A reinforcer pathology approach to cannabis misuse: Evaluation of independent and interactive roles of cannabis demand and delay discounting in a sample of community adults.

Abstract

Cannabis use is prevalent and concerns about cannabis misuse are increasing. A reinforcer pathology approach emphasizes the roles of drug reinforcing value (demand) and overvaluation of immediate rewards (delay discounting [DD]) in drug use but has been applied to a lesser extent to cannabis. The present study investigated the independent and interactive roles of these processes in relation to cannabis misuse in a community sample of adult cannabis users (N = 324; 44.8% female; Mage = 33.25). Participants completed a Marijuana Purchase Task (MPT), the Monetary Choice Questionnaire (MCQ), and the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) to assess demand, DD, and cannabis misuse, respectively. Zero-order correlations revealed significant associations between CUDIT-R scores and both the demand indices (|rs | = .21–.56, p < .01–.001) and DD (r = .21, p < .01). In multivariate analyses, lower elasticity (i.e., price insensitivity) was robustly associated with higher CUDIT-R scores, while other demand indicators did not explain additional unique variance. However, as elasticity, intensity, and Omax exhibited robust zero-order intercorrelations, shared variance appeared to drive the association. An interactive relationship between elasticity and DD was not significant. These findings indicate that cannabis misuse is associated with both cannabis demand, particularly as measured by insensitivity to escalating costs, and immediate reward orientation, but the relationship was not synergistic. These results support a reinforcer pathology approach to cannabis misuse and, although causality cannot be inferred cross-sectionally, suggest that evaluating the longitudinal significance of these indicators is warranted. Public Significance Statement—Using a reinforcer pathology framework, the present study reveals that an overvaluation of cannabis (demand) and devaluation of future rewards (delay discounting) have independent, additive associations with hazardous cannabis use. Results of the study support the utility of the application of this framework to cannabis misuse, warranting further investigation into longitudinal and clinical significance. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Publication Title

Experimental and Clinical Psychopharmacology

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