European Child & Adolescent Psychiatry

, Volume 17, Issue 5, pp 274–282

Affect dysregulation in cannabis abusers

A study in adolescents and young adults
  • Géraldine Dorard
  • Sylvie Berthoz
  • Olivier Phan
  • Maurice Corcos
  • Catherine Bungener
ORIGINAL CONTRIBUTION

Abstract

Psychiatric comorbidity and impaired emotional functioning have been previously reported in adult substance abusers but have been less well documented in adolescents. Thus, we investigated mental health problems and emotion regulation abilities in adolescents and young adults with cannabis dependence. Moreover, we explored the relationships between consumption modalities and affective style. Therefore, 32 cannabis abusers (CA) and 30 healthy controls completed a battery of self-reports measuring depression (BDI-13), anxiety (STAI-Y), alexithymia (TAS20; BVAQ-B), anhedonia (PAS; SAS), and sensation seeking (SSS). The MINI was administered to evaluate cannabis dependence and axis I DSM-IV comorbid diagnoses. A semi-structured clinical interview was given to determine psychoactive substance use. Statistical analyses revealed that more than half of the CA reported at least one other non-drug or alcohol comorbid diagnosis. The most common were mood and anxiety disorders. CA subjects scored significantly higher on all affective dimensions except alexithymia total scores; however, they had greater scores for the two subscales measuring the difficulties in identifying feelings. Logistic regressions demonstrated that CA subjects were more likely to experience high levels of trait anxiety, physical anhedonia and sensation seeking than the controls. Various correlations were observed between the affective scores and the substance considered. The amount of substance use and, particularly, the prevalence of polydrug use we observed are alarming. This study demonstrates that cannabis dependence in adolescents and young adults is related to a great psychological distress and specific emotional dimensions and puts emphasis on the importance of substance use prevention as early as middle school.

Keywords

adolescence substance use disorders cannabis emotion comorbidity 

References

  1. 1.
    Adlaf EM, Paglia A (2001) Drug Use Among Ontario Students, 1977–2001: Findings from the OSDUS. In: CAMH Research Document N°10. Centre for Addiction and Mental Health, TorontoGoogle Scholar
  2. 2.
    Beck F (2005) Les usages en population adolescente. In: Angel P, Richard D, Valleur M (eds) Toxicomanies. Masson, Paris, pp 268–281Google Scholar
  3. 3.
    Bender R, Lange S (2001) Adjusting for multiple testing—when and how? J Clin Epidemiol 54:343–349PubMedCrossRefGoogle Scholar
  4. 4.
    Best D, Gross S, Manning V, Gossop M, Witton J, Strang J (2005) Cannabis use in adolescents: the impact of risk and protective factors and social functioning. Drug Alcohol Rev 24:483–488PubMedCrossRefGoogle Scholar
  5. 5.
    Bruchon Schweitzer M, Paulhan I (1990) Manuel de l’Inventaire d’Anxiété Etat - Trait, Forme I. Editions ECPA, ParisGoogle Scholar
  6. 6.
    Carton S, Jouvent R, Widlöcher D (1992) Cross-cultural validity of the sensation seeking scale: development of a French abbreviated form. Eur Psychiat 7:225–234Google Scholar
  7. 7.
    Choquet M, Beck F, Hassler C, Spilka S, Morin D, Legleye S (2004) Les substances psychoactives chez les collégiens et lycéens : consommations en 2003 et évolutions depuis dix ans. Tendances 35:1–6Google Scholar
  8. 8.
    Collet L, Cottraux J (1986) Inventaire abrégé de la dépression de Beck (13 items). Etude de la validité concurrente avec les échelles de Hamilton et de ralentissement de Widlöcher. Encephale 12:77–79PubMedGoogle Scholar
  9. 9.
    Corcos M, Speranza M (2003) Psychopathologie de l’alexithymie. Dunod, ParisGoogle Scholar
  10. 10.
    Del Boca F, Noll J (2000) Truth or consequences: the validity of self-report data in health services research on addictions. Addiction 95:347–360CrossRefGoogle Scholar
  11. 11.
    Farges F, Corcos M, Speranza M, Loas G, Perez-Diaz F, Venisse JL, Lang F, Bizouard P, Halfon O, Flament M, Jeammet P (2004) Alexithymie et toxicomanie: lien avec la dépression. Encephale 33:201–211CrossRefGoogle Scholar
  12. 12.
    Fergusson D, Horwood L (1997) Early onset cannabis use and psychosocial adjustment in young adults. Addiction 92:279–296PubMedCrossRefGoogle Scholar
  13. 13.
    Gignac M, Wilens T, Biederman J, Kwon A, Mick E, Swezey A (2005) Assessing cannabis use in adolescents and young adults: what do urine screen and parental report tell you? J Child Adol Psychopharmacol 15:742–750CrossRefGoogle Scholar
  14. 14.
    Haviland MG, Warren W, Riggs M, Nitch S (2002) Concurrent validity of two observer-rated alexithymia measures. Psychosomatics 43:472–477PubMedCrossRefGoogle Scholar
  15. 15.
    Hibell B, Andersson B, Ahlstrom S, Balakireva O, Bjarnason T, Kokkevi A, Morgan M (2000) The 1999 ESPAD Report: Alcohol and Other Drug Use Among Students in 30 European Countries. Stockholm: Swedish Counsil for Information on Alcohol and Other Drugs and the Pompidou Group at the Council of EuropeGoogle Scholar
  16. 16.
    Hoddes E, Zarcone V, Smythe H, Philipps R, Dement WC (1973) Quantification of sleepiness: a new approach. Psychophysiology 10:431–436PubMedCrossRefGoogle Scholar
  17. 17.
    Inserm (2001) Cannabis: quels effets sur le comportement et la santé? Les Editions Inserm, ParisGoogle Scholar
  18. 18.
    Johns A (2001) Psychiatric effects of cannabis. Brit J Psychiat 178:116–122PubMedCrossRefGoogle Scholar
  19. 19.
    Johnston L, O’Malley P, Bachman J (2002) Monitoring the future national survey results on drug use, 1975–2001. Vol I: secondary school students. NIH Publication, BethesdaGoogle Scholar
  20. 20.
    Kalant H (2004) Adverse effects of cannabis on health: an update of the literature since 1996. Prog Neuro-Psychopharmacol Biol Psychiat 28:849–863CrossRefGoogle Scholar
  21. 21.
    Khantzian E (1997) The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harvard Rev Psychiat 4:231–244CrossRefGoogle Scholar
  22. 22.
    Kosmadakis C, Bungener C, Pierson A, Jouvent R, Widlöcher D (1995) Traduction et validation de l’Echelle Révisée d’Anhédonie Sociale (SAS Social Anhedonia Scale, M. L. Eckblad, L. J. Chapman et al, 1982), Etude des validités interne et concourante chez 126 sujets sains. Encephale 21:437–443PubMedGoogle Scholar
  23. 23.
    Lane RD, Quinlan DM, Schwartz GE, Walker PA, Zeiltin SB (1990) The Levels of Emotional Awarness Scale: a cognitive-developmental measure of emotion. J Pers Assess 55:124–134PubMedCrossRefGoogle Scholar
  24. 24.
    Lecrubier Y, Sheehan D, Weiller E, Amorin P, Bonora I, Harnett Sheehan K, Janavs J, Dunbar G (1999) The MINI International Neuropsychiatric Interview (MINI) a short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiat 5:224–231Google Scholar
  25. 25.
    Loas G (1993) Traduction et validation de l’échelle d’anhédonie physique de Chapman. Encephale 19:639–644PubMedGoogle Scholar
  26. 26.
    Loas G (1995) Adaptation et traduction française des échelles d’anhédonie sociale et physique de Chapman. Encephale 21:484PubMedGoogle Scholar
  27. 27.
    Loas G, Boyer P (1994) L’évaluation de l’anhédonie en psychopathologie: seconde étude de validation de la version française de l’échelle d’anhédonie physique de Chapman et Chapman (PAS). Etude portant sur 356 personnes. Ann Méd-Psychol 152:256–259Google Scholar
  28. 28.
    Loas G, Fremaux D, Marchand M (1995) Etude de la structure factorielle et de la cohérence interne de la version française de l’échelle d’alexithymie de Toronto à 20 items (TAS-20) chez un groupe de 185 sujets sains. Encephale 21:117–122PubMedGoogle Scholar
  29. 29.
    Loas G, Otmani O, Fremaux D, Lecercle C, Duflot M, Delahousse J (1996) Etude de la validité externe, de la fidélité et détermination des notes seuil des échelles d’alexithymie de Toronto (TAS et TAS-20) chez un groupe de malades alcooliques. Encephale 22:35–40PubMedGoogle Scholar
  30. 30.
    Macleod J, Oakes R, Copello A, Crome I, Egger M, Hickman M, Oppenkowski T, Stockes-Lampard H, Smith GD (2004) Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal general population studies. Lancet 363:1579–1588PubMedCrossRefGoogle Scholar
  31. 31.
    McGee R, Williams S, Poulton R, Moffitt T (2000) A longitudinal study of cannabis use and mental health from adolescence to early adulthood. Addiction 95:491–503PubMedCrossRefGoogle Scholar
  32. 32.
    Mueser K, Drake R, Wallach M (1998) Dual Diagnosis: a review of etiological theories. Addict Behav 23:717–734PubMedCrossRefGoogle Scholar
  33. 33.
    Pedersen W (1991) Mental health, sensation seeking and drug use patterns: a longitudinal study. Brit J Addict 86:195–204CrossRefGoogle Scholar
  34. 34.
    Ramo D, Anderson K, Tate S, Brown S (2005) Characteristics of relapse to substance use in comorbid adolescents. Addict Behav 30:1811–1823PubMedCrossRefGoogle Scholar
  35. 35.
    Rey JM, Martin A, Krabman P (2004) Is the party over? Cannabis and juvenile psychiatric disorder: the past 10 years. J Am Acad Child Adol Psychiat 43:1194–1205CrossRefGoogle Scholar
  36. 36.
    Rey JM, Sawyer MG, Raphael B, Patton GC, Lynskey M (2002) Mental health of teenagers who use cannabis. Brit J Psychiat 180:216–221PubMedCrossRefGoogle Scholar
  37. 37.
    Segal B, Huba G, Singer J (1980) Sensation-seeking and anxiety as factors in social drinking men. J Stud Alcohol 18:1108–1114Google Scholar
  38. 38.
    Steinberg L (2005) Cognitive and affective development in adolescence. Trends Cogn Sci 9:69–74PubMedCrossRefGoogle Scholar
  39. 39.
    Stephens R, Babor T, Kadden R, Miller M (2002) The Marijuana Treatment Project: rationale, design and participant characteristics. Addiction 97:109–124PubMedCrossRefGoogle Scholar
  40. 40.
    Taylor G, Bagby R, Parker J (1997) Disorders of affect regulation. Cambridge University Press, CambridgeGoogle Scholar
  41. 41.
    Troisi A, Pasini A, Saracco M, Spalletta G (1998) Psychiatric symptoms in male cannabis users not using other illicit drugs. Addiction 93:487–492PubMedCrossRefGoogle Scholar
  42. 42.
    Zech E, Luminet O, Rimé B, Wagner H (1999) Alexithymia and its measurement: confirmatory factor analyses of the 20-item toronto alexithymia scale and the bermond-vorst alexithymia questionnaire. Eur J Personality 13:511–532CrossRefGoogle Scholar
  43. 43.
    Zuckerman M (1984) Sensation seeking: a comparative approach to a human trait. Behav Brain Sci 7:413–471CrossRefGoogle Scholar
  44. 44.
    Zuckerman M (1994) Behavioral expressions and biosocial bases of sensation seeking. Cambridge University Press, New YorkGoogle Scholar
  45. 45.
    Zuckerman M, Kolin E, Price L, Zoob I (1964) Development of a sensation-seeking scale. J Consult Clin Psych 28:477–482Google Scholar

Copyright information

© Steinkopff Verlag 2008

Authors and Affiliations

  • Géraldine Dorard
    • 1
  • Sylvie Berthoz
    • 2
  • Olivier Phan
    • 2
  • Maurice Corcos
    • 2
  • Catherine Bungener
    • 1
  1. 1.Laboratory of Clinical Psychopathology and NeuropsychologyParis Descartes University, Institut Henri PiéronBoulogne BillancourtFrance
  2. 2.Department of Psychiatry for Adolescents and Young Adults, Institut Mutualiste MontsourisUniv. Paris-Sud and Paris Descartes Universities, Inserm U669Paris Cdx 14France

Personalised recommendations