title: Posttraumatic stress disorder and cannabis use characteristics among military veterans with cannabis dependence.
abstract: OBJECTIVE
  The present study is the first to explore links between PTSD and cannabis use characteristics immediately prior to a cannabis quit attempt, including motives, use problems, withdrawal, and craving.
  
  
  METHODS
  Measures of PTSD diagnosis, symptom severity, and cannabis use characteristics were administered to a sample of cannabis dependent military veterans (n = 94). Hypotheses were tested with a series of analyses of variance and covariance and hierarchical multiple regressions with Bonferroni corrections. Analyses were conducted with and without adjusting for variance shared with substance use (cannabis, alcohol, tobacco) in the previous 90 days, and co-occurring mood, anxiety, and substance use diagnoses.
  
  
  CONCLUSIONS
  Compared to participants without PTSD, participants with PTSD reported significantly increased: (a) use of cannabis to cope, (b) severity of cannabis withdrawal, and (c) experiences of craving related to compulsivity, emotionality, and anticipation, with findings regarding coping and craving remaining significant after adjusting for covariates. Among the total sample, PTSD symptom severity was positively associated with (a) use of cannabis to cope, (b) cannabis use problems, (c) severity of cannabis withdrawal, and (d) experiences of craving related to compulsivity and emotionality, with findings regarding withdrawal and emotion-related craving remaining significant after adjusting for covariates. Thus, links between PTSD and using cannabis to cope, severity of cannabis withdrawal, and especially craving appear robust across measures of PTSD and analytical method.
  
  
  CONCLUSIONS
  The results of this study provide support for models that posit a pernicious feedback loop between PTSD symptomatology and cannabis use.
authors.affiliation: Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.
authors.forename: Matthew Tyler
authors.initials: MT
authors.lastname: Boden
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Babson
authors.forename: Anka A
authors.initials: AA
authors.lastname: Vujanovic
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Short
authors.forename: Marcel O
authors.initials: MO
authors.lastname: Bonn-Miller
mesh_terms: D000223:Adaptation, Psychological / Q000187:drug effects*; D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications*; D008875:Middle Aged; D009042:Motivation / Q000187:drug effects / Q000502:physiology; D012044:Regression Analysis; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D013375:Substance Withdrawal Syndrome / Q000145:classification*; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data