Reaching out towards cannabis: Approach-bias in heavy cannabis users predicts changes in cannabis use

Janna Cousijn, Anna E Goudriaan, Reinout W Wiers

Research output: Contribution to journalArticleAcademicpeer-review

162 Citations (Scopus)


AIMS: Repeated drug exposure can lead to an approach-bias, i.e. the relatively automatically triggered tendencies to approach rather that avoid drug-related stimuli. Our main aim was to study this approach-bias in heavy cannabis users with the newly developed cannabis Approach Avoidance Task (cannabis-AAT) and to investigate the predictive relationship between an approach-bias for cannabis-related materials and levels of cannabis use, craving, and the course of cannabis use.

DESIGN, SETTINGS AND PARTICIPANTS: Cross-sectional assessment and six-month follow-up in 32 heavy cannabis users and 39 non-using controls.

MEASUREMENTS: Approach and avoidance action-tendencies towards cannabis and neutral images were assessed with the cannabis AAT. During the AAT, participants pulled or pushed a joystick in response to image orientation. To generate additional sense of approach or avoidance, pulling the joystick increased picture size while pushing decreased it. Craving was measured pre- and post-test with the multi-factorial Marijuana Craving Questionnaire (MCQ). Cannabis use frequencies and levels of dependence were measured at baseline and after a six-month follow-up.

FINDINGS: Heavy cannabis users demonstrated an approach-bias for cannabis images, as compared to controls. The approach-bias predicted changes in cannabis use at six-month follow-up. The pre-test MCQ emotionality and expectancy factor were associated negatively with the approach-bias. No effects were found on levels of cannabis dependence.

CONCLUSIONS: Heavy cannabis users with a strong approach-bias for cannabis are more likely to increase their cannabis use. This approach-bias could be used as a predictor of the course of cannabis use to identify individuals at risk from increasing cannabis use.

Original languageEnglish
Pages (from-to)1667-74
Number of pages8
Issue number9
Publication statusPublished - Sept 2011
Externally publishedYes

Bibliographical note

© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.


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