Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories?

S DeGrace*, P Romero-Sanchiz, P Tibbo, S Barrett, P Arenella, T Cosman, P Atasoy, J Cousijn, R Wiers, M T Keough, I Yakovenko, R O'Connor, J Wardell, A Rudnick, R Nicholas Carleton, A Heber, S H Stewart

*Corresponding author for this work

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Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = .36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = .19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.

Original languageEnglish
Article number104387
JournalBehaviour Research and Therapy
Publication statusPublished - Oct 2023

Bibliographical note

Funding Information:
This work was supported through a Cannabis and Mental Health Catalyst Grant (Principal Investigator: SHS) from the Mental Health Commission of Canada and by a grant (Principal Investigator: SD) from the Nova Scotia Health Research Fund . SD is supported by graduate studentships from the Chronic Pain Centre of Excellence for Canadian Veterans' Capacity Building Initiative , the L’Oréal-UNESCO & France-Canada Research Fund for Women in Science Scholarship , and the Dalhousie Medical Research Foundation's MacQuarrie Neuroscience Research Graduate Studentship . TC was funded through a summer studentship from the Dalhousie University Department of Psychiatry Research Fund . PT is supported thru the Dr Paul Janssen Chair in Psychotic Disorders , Dalhousie University , Halifax, NS. SHS is supported through a Tier 1 Canada Research Chair in Addictions and Mental Health .

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© 2023 The Author(s)

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