives. Implications for the treatment of co-occurring posttraumatic stress and marijuana use are discussed.

The Role of Maladaptive Beliefs in Cognitive Behavioral Therapy: Evidence from Social Anxiety Disorder

Beliefs that are negatively biased, inaccurate, and rigid are thought to play a key role in the mood and anxiety disorders. Our goal in this study was to examine whether a change in maladaptive beliefs mediated the outcome of individual cognitive-behavioral therapy (CBT) for social anxiety disorder (SAD). In a sample of 47 individuals with SAD receiving CBT, we measured maladaptive interpersonal beliefs as well as emotional and behavioral components of social anxiety, both at baseline and after treatment completion. We found that (a) maladaptive interpersonal beliefs were associated with social anxiety at baseline and treatment completion; (b) maladaptive interpersonal beliefs were significantly reduced from baseline to treatment completion; and (c) treatment-related reductions in maladaptive interpersonal beliefs fully accounted for reductions in social anxiety after CBT. These results extend the literature by providing support for cognitive models of mental disorders, broadly, and SAD, specifically.

The interactive effects of emotional clarity and cognitive reappraisal in Posttraumatic Stress Disorder

The goal of this investigation was to examine how emotional clarity and a specific emotion regulation strategy, cognitive reappraisal, interact to predict Posttraumatic Stress Disorder (PTSD) symptom severity and positive affect among treatment seeking military Veterans (N=75, 93% male) diagnosed with PTSD. PTSD is a highly relevant context because PTSD features include heightened stress reactivity, diminished ability to differentiate and understand emotions, and reliance on maladaptive forms of emotion regulation. We found that the combination of high levels of emotional clarity and frequent use of cognitive reappraisal were associated with (a) lesser total PTSD severity after accounting for shared variance with positive affect and the extent to which emotions are attended to (attention to emotions), and (b) greater positive affect after accounting for shared variance with total PTSD severity and attention to emotions. This is the first study to demonstrate interactive effects of emotional clarity and cognitive reappraisal.

Changes in facets of mindfulness and posttraumatic stress disorder treatment outcome

Though there has been a recent surge of interest in the relations between facets of mindfulness and Posttraumatic Stress Disorder (PTSD), there has been a dearth of empirical studies investigating the impact of changes in facets of mindfulness on PTSD treatment outcomes. The present study tested the prospective associations between pre- to post-treatment changes in facets of mindfulness and PTSD and depression severity at treatment discharge, among 48 military Veterans in residential PTSD treatment adhering to a cognitive-behavioral framework. Together, changes in facets of mindfulness significantly explained post-treatment PTSD and depression severity (19-24% of variance). Changes in acting with awareness explained unique variance in post-treatment PTSD severity and changes in nonjudgmental acceptance explained unique variance in post-treatment depression severity. These results remained significant after adjusting for shared variance with length of treatment stay.

Posttraumatic stress disorder and cannabis use characteristics among military veterans with cannabis dependence.

BACKGROUND AND OBJECTIVES The present study is the first to explore links between PTSD and cannabis use characteristics immediately prior to a cannabis quit attempt, including motives, use problems, withdrawal, and craving. METHODS Measures of PTSD diagnosis, symptom severity, and cannabis use characteristics were administered to a sample of cannabis dependent military veterans (n = 94). Hypotheses were tested with a series of analyses of variance and covariance and hierarchical multiple regressions with Bonferroni corrections. Analyses were conducted with and without adjusting for variance shared with substance use (cannabis, alcohol, tobacco) in the previous 90 days, and co-occurring mood, anxiety, and substance use diagnoses. RESULTS AND CONCLUSIONS Compared to participants without PTSD, participants with PTSD reported significantly increased: (a) use of cannabis to cope, (b) severity of cannabis withdrawal, and (c) experiences of craving related to compulsivity, emotionality, and anticipation, with findings regarding coping and craving remaining significant after adjusting for covariates. Among the total sample, PTSD symptom severity was positively associated with (a) use of cannabis to cope, (b) cannabis use problems, (c) severity of cannabis withdrawal, and (d) experiences of craving related to compulsivity and emotionality, with findings regarding withdrawal and emotion-related craving remaining significant after adjusting for covariates. Thus, links between PTSD and using cannabis to cope, severity of cannabis withdrawal, and especially craving appear robust across measures of PTSD and analytical method. SCIENTIFIC SIGNIFICANCE The results of this study provide support for models that posit a pernicious feedback loop between PTSD symptomatology and cannabis use.

Facets of emotional awareness and associations with emotion regulation and depression.

Emotion theories posit that effective emotion regulation depends upon the nuanced information provided by emotional awareness; attending to and understanding ones own emotions. Additionally, the strong associations between facets of emotional awareness and various forms of psychopathology may be partially attributable to associations with emotion regulation. These logically compelling hypotheses are largely uninvestigated, including which facets compose emotional awareness and how they relate to emotion regulation strategies and psychopathology. We used exploratory structural equation modeling of individual difference measures among a large adult sample (n = 919) recruited online. Results distinguished 4 facets of emotional awareness (type clarity, source clarity, involuntary attention to emotion, and voluntary attention to emotion) that were differentially associated with expressive suppression, acceptance of emotions, and cognitive reappraisal. Facets were associated with depression both directly and indirectly via associations with emotion regulation strategies. We discuss implications for theory and research on emotional awareness, emotion regulation, and psychopathology.

Are emotional clarity and emotion differentiation related

Distinct literatures have developed regarding the constructs of emotional clarity (peoples meta-knowledge of their affective experience) and emotion differentiation (peoples ability to differentiate affective experience into discrete categories, e.g., anger vs. fear). Conceptually, emotion differentiation processes might be expected to contribute to increased emotional clarity. However, the relation between emotional clarity and emotion differentiation has not been directly investigated. In two studies with independent, undergraduate student samples, we measured emotional clarity using a self-report measure and derived emotion differentiation scores from scenario-based (Study 1) and event-sampling-based (Study 2) measures of affect. We found that emotional clarity and emotion differentiation are: (i) associated to a very small and statistically insignificant degree; and (ii) differentially associated with trait and scenario-based/event-sampling-based measures of affect intensity and variability. These results suggest that emotional clarity and differentiation are distinct constructs with unique relations to various facets of affective experience.

A longitudinal test of the bi-directional relations between avoidance coping and PTSD severity during and after PTSD treatment

Avoidance coping and symptoms of posttraumatic stress disorder (PTSD) covary. However, relatively little research has examined the bi-directional relation between these constructs among individuals in treatment for PTSD. The current longitudinal study examined the reciprocal associations between avoidance coping and PTSD symptom severity during and after residential PTSD treatment among a sample of 1073 military veterans (88.9% male; M(age) = 52.39 years) with chronic, treatment-resistant PTSD. Greater avoidance coping at intake predicted more severe PTSD symptoms at discharge, and severity of PTSD symptoms at discharge predicted increased avoidance at follow-up. Conversely, PTSD symptom severity at intake was not related to avoidance coping at discharge, and in turn avoidance coping at discharge was not related to PTSD symptom severity at follow-up. These findings offer a number of important clinical implications including evidence suggesting avoidance may predict poorer treatment response among individuals seeking treatment for chronic PTSD, and that greater end-of-treatment PTSD symptom severity may predict increased avoidance following treatment.

Poor sleep quality as a risk factor for lapse following a cannabis quit attempt

Treatments for cannabis dependence are associated with high rates of lapse/relapse, underscoring the importance of identifying malleable risk factors that are associated with quit failure. Whereas research has demonstrated that poor sleep quality following cannabis discontinuation is related to subsequent use, there has yet to be an examination of whether poor sleep quality prior to a quit attempt results in a similar pattern of lapse. The present study addressed this gap by examining the role of pre-quit sleep quality on early lapse to cannabis use following a self-guided quit attempt, among 55 cannabis dependent military veterans. Results indicated that participants who experienced poor pre-quit sleep quality had greater risk for lapse within the first 2 days (out of 7) following their quit attempt. Findings are discussed in terms of improving treatments for individuals who report poor sleep quality prior to a cannabis quit attempt.