Difficulties in emotion regulation are associated with panic symptom severity following a quit attempt among cannabis dependent veterans

Abstract

Background and Objectives: Prior research suggests that difficulties in emotion regulation are associated with elevations in panic symptoms. The present study aimed to extend this work by prospectively examining the relation between difficulties in emotion regulation and panic symptoms over the course of a self-guided cannabis cessation attempt. Design and Method: One hundred and four cannabis-dependent military veterans participated in the study. Difficulties in emotion regulation and panic symptoms were assessed at baseline and at each week during a four-week cessation attempt for a total of five time-points. Results: Fewer difficulties in emotion regulation were associated with a greater reduction in panic symptoms during the self-guided cannabis cessation period. Results remained significant after statistically adjusting for mean substance use (i.e., cannabis, alcohol, and tobacco) during the study period. Conclusions: Results are discussed in terms of integrating adaptive emotion regulation skills training into existing evidence-based treatments for cannabis dependence.

Keywords:

• emotion regulation
• panic
• cannabis
• marijuana
• cessation

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Notes

1. We also conducted analyses using an alternative scoring method for the DERS, in which the awareness subscale was removed from the total score (Bardeen, Fergus, & Orcutt, 2012). Results were unchanged. We found a significant intercept (β = 0.75; SE = 0.04, Z = 19.33, p < .001), and a significant linear slope (β = 0.03; SE = 0.01, Z = 2.41, p = .03). However, a non-significant quadratic slope (β = −0.00; SE = 0.01, Z = −0.91, p = .36) was observed. In addition, consistent with the primary analysis, we found that difficulties in emotion regulation had a significant main effect (β = 0.00; SE = 0.00, Z = 9.32, p < .001), and significant interaction with the linear (β = −0.00; SE = 0.00, Z = −2.26, p = .05), but not quadratic slope (β = 0.00; SE = 0.00, Z = 1.29, p = .19).

2. Results remained consistent after adjusting for covariates over the cessation attempt (i.e., substance use [cannabis, alcohol, and tobacco]). In terms of difficulties in emotion regulation, we found a significant intercept (β = 0.68; SE = 0.05, Z = 14.52, p < .001), and a significant linear slope (β = 0.97; SE = 0.45, Z = 2.13, p = .03). However, a non-significant quadratic slope (β = −0.02; SE = 0.01, Z = −1.49, p = .13) was observed. In addition, consistent with the primary analysis, we found that difficulties in emotion regulation had a significant main effect (β = 0.00; SE = 0.00, Z = 8.74, p < .001), and significant interaction with the linear (β = −0.00; SE = 0.00, Z = −2.26, p = .02) but not quadratic slope (β = 0.00; SE = 0.00, Z = 1.50, p = .13).

Additional information

Funding

Support for this research was provided by a VA Clinical Science Research and Development (CSR&D) Career Development Award – 2 granted to Dr. Bonn-Miller, and VA Health Services Research and Development (HSR&D) service funds provided to Dr. Babson. These funding sources had no other roles other than financial support. The expressed views do not necessarily represent those of the Department of Veterans Affairs.