The association between adolescent cannabis use and anxiety: A parallel process analysis

Addict Behav. 2018 Mar;78:107-113. doi: 10.1016/j.addbeh.2017.11.005. Epub 2017 Nov 4.


Introduction: Associations between anxiety symptoms and cannabis use have been previously explored, yet the directionality of these associations remains highly debatable. The present study aims to prospectively examine patterns of cannabis use and anxiety during adolescence focusing on their co-development and bidirectional influences.

Methods: Adolescents (n=250) of predominantly Hispanic ethnicity, aged 14-17 at baseline, exposed to drugs, alcohol, or cigarettes completed three (bi-annual) assessments across a 1-year period. Latent growth curve modeling (LGCM) and parallel process growth curves were conducted to examine potential associations in the joint development of anxiety and cannabis use.

Results: Our results suggest that, during adolescence, early cannabis use has a greater influence on prospective reports of anxiety, than vice versa. Specifically, adolescents exhibiting higher initial levels of cannabis use displayed more persisting self-reported anxiety across time, as compared to those with less frequent use (b=0.28, p=0.024). In contrast, early levels of anxiety were not found to influence rates of change in cannabis use. These analyses considered concurrent depression, alcohol, and nicotine use.

Conclusions: Our findings suggest that prevention and targeted intervention programs for cannabis use in adolescence would benefit from anxiety management strategies; in order to reduce subsequent anxiety associated with cannabis use. Future studies should continue to employ longitudinal designs across larger time periods and aim to replicate these findings with more diverse samples.

Keywords: Adolescents; Anxiety; Cannabis; LCGM; Parallel process.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Anxiety / etiology*
  • Female
  • Humans
  • Male
  • Marijuana Abuse / psychology
  • Marijuana Use / psychology*
  • Prospective Studies
  • Self Report