Intensive Longitudinal Assessment of Cannabis use and Related Experiences

Thesis (Ph.D.)--University of Washington, 2020Cannabis misuse is a behavior associated with substantial negative life outcomes and is a growing public health concern. Epidemiology indicates cannabis misuse peaks during young adulthood, which has been identified as an important developmental period for intervention. Many young adults use cannabis to cope with unpleasant momentary experiences, and those who do frequently experience more substantial negative cannabis-related and mental health consequences. Based on behavioral theory, and the allostatic model (or self-medication hypothesis), recently developed effective treatments for substance misuse have focused on improving craving management by adjusting peoples' avoidant relationship with unpleasant momentary experiences such as craving and negative affect. Despite demonstrated effectiveness, there is limited empirical evidence to support craving management as a hypothesized mechanism of action for mindfulness-based treatments. The present dissertation project addresses this gap in the literature with a systematic review and two empirical research studies. The review compiles existing scientific research on the association between mindfulness, a primary hypothesized moderator of craving, and psychiatric outcomes. The first study investigates the longitudinal association between craving and use with single-time point assessment, and intensive longitudinal assessment. The second study explores dispositional and momentary factors as hypothesized moderators of the association between craving and use. Results from the present dissertation project carry significant import for future trials of treatments targeting craving and craving management. Findings indicate that intensive longitudinal assessment of craving may produce more valid results than single time-point assessment alone, and dispositional non- judgment of experience may moderate the association between momentary craving and subsequent use for problematic cannabis users