Social cognitive predictors of treatment outcome in cannabis dependence

Gullo, Matthew J., Matveeva, Marya, Feeney, Gerald F. X., Young, Ross McD. and Connor, Jason P. (2017) Social cognitive predictors of treatment outcome in cannabis dependence. Drug and Alcohol Dependence, 170 74-81. doi:10.1016/j.drugalcdep.2016.10.030

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Author Gullo, Matthew J.
Matveeva, Marya
Feeney, Gerald F. X.
Young, Ross McD.
Connor, Jason P.
Title Social cognitive predictors of treatment outcome in cannabis dependence
Journal name Drug and Alcohol Dependence   Check publisher's open access policy
ISSN 1879-0046
Publication date 2017-01-01
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.drugalcdep.2016.10.030
Open Access Status File (Author Post-print)
Volume 170
Start page 74
End page 81
Total pages 8
Place of publication E Park, Shannon, Clare Ireland
Publisher Elsevier Ireland
Collection year 2017
Language eng
Formatted abstract
Background: Drug-related outcomes expectancies and refusal self-efficacy are core components of Social Cognitive Theory. Both predict treatment outcome in alcohol use disorders. Few studies have reported expectancies and refusal self-efficacy in cannabis dependence. None have examined both, although both constructs are key targets in Cognitive-Behavioural Therapy (CBT). This study tests the predictive role of expectancies and refusal self-efficacy in treatment outcome for cannabis dependence.

Design: Outpatients completed a comprehensive assessment when commencing cannabis treatment and predictors of treatment outcome were tested.

Setting: A university hospital alcohol and drug outpatient clinic.

Participants: 221 cannabis-dependent patients participated in a 6-week CBT program where the goal was abstinence.

Measurements: Cannabis Expectancy Questionnaire and Cannabis Refusal Self-Efficacy Questionnaire, cannabis dependence severity [Severity of Dependence Scale], psychological distress [General Health Questionnaire] at baseline; the timeline follow-back procedure at baseline and each session.

Findings: Patients reporting lower confidence in their ability to resist cannabis during high negative affect (emotional relief refusal self-efficacy) had a lower likelihood of abstinence (p = 0.004), more days of use (p < 0.001), and larger amount used (p < 0.001). Negative cannabis expectancies predicted greater likelihood of abstinence (p = 0.024). Higher positive expectancies were associated with lower emotional relief self-efficacy, mediating its association with outcome (p < 0.001).

Conclusions: Emotional relief refusal self-efficacy and negative expectancies are predictive of better treatment outcomes for cannabis dependence. Positive expectancies may indirectly predict poorer outcome because of a negative association with self-efficacy, but this conclusion remains tentative as directionality could not be established.
Keyword Cannabis dependence
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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