A longitudinal mediational investigation of risk pathways among cannabis use, interpersonal trauma exposure, and trauma-related distress

Psychol Trauma. 2023 Sep;15(6):969-978. doi: 10.1037/tra0001207. Epub 2022 Jan 31.


Objective: College students are at high risk for cannabis use, interpersonal trauma (IPT) exposure, and trauma-related distress (TRD). Two phenotypic etiologic models posited to explain associations between cannabis use and trauma-related phenotypes are the self-medication (trauma/TRD → cannabis use) and high-risk (cannabis use → trauma/TRD) hypotheses. The primary objective of the present study was to investigate direct and indirect associations among cannabis use, IPT exposure, and TRD above and beyond established covariates.

Method: The current study used data from the first assessment (i.e., baseline survey at Year 1 Fall) and two follow-up assessments (i.e., Year 1 Spring and Year 2 Spring) from an ongoing longitudinal study on college behavioral health. Participants were 4 cohorts of college students (n = 9,889) who completed measures of demographics, substance use, IPT, and TRD. Indirect effects of IPT on cannabis through TRD (i.e., self-medication) and cannabis on TRD through IPT (i.e., high-risk), including tests of covariate effects (e.g., gender, age, race, cohort, alcohol, nicotine), were simultaneously estimated using a longitudinal mediation modeling framework.

Results: Results suggest that more IPT exposure increases risk for TRD and subsequent nonexperimental (use 6+ times) cannabis use, and that experimental (use 1-5 times) and nonexperimental cannabis use increases risk for IPT exposure and subsequent TRD.

Conclusions: Both the self-medication and high-risk hypotheses were supported. Findings support a bidirectional causal relationship between cannabis use and trauma-related phenotypes. Additionally, results highlight areas for colleges to intervene among students to help reduce cannabis use and create a safer environment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

MeSH terms

  • Cannabis*
  • Ethanol
  • Humans
  • Longitudinal Studies
  • Students
  • Substance-Related Disorders*


  • Ethanol