Key Insight: Population-level research showing a mechanism “predicts more use” does NOT mean it works that way for every individual. Your idiographic EMA approach reveals that the SAME mechanism can be:
This validates the necessity of idiographic assessment before intervention.
Rather than classifying mechanisms as simply “unidirectional” or “bidirectional,” mechanisms are now rated on likelihood of bidirectional relationships:
| Bidirectionality Likelihood | # Mechanisms | Examples |
|---|---|---|
| Highly Likely | 4 | Stress, Anxiety, Calm, Positive Emotions |
| Moderately Likely | 13 | Craving, Bored, Irritable, Interpersonal Conflict |
| Less Likely but Possible | 11 | Sleep, Relaxation, Depression, Headache |
| Not Applicable | 2 | Time of Day, Day of Week (contextual cues) |
Choose mechanisms that are: 1. Less Likely Bidirectional (simpler to study; clearer interpretation) 2. Strong evidence base for interventions 3. Highly relevant to cannabis users
Top Recommendation: #7 Wanting to Sleep - Less likely bidirectional (wanting sleep → use is very robust pattern) - Gold-standard interventions (Brief-BTI, digital CBT-I) - Top reason for cannabis use; addresses withdrawal barrier
Choose HIGHLY LIKELY Bidirectional mechanism to demonstrate: 1. Individual variation in directional relationships 2. Value of idiographic assessment 3. Necessity of tailored intervention based on direction
Top Recommendation: #29 Positive Emotions or #13 Calm - Requires 1-2 week EMA screening to determine direction - Demonstrates protective factor enhancement innovation - Tests directional tailoring
Refined mechanism list: 24 distinct mechanisms (down from 30)
Overall Rating: VERY HIGH - TOP RECOMMENDATION
Bidirectionality Likelihood: LESS LIKELY BUT
POSSIBLE
Type: Generally Unidirectional Risk (wanting sleep →
use is robust)
Sleep is the top reason for cannabis use, both medical and recreational (Babson et al., 2017). Withdrawal insomnia is the most distressing withdrawal symptom and a major barrier to quitting. Vicious cycle: use for sleep → tolerance → withdrawal insomnia → more use. Cannabis suppresses REM sleep; withdrawal causes REM rebound and nightmares (Gates et al., 2014).
General pattern: Wanting to sleep/sleep problems → cannabis use is very robust
Evidence for bidirectional relationships: - Sleep context: Wanting to sleep for relaxation → use; wanting to sleep before performance task (important meeting, exam) → less use (fear of grogginess, oversleeping) - Knowledge of consequences: Those aware cannabis disrupts sleep architecture may avoid using when quality sleep is important - Timing: Wanting to sleep early evening vs. at bedtime - different patterns - Dependence awareness: Wanting to sleep triggers recognition of dependence (“I shouldn’t need cannabis”) → less use for some
Path to MORE use (sleep aid/dependence):
Path to LESS use (performance/awareness):
Delivery: Excellent - Digital CBT-I apps
well-established
Comparative Potential: HIGH - Could compare components
or full protocol vs. components
If wanting to sleep→MORE use: - Provide effective non-cannabis sleep interventions - Start with Brief-BTI or digital CBT-I (strongest evidence) - Expect temporary worsening during withdrawal (prepare patients) - Support through first 1-2 weeks when withdrawal insomnia worst
If wanting to sleep→LESS use: - Understand protective pattern (performance concern, quality awareness, autonomy) - May still be experiencing insomnia - consider offering interventions anyway - Frame as improving sleep health, not cannabis treatment
TOP RECOMMENDATION. Addresses withdrawal barrier, gold-standard interventions, clear functional replacement. Less likely bidirectional makes it good first-study choice.
Suggested Design: 2-arm RCT (Brief-BTI vs. waitlist). Primary outcome: Sleep-motivated cannabis use (EMA). Secondary: Sleep quality (PSQI, actigraphy), ISI, overall use. Test mediation: Does sleep improvement → reduced use?
Overall Rating: VERY HIGH - INNOVATIVE
Bidirectionality Likelihood: HIGHLY LIKELY
Type: Bidirectional - Protective OR Enhancement
depending on individual
Broaden-and-build theory (Fredrickson, 2001): Positive emotions broaden coping repertoire and build resources. Addresses hedonic dysregulation (inability to experience pleasure without substances). Trait positive affect predicts less substance use. Creates upward spirals of well-being. Positive emotions buffer against stress and negative affect.
This mechanism is HIGHLY LIKELY bidirectional - strong theoretical and empirical basis:
Path to MORE use (enhancement/amplification):
Path to LESS use (protective satisfaction):
If positive emotions→LESS use (Protective): - BUILD more positive emotion capacity (MORE, LKM, gratitude, BA) - Goal: Increase time in protective zone
If positive emotions→MORE use (Enhancement): - Help SAVOR positive emotions without amplifying with cannabis - DON’T build more positive emotions (could increase enhancement opportunities) - Mindful presence, values exploration
Requires: 1-2 week EMA screening to determine direction
INNOVATIVE positive psychology approach. MORE specifically designed for SUD. Best as SECOND study testing directional tailoring after proof-of-concept.
Overall Rating: VERY HIGH
Bidirectionality Likelihood: HIGHLY LIKELY
Type: Generally Risk but with Important Exceptions
Anxiety #1 self-reported reason for cannabis use. Chronic use may worsen anxiety (Kedzior & Laeber, 2014). EMA shows anxiety predicts use within-person. Anxiety is withdrawal symptom (vicious cycle).
Highly likely bidirectional:
Path to MORE use: - “I’m so anxious, I need something to calm me down” - “Cannabis is the only thing that helps my anxiety” - “I can’t handle this anxiety - I need relief now” - Medical justification: “I use cannabis for my anxiety disorder”
Path to LESS use: - “I’m anxious about this presentation - cannabis would make me more paranoid” - “When I use cannabis while anxious, I get way MORE anxious, not less” - “I need to stay sharp - can’t risk being impaired” - “Last time I used when anxious, I had a panic attack” - “Cannabis makes my anxiety worse long-term - breaking the cycle”
If anxiety→MORE use: - Provide anxiety management alternatives - First line: Grounding or box breathing (fastest relief) - Psychoeducation: Cannabis worsens anxiety long-term
If anxiety→LESS use: - Understand: Fear of paranoia? Performance need? Implementation intentions working? - DON’T assume managing anxiety well - may be white-knuckling - Consider offering anxiety treatment anyway (frame as wellness)
Multiple interventions, excellent comparative effectiveness potential. CRITICAL: Anxiety HIGHLY LIKELY bidirectional - anxiety type, expectancies, anxiety sensitivity, context all influence direction. MUST assess individual pattern.
Overall Rating: VERY HIGH - INNOVATIVE
Bidirectionality Likelihood: HIGHLY LIKELY
Type: Bidirectional - Protective OR Enhancement
Calm represents successful emotion regulation. Baseline calm protects against stress-induced use. Trait mindfulness (increases calm) predicts less substance use (Bowen et al., 2014). Positive affect broadening: Calm is low-arousal positive state that broadens coping repertoire (Fredrickson, 2001).
Intervention Logic: INCREASE frequency/duration of calm states so people spend more time in protective zones - BUT ONLY for those where calm→less use.
Highly likely bidirectional - strong evidence:
Path to MORE use (enhancement): - “I’m feeling good and relaxed - cannabis will make this even better” - “This calm is nice, but being high would be amazing” - “Finally relaxed - time to celebrate with cannabis” - “Calm is boring - I want euphoric, not just calm” - Habitual: Weekend evening calm = recreational use cue
Path to LESS use (protective satisfaction): - “I’m already calm and content - I don’t need cannabis” - “This natural calm feels good and pure - don’t want to make it artificial” - “When calm, I have mental space to remember why I’m quitting” - “Being calm without cannabis proves I can regulate emotions on my own” - “Calm means I’m not stressed/anxious - THOSE are my triggers” - Incompatible: “I’m calm before [important task] - using would ruin that”
If calm→LESS use (Protective): - BUILD calm capacity (LKM, coherent breathing, autogenic, mindfulness) - Increase time in protective zone - Frame as building resource, not treating problem
If calm→MORE use (Enhancement): - Help SAVOR calm without amplifying - DON’T build more calm (could increase enhancement opportunities) - Mindful presence, alternative enhancement
Requires: EMA screening to determine direction
INNOVATIVE protective factor enhancement. Proactively build calm rather than react to stress. HIGHLY LIKELY bidirectional - REQUIRES screening. Best as SECOND study demonstrating directional tailoring.
Overall Rating: VERY HIGH
Bidirectionality Likelihood: HIGHLY LIKELY
Type: Generally Risk but Context-Dependent
Stress is TOP predictor in EMA studies (Buckner et al., 2015). Daily stress predicts same-day/next-day use. Temporal dynamics: Effects within 2-4 hours (ideal for JITAI). Coping motives mediate stress-cannabis relationship.
Highly likely bidirectional - multiple moderators:
Path to MORE use: - “I’m so stressed, I need something to help me relax and escape” - “Cannabis is my stress management tool” - “I’m overwhelmed - I need to check out” - “I deserve to relax after such a stressful day” - Automatic: Stress = use cue
Path to LESS use: - “I’m stressed about this deadline - need to stay sharp to fix it” - “Cannabis would make my stress worse by reducing my ability to cope” - “I’m stressed BECAUSE of cannabis (money, relationships) - using would compound it” - “When stressed and use, I just get paranoid, not better” - “This stress is information - telling me to act, not avoid” - Implementation intention: “When stressed, I will use breathing, not cannabis”
If stress→MORE use: - Provide stress management alternatives - First line: Mindful breathing (quickest, easiest) - JITAI ideal (2-4 hour window)
If stress→LESS use: - Understand: Performance stress? Awareness cannabis worsens? Problem-focused coping? - DON’T intervene on stress - already adaptive - Explore: Are there stress types where pattern flips?
Gold standard interventions, ideal for JITAI. CRITICAL: Stress HIGHLY LIKELY bidirectional. Stress type, controllability, coping style, context all influence direction. MUST assess individual pattern.
Overall Rating: VERY HIGH
Bidirectionality Likelihood: LESS LIKELY BUT
POSSIBLE
Type: Generally Unidirectional Risk
“Relaxation” is top self-reported reason for cannabis use (Cooper & Haney, 2009). Cannabis highly effective for inducing relaxation. Immediate relaxation effect strongly reinforces use.
Less likely bidirectional, but possible:
Path to MORE use: - “I need to relax and cannabis is the fastest, most effective way” - “I deserve to relax with cannabis after stressful day” - “I can’t relax without cannabis anymore” - “Wanting to relax = time to smoke - automatic” - “Natural relaxation takes too long/doesn’t work as well”
Path to LESS use: - “I want to relax but need to stay alert for [task] - I’ll use breathing instead” - “I want natural relaxation, not artificial - cannabis doesn’t count as real relaxation” - “When I relax with cannabis, I just get sleepy/foggy” - “I can relax without cannabis - I’ll try PMR/breathing first” - “I want to relax AND stay productive - cannabis would make me too relaxed”
If wanting to relax→MORE use: - Provide equally effective alternatives (PMR, autogenic show LARGE effects) - “Horse race” - try multiple techniques, choose what works - Must produce comparable relaxation or won’t replace cannabis
If wanting to relax→LESS use: - Understand: Have effective alternatives? Context prevents? Values-based? - If no alternatives but white-knuckling, still offer relaxation training
Multiple gold-standard interventions with LARGE effect sizes. “Horse race” of relaxation techniques possible. Less likely bidirectional - good for simpler study design.
Overall Rating: VERY HIGH (but “obvious”)
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Self-Efficacy Moderates
Most established addiction mechanism. Craving predicts lapse/relapse (Haughey et al., 2008). Cravings peak and subside within 20-30 min (urge surfing rationale). Well-understood neural correlates.
Moderately likely bidirectional:
Path to MORE use: - “The craving is too strong, I can’t resist” - “Only way to make craving stop is to use” - “I’ve been craving all day, I deserve to use” - Automatic: Craving triggers habitual use without conscious decision
Path to LESS use: - “Craving means quit attempt is working - sign of progress” - “This will pass in 20 minutes if I ride it out” - “Craving is opportunity to practice urge surfing skills” - “Every time I resist, I get stronger” - “Craving means I’m in withdrawal - body is healing, won’t undo it” - Implementation intention: “When I crave, I will [alternative]” - “Craving is trying to control me - I won’t let it”
If craving→MORE use: - Urge surfing, defusion, competing responses - Psychoeducation: Cravings are temporary (20-30 min) - JITAI potential excellent
If craving→LESS use: - DON’T intervene - already adaptive! - Understand: High SE? Implementation intentions working? Views craving as progress? - Reinforce existing coping - Make protective process explicit and reliable
Strongest evidence base but most “obvious.” Better as SECOND study. MODERATELY LIKELY bidirectional - SE, stage of change, implementation intentions, mindfulness all moderate.
Overall Rating: HIGH - UNDERSTUDIED
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Alternatives Matter
Boredom increasingly recognized for cannabis, especially frequent users. Low arousal/understimulation. Boredom proneness trait predicts use (Lee et al., 2013; Weybright et al., 2015).
Moderately likely bidirectional:
Path to MORE use: - “I’m so bored, I need something to do/feel” - “Can’t stand this boredom - getting high is at least SOMETHING” - “When bored, cannabis makes everything more interesting” - “I have nothing better to do, might as well get high”
Path to LESS use: - “I’m bored, so I should find something actually engaging, not just get high” - “I’m bored WITH cannabis - it’s become boring itself” - “When I use because I’m bored, I just end up more bored and foggy” - “Boredom means I need meaningful activity, not altered consciousness” - Mindfulness: “I’m bored, and that’s okay - I can sit with this”
If boredom→MORE use: - Assess boredom type (understimulation vs. lack of meaning) - BA or sensation-seeking alternatives (provide stimulation) - Values-based planning (provide meaning) - Challenge: Activities must genuinely engage
If boredom→LESS use: - Understand: Bored WITH cannabis? Awareness cannabis doesn’t solve? Mindful tolerance? - May still benefit from life enrichment (frame as wellness)
UNDERSTUDIED = innovation opportunity. MODERATELY LIKELY bidirectional - boredom proneness, sensation-seeking, alternatives availability moderate.
Overall Rating: HIGH
Bidirectionality Likelihood: LESS LIKELY BUT
POSSIBLE
Type: Generally Risk but Awareness Disrupts
Cannabis becomes habitual with repetition. Habit strength increases with frequency. Dual-process: Bypasses conscious decision. Cue-triggered automatic responses (de Wit & Richards, 2004).
Less likely bidirectional, but possible:
Path to MORE use: - Automatic: Cue triggers use without conscious decision - “I used before I realized what I was doing” - “It’s just what I do - I don’t even think about it” - “Habit is so strong, resisting feels impossible” - Mindless: Using while doing other things
Path to LESS use: - Meta-awareness: “I just reached for cannabis automatically - wait, do I actually want this?” - “Noticing automatic urge made me pause and choose differently” - Implementation intention working: Cue triggers alternative response - “Becoming aware of my habits helped me break them” - Reactance: “I don’t like being controlled by automatic patterns”
If habit/cues→MORE use: - Implementation intentions (if-then plans for cues) - Mindful awareness (catch automaticity, introduce choice) - If very strong: HRT
If habit/cues→LESS use: - Understand: Meta-awareness working? Implementation intentions in place? Reactance? - Reinforce existing disruption skills - Don’t assume permanent - habits can re-emerge
Relevant for frequent users. Implementation intentions smartphone-friendly. LESS LIKELY bidirectional but awareness can disrupt.
Overall Rating: HIGH
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Severity/Awareness Matter
Depression predicts cannabis use (bidirectional relationship). Depressed mood predicts same-day use. Self-medication common though worsens over time. Dysphoria common in withdrawal (Degenhardt et al., 2003).
Moderately likely bidirectional:
Path to MORE use: - “I feel so depressed - cannabis is only thing that helps” - “Too depressed to care about quit goals” - “Cannabis helps me escape this horrible feeling” - “When depressed, nothing matters including commitment not to use” - “Feel numb - cannabis makes me feel SOMETHING”
Path to LESS use: - “Depressed and cannabis would just make me more depressed” - “Too depressed to even bother using - takes too much energy” - “When depressed, I don’t enjoy cannabis anyway - doesn’t help” - “Depressed BECAUSE of cannabis - using would be self-sabotage” - “Depression makes me realize what’s important - health, not getting high” - Anhedonia: “Too depressed to enjoy anything including cannabis”
If depression→MORE use: - Treat depression (BA first line for SUD+depression comorbidity) - May need more than single session
If depression→LESS use: - CRITICAL: Even if protective for cannabis, depression needs treatment - Still offer BA/treatment (frame as wellness) - Monitor: If depression improves, does cannabis use pattern change?
Strong evidence. BA most promising. MODERATELY LIKELY bidirectional - severity, awareness, anhedonia matter. IMPORTANT: Depression needs treatment regardless of cannabis use pattern.
Overall Rating: HIGH
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but ER Capacity Moderates
Transdiagnostic predictor across substances. Emotion dysregulation moderates affect→use relationship (Gratz & Roemer, 2004). Negative affect increases in withdrawal.
Moderately likely bidirectional:
Path to MORE use: - “I feel terrible - need to escape this feeling” - “Can’t handle negative emotions without cannabis” - “Cannabis is my emotion regulation tool” - “These feelings are unbearable - need relief now” - Automatic: Negative feelings trigger use
Path to LESS use: - “Feel bad, but using would just make me avoid dealing with what’s wrong” - “Feel terrible, which means I need real help, not temporary escape” - “Cannabis might numb pain temporarily but doesn’t solve anything” - “I’m trying to learn to manage emotions without substances” - “These feelings are information - telling me something important” - Implementation intention: “When I feel bad, I will use coping skills”
If negative emotions→MORE use: - Build ER capacity - Affect labeling (simple, immediate) - ER training (toolkit of strategies) - Consider targeting specific emotions instead
If negative emotions→LESS use: - Understand: Good ER skills? Awareness cannabis doesn’t help? Problem-solving orientation? - Even if protective, assess if managing well or white-knuckling - May still benefit from ER training (frame as wellness)
Very relevant but TOO BROAD. Specific emotions (anxiety, stress, depression) better targets. MODERATELY LIKELY bidirectional - ER capacity key moderator.
Overall Rating: HIGH
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Conflict Type/Context
Matter
Interpersonal stress/conflict predicts use. Multiple pathways: conflict→affect→use; social pressure; contextual cues (Longabaugh et al., 2005).
Moderately likely bidirectional:
Path to MORE use: - “Can’t deal with this fight - need to escape” - “They’re making me so angry/hurt - need to numb this” - “Conflict is overwhelming - cannabis will help me not care” - “After fighting, I deserve to relax” - “Conflict makes me want to be alone and high”
Path to LESS use: - “We’re in a fight and I need to be clear-headed to work this out” - “They’re already mad about my cannabis use - using would make it worse” - “This conflict is important - can’t check out” - “When high during conflicts, I say things I regret” - “The fight is ABOUT my cannabis - using would prove their point” - “This relationship is in trouble because of cannabis - using won’t help”
If interpersonal conflict→MORE use: - Teach conflict resolution, communication, ER during conflict - Best as in-person initial + real-world practice
If interpersonal conflict→LESS use: - Understand: Fear of consequences? Values-based? Good skills already? - Don’t intervene on conflict - adaptive - Assess: Are there OTHER interpersonal situations that DO trigger use?
Very relevant but challenging for brief/remote delivery. MODERATELY LIKELY bidirectional - conflict type, relationship quality, coping style matter.
Overall Rating: HIGH
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Withdrawal vs. Situational
Matters
Withdrawal symptom and relapse trigger. Increases with heavy use. Predicts use especially among dependent users (Allsop et al., 2011; Budney et al., 2004).
Moderately likely bidirectional:
Path to MORE use: - “I’m so irritable - need cannabis to calm down” - “I’m irritable because I haven’t used yet - need to use to feel normal” - “Everyone’s annoying me - need to get high so I don’t snap” - “Can’t control my irritability without cannabis” - Withdrawal: “Irritable from withdrawal - using will make it go away”
Path to LESS use: - “I’m irritable BECAUSE of withdrawal - using would perpetuate cycle” - “Irritable, but cannabis won’t solve actual problem” - “Need to address what’s frustrating me, not numb it” - “When use while irritable, don’t deal with problems and they get worse” - “I’m irritable but have important [task] - can’t be impaired” - Implementation intention: “When irritable, I will use relaxation, not cannabis”
If irritability→MORE use: - Assess: Withdrawal vs. situational? - If withdrawal: Expect temporary worsening; provide coping; normalize - Relaxation training, TIPP skills (rapid de-escalation)
If irritability→LESS use: - Understand: Insight about withdrawal cycle? Problem-solving orientation? - Even if protective, irritability still problematic (relationships, QOL) - Offer interventions anyway (frame as QOL improvement)
Relevant but overlaps with negative affect. Relaxation most smartphone-friendly. MODERATELY LIKELY bidirectional - withdrawal vs. situational, insight, context matter.
Overall Rating: MODERATE
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Context Matters
Path to MORE use: - “This headache is killing me - cannabis is only thing that helps” - “Can’t function with headache - need relief now” - “Cannabis works better than ibuprofen” - Medical justification: “This is medical use”
Path to LESS use: - “Have a headache but need to stay sharp for work/driving” - “My headaches are FROM cannabis (rebound) - using would make worse” - “Cannabis helps temporarily but then they come back worse” - “Headache because I’m dehydrated/stressed - cannabis won’t fix root cause” - “I’ll take ibuprofen - it works and doesn’t impair me”
Good evidence but may be too intermittent unless chronic. Biofeedback shows largest effects. MODERATELY LIKELY bidirectional - context, rebound awareness matter.
Overall Rating: MODERATE-HIGH
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Bidirectional - Protective OR Enhancement
Self-compassion buffers stress. Physical comfort reduces pain-motivated use. Social comfort reduces socially-motivated use. BUT can also be enhanced with cannabis.
Path to MORE use: - “I’m comfortable and relaxed - cannabis will enhance this” - “Finally comfortable - time to celebrate with cannabis” - “Comfort is nice but being high is better”
Path to LESS use: - “I’m already comfortable - don’t need cannabis” - “This natural comfort feels authentic - don’t want to alter it” - “Being comfortable without cannabis proves my self-regulation”
Self-compassion angle innovative. MODERATELY LIKELY bidirectional - requires screening. Consider if less operationalized than “calm.”
Overall Rating: MODERATE
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Awareness Can Trigger
Self-Regulation
Path to MORE use: - “I want to get high, so I’m going to” - “I deserve to feel good” - “Life is better when I’m high” - “Desire is so strong, I can’t resist”
Path to LESS use: - “I want to get high, but that want is the PROBLEM - need to resist” - “Wanting to be high all the time means I have dependence - that scares me” - “I want to get high, but I also want [valued goal] more” - “Noticing this desire is warning sign - time to use coping skills” - “If I give in every time I want to get high, I’m not in control” - Counter-desire: “I want to get high, but ALSO want to prove I don’t need it”
Overlaps with craving. MODERATELY LIKELY bidirectional - awareness of motives can trigger self-regulation in preparation/action stages. Consider combining with #21.
RECOMMENDATION: COMBINE into single “Avoidance/Escapism” mechanism
Overall Rating: MODERATE
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Problem Type/Coping Style
Matter
Path to MORE use: - “Need to escape from everything - world is overwhelming” - “Want to unplug from problems/responsibilities - cannabis helps” - “Can’t face reality - need to check out” - “I deserve a break from everything”
Path to LESS use: - “Want to unplug, so I’ll set boundaries and take real rest, not just get high” - “Want to unplug because overwhelmed - cannabis would avoid problems, not solve” - “When use cannabis to unplug, wake up to same problems plus guilt” - “Want to unplug tells me I’m overextended - need to address that” - “Cannabis unplugging is fake - not really resting, just avoiding” - Problem-solving: “Want to unplug, so need to simplify life, not use cannabis”
#11 and #12 essentially identical - COMBINE into “Avoidance/Escapism.” MODERATELY LIKELY bidirectional - coping style, problem type matter. ACT/problem-solving most promising.
Overall Rating: MODERATE
Bidirectionality Likelihood: MODERATELY LIKELY
Type: Generally Risk but Alternatives/Anhedonia
Matter
Path to MORE use: - “Want to have fun and cannabis makes everything more fun” - “Fun activities are better when I’m high” - “I deserve to have fun - cannabis is my way” - “Can’t have fun without cannabis - I’ve lost the ability”
Path to LESS use: - “Want fun, so I’ll find genuinely engaging activities, not just get high” - “Want REAL fun, not artificial - cannabis fun doesn’t count” - “Too depressed to have fun even with cannabis” - “Cannabis used to be fun, now it’s boring/makes me anxious”