ABSTRACT
Expectancies regarding the sleep-promoting effects of cannabis may exacerbate the propensity to self-medicate sleep problems with cannabis. Given the potential clinical importance of expectancies for the sedative effects of cannabis, Goodhines et al (2020) developed the Sleep-Related Cannabis Expectancies Questionnaire (SR-CEQ). However, concurrent validity of this instrument has not been evaluated. This study aimed to replicate the two-factor structure and internal reliability and explore incremental construct validity of the SR-CEQ. Cross-sectional online survey data were collected from 287 college students (Mage = 19.07 ± 1.44 years, range 18-25; 47% male; 84% non-Hispanic White; 61% lifetime cannabis use). Confirmatory factor analysis replicated an adequate fit of the two-factor model (SRMR = 0.08) with excellent internal consistency within positive (α = .94) and negative (α = .91) subscales. Novel correlates were observed for positive (greater mood, sleep, cannabis risk; rs = .16-.48, ps = .001-.03) and negative (lesser cannabis risk; rs = -.18-.61, ps = .001-.03) subscales. Positive expectancies were greater among students with insomnia (t[285] = 2.70, p < .01; d = .33) and hazardous cannabis use (t[284] = 6.63, p < .001; d = 0.91). No group differences were observed by sex or for negative sleep-related cannabis expectances. This study extends psychometric validation of the SR-CEQ and highlights positive expectancies as a potential risk factor for insomnia and hazardous cannabis use.
ABSTRACT
Background: Sexual minority women (SMW) and transgender and/or nonbinary (TNB) individuals report an elevated prevalence of posttraumatic stress disorder (PTSD) symptoms and negative alcohol-related outcomes compared to heterosexual women and cisgender people. SMW and TNB individuals also face barriers to utilizing treatment, which can result in delayed or missed appointments. Accessible, feasible, and effective treatment approaches, such as web-based expressive writing (EW) treatments, are needed to address PTSD and negative alcohol-related outcomes in these populations. Method: We describe the design of a mixed-method pilot randomized controlled trial which will compare an EW treatment adapted for SMW and TNB people (stigma-adapted EW) and trauma (i.e., non-adapted) EW with an active (neutral-event) control to determine acceptability and feasibility of a future fully powered randomized controlled trial. The sample will include 150 trauma-exposed SMW and TNB individuals from across the United States who will be randomly assigned to stigma-adapted EW (n = 50), trauma EW (n = 50), or control (n = 50). Participants will be assessed before treatment, one-week after the first writing session, and three-months after the first writing session. This paper identifies steps for evaluating the acceptability and feasibility of the proposed study and determining changes in outcomes resulting from adapted and non-adapted EW treatments to inform refinements. This paper also highlights our strategy for testing theory-driven mediators and moderators of treatment outcomes. Conclusions: This mixed-method pilot trial will inform the first fully powered, self-administered, brief web-based treatment to reduce PTSD symptom severity and negative alcohol-related outcomes among trauma-exposed SMW and TNB individuals.
ABSTRACT
Intensive longitudinal designs (e.g., experience sampling methods [ESMs]) hold promise for examining the dynamic interplay between daily adversity, coping strategies, and behavioral and mental health issues among marginalized populations. However, few studies have used intensive longitudinal designs with sexual minority women (SMW), an understudied and at-risk population. We assessed feasibility and acceptability of using once-daily, interval-contingent ESM with 161 trauma-exposed SMW (Mage = 29.1, SD = 7.57); 20.5% nonbinary; 32.3% queer; 52.2% people of color; 14.3% with annual incomes ≤$9,999; and 30.4% in Southern United States (U.S.). SMW completed one comprehensive online baseline assessment and once-daily brief online assessments for 14 days. Daily surveys assessed past-24-hour stressors, stress responses, and behavioral and mental health symptoms. At the end of the 14-day ESM period, SMW answered three open-ended questions about participating in this study and about research with SMW. Regarding feasibility, 151 participants (94.0%) initiated the post-baseline ESM study portion and 72 (45.0%) completed all 14 daily surveys. An average of 11.70 (median = 13, SD = 3.31) daily surveys (83.5%) were completed by those who initiated the ESM. ESM completion level varied by race/ethnicity and U.S. region. Qualitative acceptability data revealed several themes, namely that SMW (1) enjoyed participating and felt positively about the ESM experience, (2) felt supported to reflect on impacts of early and ongoing stressors, (3) appreciated the chance to self-reflect and challenge existing thought patterns and coping behaviors, (4) recognized their capacity to tolerate trauma-related distress, (5) recommended that researchers focus on SMW's diverse stressors and daily experiences, (6) wanted a rationale for providing sensitive information and more space to narrate their experiences, and (7) recognized the need for affirmative treatment and policies. Findings could inform modifications to ESM protocols to improve their feasibility and acceptability among trauma-exposed SMW and promote ongoing utility of this valuable method.
