Problematic cannabis use and attachment insecurities as Joint predictors of Depression: Cross-Sectional and...

Cannabis use, depression, and attachment insecurities (anxiety, avoidance) have been previously linked, though typically examined using bivariate methods. This study tested cross-sectional and longitudinal associations among these constructs, assessing whether problematic cannabis use contributes to depression, and whether attachment insecurities exacerbate this effect. Data were collected from 1,745 Jewish Israeli adults at two timepoints (2024 = T1; 2025 = T2) of whom 412 reported lifetime cannabis use. Problematic cannabis use, depression, and attachments insecurities were assessed with the ASSIST, PHQ-9 and ECR ,respectively. Analyses in the full sample examined the full range of cannabis involvement, including no use, and in the lifetime-user subsample the impact of problematic use severity. Cross-sectional models at T1 and T2 tested whether depressive symptoms were predicted by problematic cannabis use and moderated by attachment anxiety and avoidance. A longitudinal model examined whether problematic cannabis use and attachment insecurities at T1 predicted changes in depression from T1 to T2. At both timepoints, attachment anxiety significantly moderated the cannabis-depression association (p = 0.013 at T1, p = 0.002 at T2), with a stronger link at higher anxiety levels. Similar patterns appeared in the lifetime-user subsample. Longitudinally, a significant three-way interaction (p = 0.014) indicated that increases in depression were greatest among individuals high in both anxiety and avoidance, while avoidance buffered this effect among users. Attachment insecurities are key vulnerability factors that intensify the depressive impact of problematic cannabis use. These findings underscore the importance of developing clinical interventions targeting both substance use and attachment-related vulnerabilities and emotional dysregulation.