Aim
Cannabis use is associated with greater likelihood of psychosis. The relationship between attitudes about cannabis and use has not been examined in youth at clinical high‐risk (CHR) for psychosis. Additionally, the shifting legal landscape can provide a valuable context for evaluating use and related attitudes.
Methods
This study included 174 participants (44 CHR, 43 healthy control [HC] youth‐parent dyads). Youth completed measures of self‐reported cannabis use confirmed with a urinalysis, self‐perceived risk and perceived peer attitudes. Parents reported attitudes about youth use. Legalization occurred halfway during a 5‐year study in Colorado, providing an opportunity to cross‐sectionally examine its role in use and attitudes.
Results
Frequency of youth reporting cannabis use was significantly higher in CHR (69%) than control group (30%). Use in CHR group was associated with higher perceived peer approval (r = .57), increased parental permissiveness (r = .28) and lower self‐perceived risk (r = −.26). Comparing samples participating pre and post‐legalization, use remained stable within each group. Group differences in parental permissiveness shifted; trend toward decrease in permissiveness in CHR group (η2partial = .07) and a significant increase in HCs (η2partial = .16) were observed. Post‐legalization, use in CHR group correlated with higher perceived peer approval (r = .64), lower self‐perceived risk (r = −.51) and higher parental permissiveness (r = .35, trend).
Conclusions
Taken together, results indicate a relationship between self and peer/parental attitudes about cannabis and use in youth at CHR for psychosis. These factors are important to consider within the legalization context given the changes in parental attitudes and a stronger association between use and attitudes in this group post‐legalization.