Distress tolerance and cannabis craving: The impact of laboratory-induced distress.

Abstract

Low levels of distress tolerance have been identified as an important vulnerability factor for negative cannabis outcomes. The current study is the first known experimental manipulation of state distress to test whether distress tolerance interacts with state distress to predict urge to use cannabis. Current cannabis users (N = 126; 88.9% with cannabis use disorder; 54.0% non-Hispanic Caucasian) were randomly assigned to a distress task condition or neutral (reading) task condition. Participants in the two conditions did not differ on distress tolerance, negative affect (NA), or craving at baseline. The distress tolerance X condition interaction significantly predicted task NA, such that low (but not high) distress tolerance was related to greater state NA throughout the task. The distress tolerance X condition interaction significantly predicted cannabis craving during the task, such that the distress condition was related to greater cannabis craving at lower (but not higher) levels of distress tolerance. In the distress condition, those who endorsed coping motives during the task reported lower distress tolerance. Together, these findings suggest that individuals with lower distress tolerance experienced greater NA during a laboratory-induced distress and reported greater cannabis craving when NA was greatest during the task. This experimental study adds to a growing, but limited, literature implicating lower levels of distress tolerance to the maintenance and relapse of cannabis use.

Impact of a computerized distress intolerance intervention on electrocortical reactivity to cannabis and threat cues: A randomized controlled trial.

“…Researchers have theorized that elevated DI amplifies an individual's reactivity to negatively-valenced and relief stimuli in the context of acute stress (McHugh & Otto, 2012). In line with this perspective, elevated DI has been linked with acute stress potentiation of attention bias to negatively-valenced stimuli (Macatee, McDermott, et al, 2018), persistent negative emotional responding to an acute stressor (Albanese et al, 2021;Cougle et al, 2011), and cannabis craving in the context of acute stress (Buckner et al, 2019). Further, neurobiological studies in substance users have revealed altered activity in corticolimbic regions involved in attentional control/affective salience among those who persisted for less time on a distressing laboratory task and reported greater substance use after treatment (Daughters et al, 2017;Reese et al, 2019).…”

A Mini-Review of Relationships Between Cannabis Use and Neural Foundations of Reward Processing, Inhibitory Control and Working Memory

“…One aspect of cognition that may be specifically relevant to individuals with CUD and may supplement the dual-process model of addiction is emotional regulation. Negative affect is associated with craving for cannabis (101), and stress induced by lab-based social tasks has elicited craving for cannabis in people with CUD (102), particularly among people with low distress tolerance (103). Many individuals report using to alleviate distress (104), and edible CBD consumption may reduce social anxiety (105).…”

Using a transdiagnostic approach to examine the associations among internalizing symptoms, emotion regulation, and distress tolerance

“…Moreover, ER and DT have been acknowledged as influential factors in how individuals respond to stressful situations. For instance, using unhelpful ER strategies (e.g., brooding, rumination; Lewis et al, 2018) or having difficulty tolerating distress (e.g., Buckner et al, 2019) has been individually linked to higher levels of state distress, measured by participants’ ratings (i.e., SUDS) of how nervous or stressed they felt before, during, and immediately after completing a stress-inducing task under experimental conditions. Thus, exploring their interrelationship across internalizing symptoms is crucial.…”