Posttraumatic stress disorder (PTSD) symptoms are related to a number of adverse consequences such as substance use and general medical conditions. The present longitudinal study seeks to find the longitudinal patterns of cannabis use as precursors of PTSD symptoms. Such information will serve as a guide for intervention programs for PTSD.
Methods
Growth mixture modeling was conducted to identify the cannabis use trajectory groups using a community sample of 674 participants (53% African Americans, 47% Hispanics of Puerto Rican decent; 60% females) from the Harlem Longitudinal Development Study. Logistic regression analyses were performed to examine the association between earlier trajectories of cannabis use (ages 14 to 36) and later symptoms of PTSD (at age 36) for the full model including the entire sample (N = 674) as well as the reduced model including only participants who had experienced a traumatic event (n = 205).
Results
Five trajectory groups of cannabis use were obtained. The chronic use group (full model: adjusted odds ratio [AOR] = 4.68, P < .01; reduced model: AOR = 4.27, P < .05), the late quitting group (full model: AOR = 6.18, P < .01; reduced model: AOR = 6.67, P < .01), and the moderate use group (full model: AOR = 3.97, P < .01; reduced model: AOR = 3.32, P < .05) were all associated with an increased likelihood of having PTSD symptoms at age 36 compared with the no use group.
Conclusions
The findings provide information that PTSD symptoms in the mid-30s can possibly be reduced by decreasing membership in the chronic cannabis use trajectory group, the late quitting trajectory group, and the moderate cannabis use trajectory group.
HolemanTC.The invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery. In: TanielianT, JaycoxLH, eds. Post-Traumatic Stress Disorder Among Adults. Santa Monica, CA: RAND Corporation; 2008:273.
2.
VlahovD, GaleaS, AhernJ, . Consumption of cigarettes, alcohol, and marijuana among New York City residents six months after the September 11 terrorist attacks. Am J Drug Alcohol Abuse.2004;30:385–407.
3.
PacellaML, HruskaB, DelahantyDL. The physical health consequences of PTSD and PTSD symptoms: a meta-analytic review. J Anxiety Disord.2013;27:33–46.
4.
Messman-MooreTL, WardRM, BrownAL. Substance use and PTSD symptoms impact the likelihood of rape and revictimization in college women. J Interpers Violence.2009;24:499–521.
5.
KhouryL, TangYL, BradleyB, CubellsJF, ResslerKJ. Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population. Depress Anxiety.2010;27:1077–1086.
6.
KingstonS, RaghavanC. The relationship of sexual abuse, early initiation of substance use, and adolescent trauma to PTSD. J Trauma Stress.2009;22:65–68.
7.
UllmanSE, NajdowskiCJ, FilipasHH. Child sexual abuse, post-traumatic stress disorder, and substance use: predictors of revictimization in adult sexual assault survivors. J Child Sex Abuse.2009;18:367–385.
8.
BrookJS, BrookDW, GordonAS, WhitemanM, CohenP. The psychological etiology of adolescent drug use: a family interactional approach. Genet Soc Gen Psychol Monogr.1990;116:111–267.
9.
WrightBRE, CaspiA, MoffittTE, SilvaPA. The effects of social ties on crime vary by criminal propensity: a life-course model of interdependence. Criminology.2001;39:321–348.
10.
Bonn-MillerMO, BabsonKA, VujanovicAA, FeldnerMT. Sleep problems and PTSD symptoms interact to predict marijuana use coping motives: a preliminary investigation. J Dual Diagn.2010;6:111–122.
11.
PotterCM, VujanovicAA, Marshall-BerenzEC, BernsteinA, Bonn-MillerMO. Posttraumatic stress and marijuana use coping motives: the mediating role of distress tolerance. J Anxiety Disord.2011;25:437–443.
12.
BucknerJD, ZvolenskyMJ, CrosbyRD, WonderlichSA, EckerAH, RichterA. Antecedents and consequences of cannabis use among racially diverse cannabis users: an analysis from ecological momentary assessment. Drug Alcohol Depend.2015;147:20–25.
13.
JohnsonSD, StrileyC, CottlerLB. The association of substance use disorders with trauma exposure and PTSD among African American drug users. Addict Behav.2006;31:2063–2073.
14.
Dell'OssoL, CarmassiC, MassimettiG, DaneluzzoE, Di TommasoS, RossiA. Full and partial PTSD among young adult survivors 10 months after the L'Aquila 2009 earthquake: gender differences. J Affect Disord.2011;131:79–83.
15.
RobertsAL, GilmanSE, BreslauJ, BreslauN, KoenenKC. Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med.2011;41:71–83.
16.
FeldnerMT, BabsonKA, ZvolenskyMJ. Smoking, traumatic event exposure, and post-traumatic stress: a critical review of the empirical literature. Clin Psychol Rev.2007;27:14–45.
17.
MartinD, MartinM, DellR, DavisC, GuerrieriK. Profile of incarcerated juveniles: comparison of male and female offenders. Adolescence.2008;43:607–622.
18.
FordJD, ElhaiJD, ConnorDF, FruehBC. Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. J Adolesc Health.2010;46:545–552.
19.
WalterKH, GunstadJ, HobfollSE. Self-control predicts later symptoms of posttraumatic stress disorder. Psychol Trauma.2010;2:97–101.
20.
CampbellDG, FelkerBL, LiuC-F, . Prevalence of depression–PTSD comorbidity: implications for clinical practice guidelines and primary care-based interventions. J Gen Intern Med.2007;22:711–718.
21.
LeeJY, BrookJS, FinchSJ, BrookDW. Pathways from victimization to substance use: post traumatic stress disorder as a mediator. Psychiatry Res.2016;237:153–158.
22.
KomarovskayaI, BrownAD, Galatzer-LevyIR, . Early physical victimization is a risk factor for posttraumatic stress disorder symptoms among Mississippi police and firefighter first responders to Hurricane Katrina. Psychol Trauma.2014;6:92–96.
23.
BrookJS, LeeJY, FinchSJ, SeltzerN, BrookDW. Adult work commitment, financial stability, and social environment as related to trajectories of marijuana use beginning in adolescence. Subst Abus.2013;34:298–305.
24.
LeeJY, BrookJS, FinchSJ, BrookDW. Trajectories of cigarette smoking beginning in adolescence predict insomnia in the mid thirties. Subst Use Misuse.2016;51:616–624.
25.
HuizingaDH, MenardS, ElliottDS. Delinquency and drug use: temporal and developmental patterns. Justice Q.1989;6:419–455.
26.
DerogatisLR, LipmanRS, RickelsK, UhlenhuthEH, CoviL. The Hopkins Symptom Checklist (HSCL): a self‐report symptom inventory. Behav Sci.1974;19:1–15.
27.
ChavezEL, OettingER, SwaimRC. Dropout and delinquency: Mexican-American and Caucasian non-Hispanic youth. J Clin Child Psychol.1994;23:47–55.
28.
RuggieroKJ, Del BenK, ScottiJR, RabalaisAE. Psychometric properties of the PTSD Checklist—Civilian Version. J Trauma Stress.2003;16:495–502.
PahlK, BrookJS, LeeJY. Joint trajectories of victimization and marijuana use and their health consequences among urban African American and Puerto Rican young men. J Behav Med.2013;36:305–314.
34.
MitchellH, ZvolenskyMJ, MarshallEC, Bonn-MillerMO, VujanovicAA. Incremental validity of coping-oriented marijuana use motives in the prediction of affect-based psychological vulnerability. J Psychopathol Behav Assess.2007;29:277–288.
35.
CorneliusJR, KirisciL, ReynoldsM, ClarkDB, HayesJ, TarterR. PTSD contributes to teen and young adult cannabis use disorders. Addict Behav.2010;35:91–94.
36.
BachmanJ, O'MalleyP, JohnstonL, BryantA, MerlineA. The Decline of Substance Use in Young Adulthood: Changes in Social Activities, Roles, and Beliefs. Mahwah, NJ: Lawrence Erlbaum Associates; 2002.
37.
LisdahlKM, PriceJS. Increased marijuana use and gender predict poorer cognitive functioning in adolescents and emerging adults. J Int Neuropsychol Soc.2012;18:678–688.
38.
BrookJS, LeeJY, FinchSJ, BrookDW. Developmental trajectories of marijuana use from adolescence to adulthood: relationship with using weapons including guns. Aggress Behav.2014;40:229–237.
39.
D'AmicoEJ, EdelenMO, MilesJN, MorralAR. The longitudinal association between substance use and delinquency among high-risk youth. Drug Alcohol Depend.2008;93:85–92.
40.
MandaraJ, RogersSY, ZinbargRE. The effects of family structure on African American adolescents’ marijuana use. J Marriage Fam.2011;73:557–569.
41.
EllicksonPL, MartinoSC, CollinsRL. Marijuana use from adolescence to young adulthood: multiple developmental trajectories and their associated outcomes. Health Psychol.2004;23:299–307.
42.
EllicksonPL, MartinoSC, CollinsRL. Marijuana use from adolescence to young adulthood: multiple developmental trajectories and their associated outcomes. Health Psychol.2004;23:299–307.
43.
KerigPK, BeckerSP. From internalizing to externalizing: Theoretical models of the processes linking PTSD to juvenile delinquency. In EganSJ, eds, Posttraumatic stress disorder (PTSD): Causes, symptoms and treatment. Hauppauge, NY: Nova Science Publishers, 2010:33–78.
44.
HarrisonL, MartinS, EnevT, HarringtonD. Comparing Drug Testing and Self-report of Drug Use Among Youths and Young Adults in the General Population. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2007.
TrezzaV, CampolongoP. The endocannabinoid system as a possible target to treat both the cognitive and emotional features of post-traumatic stress disorder (PTSD). Front Behav Neurosci.2013;7:100.
