ArticlePsychological medicine2025
Examining bidirectional associations between cannabis use and internalizing symptoms among high-risk emerging adults: A prospective cohort study.
Article in Psychological medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Changing Patterns of Recent Substance Use in Emerging Adulthood and Their Associations With Cognitive Functions and Mental Health.Biological psychiatry global open science · 2026Article
- Advancing an Integrated Approach to Prevention, Early Identification, and Intervention for Youth with Co-Occurring Substance Use and Mental Health Challenges.Community mental health journal · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundThe co-occurrence of cannabis use and internalizing symptoms, such as depression and anxiety, during emerging adulthood (18-25 years) is well documented. However, while bidirectional relationships are often assumed, empirical evidence is mixed. This study investigates bidirectional longitudinal relationships between cannabis frequency and consequences and internalizing symptoms (depressive and anxiety) among high-risk emerging adults.
methodsData came from seven assessments collected over a 2-year period among 961 (54% female) high-risk emerging adults participating in two longitudinal cohorts (Ontario, Canada; Tennessee, USA). Assessments were at 4-month intervals spanning 2018-2020. Latent curve models with structured residuals were used to explore bidirectional between- and within-person relationships between cannabis-related variables and internalizing symptoms.
resultsAt baseline, higher levels of cannabis frequency and consequences were associated with higher internalizing symptoms. In between-person model components, cannabis-related and internalizing variables decreased across emerging adulthood. Significant within-person bidirectional relationships were observed, partially supporting both symptom-driven and substance-induced pathways, but the findings were specific to negative cannabis consequences, not frequency, and for depressive symptoms, not anxiety symptoms, for symptom-driven pathways. These bidirectional relationships were more pronounced among females and those surpassing clinical thresholds for internalizing symptoms at baseline.
conclusionsThis study found evidence of bidirectional relationships between cannabis consequences and internalizing symptoms across emerging adulthood, with the prevailing direction from cannabis-related negative consequences to increases in internalizing symptoms. These findings highlight the importance of cannabis intervention in emerging adults, both to reduce consequences and to prevent internalizing disorders, especially targeting females and those with clinically elevated internalizing symptoms.
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