Document Type



Doctor of Philosophy (PhD)



First Advisor's Name

Stefany Coxe

First Advisor's Committee Title

Committee Member

Second Advisor's Name

Jonathan Comer

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

Elisa Trucco

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Wasim Maziak

Fourth Advisor's Committee Title

Committee Member

Fifth Advisor's Name

Raul Gonzalez

Fifth Advisor's Committee Title

Committee chair


adolescent, anxiety, cannabis use, neuropsychology

Date of Defense



Understanding the effects of cannabis use is critical for reducing adverse behavioral, social, and academic outcomes, particularly among adolescent users who are most at risk for cannabis related problems. Although support from both the animal and human literatures suggests the relationship between cannabis and anxiety may be associated with levels of use, much is still unknown. Thus, examining relationships between the most common mental health issue in adolescence and one of the most commonly used drugs is of great public health significance and impact. Prior longitudinal studies assessing effects of cannabis use on anxiety have not evaluated different patterns of use, limiting our ability to identify who may be most at risk for poorer anxiety outcomes. The need to assess the impact of cannabis trajectories on prospective anxiety will allow us to answer the question of specificity, and the role different cannabis patterns have on changes in anxiety symptoms and disorders. The current study leveraged data from a large NIDA-funded study (R01 DA031176) to examine associations between adolescent cannabis use patterns and changes in anxiety symptomology, disorder development, and the interactive effects on decision-making, with data collected from 401 teens across two years. We employed advanced latent growth curve modeling techniques within an accelerated cohort framework, to allow for additional examination of the effects patterns of cannabis use have on anxiety during mid to late adolescence. Three cannabis use trajectories emerged, including a minimal, escalating, and chronic use trajectory. Overall, findings suggest cannabis use during adolescence is associated with changes in anxiety over time. Specifically, state anxiety symptoms increased relative to minimal users at the two-year follow up. Surprisingly, less cannabis use was associated with greater likelihood of anxiety disorder development and several hypotheses are provided as to why this may occur. Further, cannabis trajectory did not influence risky decision-making independently, but rather interacted with anxiety to influence risk-taking among minimal users. Overall, the results of the present study were the first to identify how trajectories of cannabis use influence prospective anxiety in a sample of adolescents across a two-year time span. Our findings contribute to prevention and intervention efforts by identifying adolescent users who are most at risk for developing anxiety symptoms and making poor decisions. Future interventions that target reducing anxiety and cannabis cessation concurrently will further improve cognitive functioning among heavy users.





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