Anxiety mediates the association between cannabis use and attenuated positive psychotic symptoms

Cannabis use has been associated with a continuum of psychotic experiences. However, it is unclear whether mood and anxiety symptoms account for increases in attenuated positive psychotic symptoms (APPS) among cannabis users. We predicted that depression and anxiety symptoms would mediate the relation between cannabis use and APPS, and between cannabis use and endorsement of eight or more distressing APPS (D-APPS), a potentially more clinically meaningful group. Young adults (n=674) completed the Prodromal Questionnaire (PQ); Drug Use Frequency measure; Center for Epidemiologic Studies Depression Scale; State-Trait Anxiety Inventory, Trait Form, Anxiety Subscale; and Social Phobia Scale. Results indicated that symptoms of trait anxiety, but not symptoms of depression or social anxiety, mediated the relationship between cannabis use and APPS, as well as the relationship between cannabis use and D-APPS. Results indicate that symptoms of trait anxiety may play a role in the relation between cannabis use and APPS. Findings underscore the importance of considering clinical characteristics co-occurring with psychotic symptoms, such as affective symptoms, when examining the association between cannabis use and psychotic symptoms.