Increases in Negative Emotional States during the COVID-19 Pandemic Is Associated with Alcohol and Cannabis Consequences, Refusal Self-Efficacy, and Mental Health Symptoms Among College Students with Cannabis Use Disorder

Background and Purpose: To explore the self-reported impact of the COVID-19 pandemic on negative emotional states and substance use behaviors among college students meeting criteria for cannabis use disorder (CUD). Methods: Data include cross-sectional baseline data (collected in November and December 2020) from an ongoing prospective cohort study of college students meeting criteria for CUD at a large public university in the mid-Western United States (N=150; Mean age=20.6, SD=2.4; female=57%; White=90%; Heterosexual=67%). Descriptive analyses, correlations, and one-way ANOVA tests were conducted based on baseline data from the first wave of data collection. Results: During the pandemic, compared to the 30 days prior to the onset of the pandemic, most participants retrospectively reported an increase in feeling lonely (53%), stressed (68%), anxious (66%), and depressed (52%). There was a significant relationship between reporting an increase in feeling lonely due to the pandemic and decreased drinking refusal self-efficacy (F=5.69, p<0.01; eta squared=.07), increased severity of depressive symptoms (F=9.26, p<0.01; eta squared=.11), and increased severity of anxiety symptoms (F=7.56, p<0.01; eta squared=.09). Additionally, a significant relationship was found between an increase in feeling stressed due to the pandemic with decreased drinking refusal self-efficacy (F=4.91, p<0.01; eta squared=.06) and increased severity of anxiety symptoms (F=9.57, p<0.01; eta squared=.12). There was also a significant relationship between an increase in feeling anxious due to the pandemic and decreased cannabis refusal self-efficacy (F=8.00, p<0.01; eta squared=.10), increased severity of depressive symptoms (F=11.33, p<0.01; eta squared=.13), increased severity of anxiety symptoms (F=13.44, p<0.01; eta squared=.16), and increased number of cannabis-related consequences (F=4.77, p<0.05; eta squared=.06). Lastly, there was a significant relationship between an increase in feeling depressed due to the pandemic and increased severity of depressive symptoms (F=12.193, p<0.01; eta squared=.14), increased severity of anxiety symptoms (F=9.09, p<0.01; eta squared=.11), and increased number of cannabis-related consequences (F=5.40, p<0.01; eta squared=.07). Conclusions and Implications: These data suggest that many college students with CUD experienced an increase in negative emotional states (loneliness, stress, anxiety, and depression) during the pandemic compared to the 30 days prior to the onset of the pandemic, which was related to greater alcohol and cannabis consequences, difficulty with refusal self-efficacy, and increase in the severity of depression and anxiety symptoms. Future research should explore the long-term effects of the COVID-19 pandemic on negative emotional states in this at-risk population