title: Social cognitive predictors of treatment outcome in cannabis dependence.
abstract: Drug-related outcomes expectancies and refusal self-efficacy are core components of Social Cognitive Theory. Both predict treatment outcome in alcohol use disorders. Few studies have reported expectancies and refusal self-efficacy in cannabis dependence. None have examined both, although both constructs are key targets in Cognitive-Behavioural Therapy (CBT). This study tests the predictive role of expectancies and refusal self-efficacy in treatment outcome for cannabis dependence.
  
  
  
  Outpatients completed a comprehensive assessment when commencing cannabis treatment and predictors of treatment outcome were tested.
  
  
  
  A university hospital alcohol and drug outpatient clinic.
  
  
  
  221 cannabis-dependent patients participated in a 6-week CBT program where the goal was abstinence.
  
  
  
  Cannabis Expectancy Questionnaire and Cannabis Refusal Self-Efficacy Questionnaire, cannabis dependence severity [Severity of Dependence Scale], psychological distress [General Health Questionnaire] at baseline; the timeline follow-back procedure at baseline and each session.
  
  
  
  Patients reporting lower confidence in their ability to resist cannabis during high negative affect (emotional relief refusal self-efficacy) had a lower likelihood of abstinence (p=0.004), more days of use (p<0.001), and larger amount used (p<0.001). Negative cannabis expectancies predicted greater likelihood of abstinence (p=0.024). Higher positive expectancies were associated with lower emotional relief self-efficacy, mediating its association with outcome (p<0.001).
  
  
  
  Emotional relief refusal self-efficacy and negative expectancies are predictive of better treatment outcomes for cannabis dependence. Positive expectancies may indirectly predict poorer outcome because of a negative association with self-efficacy, but this conclusion remains tentative as directionality could not be established.
authors.affiliation: Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia. Electronic address: m.gullo@uq.edu.au.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gullo
authors.affiliation: Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; School of Psychology, The University of Queensland, Brisbane, QLD 4072, Australia.
authors.forename: Marya
authors.initials: M
authors.lastname: Matveeva
authors.affiliation: Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
authors.forename: Gerald F X
authors.initials: GF
authors.lastname: Feeney
authors.affiliation: Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; Faculty of Health, Queensland University of Technology, Brisbane QLD 4059, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane QLD 4059, Australia.
authors.forename: Ross McD
authors.initials: RM
authors.lastname: Young
authors.affiliation: Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD 4029, Australia; Alcohol and Drug Assessment Unit, Division of Medicine, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; School of Medicine, The University of Queensland, Brisbane, QLD 4029, Australia.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Connor
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D020377:Self Efficacy; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: CBT; Cannabis dependence; Expectancies; Self-efficacy; Treatment