%0 Journal Article %J J Subst Abuse Treat %D 2015 %T Maintenance Check-ups Following Treatment for Cannabis Dependence. %A Walker, Denise D %A Stephens, Robert S %A Towe, Sheri %A Banes, Kelsey %A Roffman, Roger %K Adult %K Cognitive Therapy %K Continuity of Patient Care %K Female %K Follow-Up Studies %K Humans %K Male %K Marijuana Abuse %K Middle Aged %K Motivational Interviewing %K Random Allocation %K Treatment Outcome %X

Substance use disorders, including cannabis use disorders and associated negative consequences, are best considered chronic and in need of continuing care. In contrast, most treatment efficacy studies evaluate a fixed number of intervention sessions at a single point in time. The present study evaluated the efficacy of posttreatment maintenance check-ups (MCUs) in maintaining and improving outcomes following nine sessions of motivational enhancement treatment/cognitive behavioral treatment (MET/CBT). Adults dependent on cannabis (n=74) were randomly assigned to the MCU or a no check-up (NCU) condition and followed up at 3- and 9-months. MCU sessions occurred 1 and 4months following the completion of the base treatment. Additional MET/CBT sessions were available to participants throughout the follow-up period. The MCUs specifically encouraged treatment re-entry for those showing ongoing signs of disorder. Participants in the MCU condition reported significantly greater abstinent rates at both follow-ups and were using on fewer days at the 3-month but not the 9-month follow-up. Contrary to hypotheses, MCU participants did not attend more additional treatment and differences in rates of cannabis use emerged prior to the first MCU session. Future research with longer follow-up periods and longer monitoring of outcomes is needed to fully evaluate the utility of MCUs or other forms of continuing care.

%B J Subst Abuse Treat %V 56 %P 11-5 %8 2015 Sep %G eng %R 10.1016/j.jsat.2015.03.006 %0 Journal Article %J Addict Behav %D 2014 %T Situational determinants of use and treatment outcomes in marijuana dependent adults. %A Blevins, Claire E %A Stephens, Robert S %A Walker, Denise D %A Roffman, Roger A %K Adaptation, Psychological %K Adult %K Cognitive Therapy %K Female %K Humans %K Male %K Marijuana Abuse %K Motivation %K Regression Analysis %K Risk Factors %K Self Efficacy %K Treatment Outcome %X

Research and theory strongly support the importance of situational determinants of substance use as targets for intervention, but few studies have systematically examined situational use characteristics in marijuana dependent adults. The present study describes situational use of marijuana in a population of 87 marijuana dependent adults and reports relationships with outcomes of treatment. Use in negative affective situations was independently associated with psychological distress, maladaptive coping strategies, lower self-efficacy, and poorer outcomes post-treatment. The findings were consistent with research on using drugs to cope with negative affect providing evidence of convergence between two different methods of assessing high risk situations for substance use. The results support continued emphasis on coping with negative affect as a target in treatments for marijuana dependence.

%B Addict Behav %V 39 %P 546-52 %8 2014 Mar %G eng %N 3 %R 10.1016/j.addbeh.2013.10.031 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Motives for cannabis use in high-risk adolescent users. %A Fox, Courtney L %A Towe, Sheri L %A Stephens, Robert S %A Walker, Denise D %A Roffman, Roger A %K Adaptation, Psychological %K Adolescent %K Female %K Humans %K Male %K Marijuana Abuse %K Marijuana Smoking %K Motivation %K Risk Factors %X

The present investigation examined the relationships between motives for cannabis use and negative consequences associated with cannabis use following a brief intervention. The sample consisted of 205 adolescent cannabis users (66.3% male), who were recruited in high schools and randomly assigned to a brief two-session motivational enhancement therapy (MET) or an educational feedback control (EFC). Results supported the hypothesis that using cannabis to cope with negative affect would predict the number of problems and dependence symptoms related to cannabis use, after controlling for age, gender, years and frequency of cannabis use, and internalizing and externalizing behavior problems. Significant interactions between internalizing behavior problems and the coping motive showed that using to cope was associated with a higher number of cannabis dependence symptoms among adolescents reporting lower levels internalizing behavior problems. Findings support the potential utility of conducting further research to explore the coping motive as an important indicator of problematic cannabis use.

%B Psychol Addict Behav %V 25 %P 492-500 %8 2011 Sep %G eng %N 3 %R 10.1037/a0024331 %0 Journal Article %J Psychol Addict Behav %D 2011 %T Social norms and self-efficacy among heavy using adolescent marijuana smokers. %A Walker, Denise D %A Neighbors, Clayton %A Rodriguez, Lindsey M %A Stephens, Robert S %A Roffman, Roger A %K Adolescent %K Adolescent Behavior %K Cross-Sectional Studies %K Diagnostic and Statistical Manual of Mental Disorders %K Female %K Health Behavior %K Humans %K Male %K Marijuana Abuse %K Marijuana Smoking %K Models, Psychological %K Peer Group %K Randomized Controlled Trials as Topic %K Self Efficacy %K Self Report %K Social Conformity %K Social Facilitation %K Young Adult %X

Adolescence is a time in which individuals are particularly likely to engage in health-risk behaviors, with marijuana being the most prevalent illicit drug used. Perceptions of others' use (i.e., norms) have previously been found to be related to increased marijuana use. Additionally, low refusal self-efficacy has been associated with increased marijuana consumption. This cross-sectional study examined the effects of normative perceptions and self-efficacy on negative marijuana outcomes for a heavy using adolescent population. A structural equation model was tested and supported such that significant indirect paths were present from descriptive norms to marijuana outcomes through self-efficacy. Implications for prevention and intervention with heavy using adolescent marijuana users are discussed.

%B Psychol Addict Behav %V 25 %P 727-32 %8 2011 Dec %G eng %N 4 %R 10.1037/a0024958