Associations between posttraumatic cognitions and cannabis cravings among trauma-exposed individuals using cannabis

Trauma-exposed individuals with posttraumatic stress disorder (PTSD) symptoms are at risk for problematic cannabis use. However, modifiable risk factors associated with cannabis use in this population are less clear. Posttraumatic cognitions (PTC; negative cognitions about the self, self-blame, and negative cognitions about the world) have recently been investigated as potential motivators for substance use, particularly to cope with distress, but extant research is limited. The current study tested whether PTC are associated with increased coping-oriented cannabis cravings using an experimental design (i.e., trauma script-driven imagery).

Trauma-exposed cannabis users (N = 56; 58.9% female; M_age = 20.69 years; White: 73.2%, Black: 21.4%) self-reported PTC and cannabis use frequency and were assessed for PTSD diagnosis. State cravings to use cannabis to cope with negative emotions were assessed before and after trauma script-driven imagery.

After covarying for cannabis use frequency and PTSD diagnosis, elevated PTC were significantly associated with increased state cravings to use cannabis to cope with negative emotions (β = .19, t(46) = 2.32, p = .025, sr² = .02). Of PTC subscales, only higher negative cognitions about the self were significantly associated with increased state cannabis cravings (β = .19, t(46) = 2.34, p = .024, sr² = .03), while self-blame and negative cognitions about the world were not.

Elevated PTC, particularly about the self, may enhance cannabis cravings in response to trauma cues. Future research may include investigating associations between PTC and cannabis use in naturalistic environments outside of the laboratory setting.