Post-traumatic stress and marijuana outcomes: The mediating role of marijuana protective behavioral strategies

Abstract

Background: The present study investigated the mediating role of protective behavioral strategies for marijuana (PBSM) on the relationship between posttraumatic stress disorder (PTSD) and marijuana outcomes (i.e. marijuana use frequency, marijuana use quantity, cannabis use disorder (CUD) symptoms, and marijuana-related problems). Methods: Participants were 1,107 traditional age college students (M_age = 20.26, SD = 3.32; 66.5% White, non-Hispanic; 68.8% female), who reported consuming marijuana at least once in the last 30 days and completed measures of PTSD symptoms, PBSM, and marijuana-related outcomes. Results: PBSM significantly mediated the positive relationships between PTSD symptoms and both CUD symptoms and marijuana-related problems. More specifically, PTSD symptoms were negatively associated with PBSM, which in turn was negatively associated with marijuana use frequency and marijuana use quantity, which were in turn positively associated with CUD symptoms and marijuana-related problems. Conclusion: Taken together, the associations between higher PTSD symptoms and greater experience of CUD symptoms and marijuana-related problems may occur because students use fewer PBSM and thus engage in larger quantity and frequency of marijuana use. These findings lend support to the utility of targeting PBSM as a harm reduction effort for students with PTSD symptoms who use marijuana.

Keywords:

• College students
• marijuana protective behavioral strategies
• posttraumatic stress disorder
• marijuana

Author contributions

HRJ wrote the introduction, parts of the discussion and the abstract, and edited the first draft of the manuscript. MBM wrote part of the discussion section and edited other sections of the first draft. HRJ and MBM conceptualized the research questions. AJB conducted the analyses, drafted the method, statistical analyses, and results sections (including tables), and edited the first draft. MRP assisted with the statistical analyses and edited the introduction, method, results, and discussion sections of the first draft. The entire team (Protective Strategies Study Team) selected the measures in the assessment battery and collected all data. All authors contributed to and approved the final manuscript.

Additional information

Funding

AJB is supported by a training grant (T32AA018108) from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in the United States. MRP is supported by a career development grant (K01AA023233) from the NIAAA. The NIAAA had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.