The moderating role of experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and cannabis dependence

Bordieri, Michael J.; Tull, Matthew T.; McDermott, Michael J.; Gratz, Kim L.

doi:10.1016/j.jcbs.2014.08.005

Cited by 40 publications

(16 citation statements)

References 55 publications

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“…In a study of statistics anxiety, willingness to experience anxiety buffered the effect anxiety had on statistics exam performance (Sandoz, Butcher, & Protti, 2017). Further, in two studies of PTSD, avoidance exacerbated PTSD's link with impulsive behaviors (Bordieri, Tull, McDermott, & Gratz, 2014;Gratz & Tull, 2012). Findings from these studies support the moderating role of non-acceptance: Accepting distress facilitates goal attainment and non-acceptance inhibits it.…”

Section: Cognitive Fusion and Goal Dysregulationmentioning

confidence: 88%

Cognitive fusion and post-trauma functioning in veterans: Examining the mediating roles of emotion dysregulation

Cox

Motl

Bakker

et al. 2018

Journal of Contextual Behavioral Science

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When cognitively fused, people have difficulty accepting and clearly perceiving their internal experiences. Following trauma, emotional non-acceptance and emotional non-clarity have been associated with post-trauma functioning. The aim of the present study was to integrate theory and research on cognitive fusion and posttrauma functioning to evaluate a theory-based model in which emotion dysregulation-specifically, emotional non-acceptance and emotional non-clarity-mediated the association between cognitive fusion and post-trauma functioning in a veteran sample. Participants were 149 veterans with a history of military-related trauma. Veterans completed measures of cognitive fusion, emotion dysregulation, posttraumatic stress disorder (PTSD) symptoms, and life satisfaction. Overall, emotion dysregulation and PTSD symptoms mediated the fusion-posttrauma functioning association in theoretically consistent ways. More specifically, fusion was related to PTSD through emotional non-clarity and fusion was related to goal dysregulation through emotional non-acceptance and PTSD. Our findings indicate that fusion impacts different aspects of post-trauma functioning through different mediators. How these different pathways could impact clinical decision making are discussed.

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Section: Cognitive Fusion and Goal Dysregulationmentioning

confidence: 88%

Cognitive fusion and post-trauma functioning in veterans: Examining the mediating roles of emotion dysregulation

Cox

Motl

Bakker

et al. 2018

Journal of Contextual Behavioral Science

View full text Add to dashboard Cite

show abstract

“…Research by Bonn-Miller and colleagues has shown that PTSD symptom severity is positively related to the use of marijuana to cope with negative internal experiences (Bonn-Miller et al, 2007; 2011), and a recent study by Bordieri et al (2014) revealed a positive association between PTSD symptom severity and marijuana dependence only among individuals with average to high levels of experiential avoidance (i.e., the tendency to avoid unwanted internal experiences; Hayes et al, 1996). If our findings are due to heightened emotional avoidance among marijuana dependent patients with PTSD, such disruptions in the emotional processing of fear-relevant information may ultimately inhibit extinction of the fear and anxiety response among these individuals, contributing to the maintenance of PTSD (Foa and Kozak, 1986; Rauch and Foa, 2006).…”

Section: Discussionmentioning

confidence: 99%

Marijuana dependence moderates the effect of posttraumatic stress disorder on trauma cue reactivity in substance dependent patients

Tull

McDermott

Gratz

2016

Drug and Alcohol Dependence

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Background Individuals with posttraumatic stress disorder (PTSD) are at heightened risk for marijuana use. Although extant studies speak to the importance of examining the co-occurrence of PTSD and marijuana use as it relates to a variety of clinically-relevant outcomes, no studies have explored the way in which marijuana use may affect in-the-moment emotional responding among individuals with PTSD. Thus, the purpose of this study was to explore the role of marijuana dependence in the relation between PTSD and subjective and biological emotional reactivity in response to a trauma cue. Methods Participants were 202 patients with and without current PTSD consecutively admitted to a residential SUD treatment facility. Patients were administered diagnostic interviews, and subjective (negative affect) and biological (cortisol) reactivity to a personalized trauma cue were assessed. Results Whereas current PTSD was associated with greater subjective emotional reactivity among participants without marijuana dependence, there were no significant differences in subjective emotional reactivity as a function of PTSD status among participants with marijuana dependence. Moreover, marijuana dependent participants (with and without PTSD) reported less subjective emotional reactivity than participants with PTSD and without marijuana dependence. No significant findings were obtained for cortisol reactivity. Conclusions Findings suggest that patients with co-occurring PTSD and marijuana dependence may experience alterations in their emotional processing in response to a trauma cue (i.e., dampening of arousal). Additional research is required to clarify the specific mechanisms through which marijuana use influences emotional reactivity and fear-related emotional processing, as well as how such effects may influence PTSD treatment.

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“…There is some evidence linking avoidance, PTSD, and marijuana use. Experiential avoidance (the tendency to avoid aversive internal experiences) moderates the relationship between PTSD severity and marijuana dependence (Bordieri, Tull, McDermott, & Gratz, ), while emotional distress tolerance (Potter et al., ) and nonjudgmental acceptance (similar to mindfulness, essentially the opposite of avoidance; Bonn‐Miller, Vujanovic, & Twohig, ) mediate the relationship between PTSD symptoms and marijuana use. If marijuana use does serve an avoidance function, symptom improvement will, theoretically, be temporary at best and will stymie emotional processing putatively necessary for recovery.…”

Section: Potential Harmful Psychiatric Effects Of Regular Marijuana Usementioning

confidence: 99%

Marijuana and other cannabinoids as a treatment for posttraumatic stress disorder: A literature review

et al. 2017

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Posttraumatic stress disorder (PTSD) is common in the general population, yet there are limitations to the effectiveness, tolerability, and acceptability of available first-line interventions. We review the extant knowledge on the effects of marijuana and other cannabinoids on PTSD. Potential therapeutic effects of these agents may largely derive from actions on the endocannabinoid system and we review major animal and human findings in this area. Preclinical and clinical studies generally support the biological plausibility for cannabinoids' potential therapeutic effects, but underscore heterogeneity in outcomes depending on dose, chemotype, and individual variation. Treatment outcome studies of whole plant marijuana and related cannabinoids on PTSD are limited and not methodologically rigorous, precluding conclusions about their potential therapeutic effects. Reported benefits for nightmares and sleep (particularly with synthetic cannabinoid nabilone) substantiate larger controlled trials to determine effectiveness and tolerability. Of concern, marijuana use has been linked to adverse psychiatric outcomes, including conditions commonly comorbid with PTSD such as depression, anxiety, psychosis, and substance misuse. Available evidence is stronger for marijuana's harmful effects on the development of psychosis and substance misuse than for the development of depression and anxiety. Marijuana use is also associated with worse treatment outcomes in naturalistic studies, and with maladaptive coping styles that may maintain PTSD symptoms. Known risks of marijuana thus currently outweigh unknown benefits for PTSD. Although controlled research on marijuana and other cannabinoids' effects on PTSD remains limited, rapid shifts in the legal landscape may now enable such studies, potentially opening new avenues in PTSD treatment research.

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The moderating role of experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and cannabis dependence

Cited by 40 publications

References 55 publications

Cognitive fusion and post-trauma functioning in veterans: Examining the mediating roles of emotion dysregulation

Cognitive fusion and post-trauma functioning in veterans: Examining the mediating roles of emotion dysregulation

Marijuana dependence moderates the effect of posttraumatic stress disorder on trauma cue reactivity in substance dependent patients

Marijuana and other cannabinoids as a treatment for posttraumatic stress disorder: A literature review

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