The Influence of Anxiety and Avoidant Coping Style on Probable CUD

Introduction: Cannabis is frequently used to cope with anxiety symptoms (Sexton et al., 2016). Unfortunately, individuals with anxiety are also at greater risk for developing probable cannabis use disorder (CUD; Marel et al., 2019), although mechanisms are not well understood. Previous literature suggests avoidant coping styles (AVC) are associated with higher anxiety levels, whereas action oriented coping styles (AOC) are associated with lower anxiety levels (Ribadier & Varescon, 2019). While cannabis coping motives are a significant predictor of probable CUD for those with anxiety (Buckner & Zvolensky, 2014), no research has identified how anxiety and specific coping styles predict probable CUD. The aim of the present study was to determine how AVC and AOC interact with anxiety to predict the presence of probable CUD. It was hypothesized that overall individuals with high anxiety would be more likely to endorse probable CUD than low anxiety. Among both anxiety levels, AVC would be more likely to have probable CUD than those with low AVC. Furthermore, individuals with high anxiety and high AOC would be less likely to have probable CUD, compared with those with low AOC, even when anxiety is high. Methods: College students (N = 371; 72.2% female) who used cannabis in the past six months were recruited as part of a study examining the influence of cannabis use on academic success. Participants completed self-report measures to assess anxiety (DASS-21), coping (B-COPE), and probable CUD (CUDIT-R). A confirmatory factor analysis was used to derive coping subscales using items from the B-COPE (Grosso et al., 2014). Results: The data was analyzed through a logistic regression conducted in HAYES Process Macro. Even after controlling for gender, anxiety (b = .032, SE = .016, p = .046) was a positive significant predictor of probable CUD, however neither AOC (b = .030, SE = .025, p = .221) or AVC (b = .048, SE = .056, p = .392) were significant predictors of probable CUD. The interaction between Anxiety X AVC on probable CUD was significant (b = -.011, SE = .005, p = .026), indicating that those with low anxiety and high AVC were more likely to have probable CUD than those with low anxiety and low AVC; however, this interaction did not apply when anxiety levels were high. The interaction between AOC and anxiety was not significant (b = .004, SE = .003, p = .134), which did not support our initial hypothesis. Discussion: Even when anxiety levels are low, individuals with higher AVC are more likely to endorse probable CUD. In contrast, individuals with higher anxiety are more likely to exhibit probable CUD, regardless of AVC levels. Interestingly, anxiety and AOC did not interact to predict probable CUD, suggesting that risk for CUD may be more about what people avoid than what they do to actively cope. These findings emphasize the importance of targeting both anxiety and AVC when considering risk for probable CUD. Longitudinal data are needed to examine how anxiety and AVC contribute to the development of CUD over time.