Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- 1 The cannabinoid system: from the point of view of a chemist
- 2 How cannabis works in the brain
- 3 Acute and subacute psychomimetic effects of cannabis in humans
- 4 The association between cannabis use and depression: a review of the evidence
- 5 Cannabis and psychosis proneness
- 6 Is there a specific ‘cannabis psychosis’?
- 7 Cannabis as a potential causal factor in schizophrenia
- 8 Cannabis abuse and the course of schizophrenia
- 9 The endogenous cannabinoid system in schizophrenia
- 10 Cannabinoid ‘model’ psychosis, dopamine–cannabinoid interactions and implications for schizophrenia
- 11 Motives that maintain cannabis use among individuals with psychotic disorders
- 12 Addressing cannabis abuse in people with psychosis
- 13 Residual cognitive effects of long-term cannabis use
- Index
- References
11 - Motives that maintain cannabis use among individuals with psychotic disorders
Published online by Cambridge University Press: 07 December 2009
Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- 1 The cannabinoid system: from the point of view of a chemist
- 2 How cannabis works in the brain
- 3 Acute and subacute psychomimetic effects of cannabis in humans
- 4 The association between cannabis use and depression: a review of the evidence
- 5 Cannabis and psychosis proneness
- 6 Is there a specific ‘cannabis psychosis’?
- 7 Cannabis as a potential causal factor in schizophrenia
- 8 Cannabis abuse and the course of schizophrenia
- 9 The endogenous cannabinoid system in schizophrenia
- 10 Cannabinoid ‘model’ psychosis, dopamine–cannabinoid interactions and implications for schizophrenia
- 11 Motives that maintain cannabis use among individuals with psychotic disorders
- 12 Addressing cannabis abuse in people with psychosis
- 13 Residual cognitive effects of long-term cannabis use
- Index
- References
Summary
Rather than attempt to explain fully the complex relationship between cannabis and psychosis, this chapter focuses on what drives people with psychotic disorders to continue their cannabis use. Regardless of what precipitated the cannabis use, it is important to understand what maintains it or why individuals with psychotic disorders continue to use it, despite the negative impact that cannabis use may be having on their mental state. Understanding the motivation for cannabis use may provide insight into the circumstances in which the individual will use substances, the amount consumed, possible consequences and ideal strategies for behaviour change (Simons et al., 1998). This insight can inform psychological treatments that attempt to reduce that use, as well as adjunctive pharmacological treatment and other aspects of psychiatric rehabilitation.
There are various factors to be considered in understanding why people with psychotic disorders continue to use cannabis. These include: (1) level of insight into both their mental illness and the effects of cannabis on symptoms; (2) biological drives for cannabis use (e.g. dopaminergic); (3) genetic or learned family influences; (4) sociocultural influences; (5) impact of affective/psychotic symptoms; (6) personality variables and coping strategies; and (7) addiction. It is argued, however, that the final common pathway or motivation to use cannabis is (8) the expectations of the direct and indirect effects cannabis use will have on affect.
- Type
- Chapter
- Information
- Marijuana and MadnessPsychiatry and Neurobiology, pp. 166 - 185Publisher: Cambridge University PressPrint publication year: 2004
References
and (1997). Reasons for substance use in schizophrenia. Acta Psychiatr. Scand., 96, 329–333CrossRefGoogle Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn revised. Washington, DC: American Psychiatric Association
, and (1995). Self reports of the interaction between substance abuse and schizophrenia. Aust. NZ J. Psychiatry, 29, 69–74CrossRefGoogle Scholar
, , et al. (1999). Examining an affect regulation model of substance abuse in schizophrenia: the role of traits and coping. J. Nerv. Ment. Dis., 187, 72–79CrossRefGoogle ScholarPubMed
, , and (2000). Substance use disorders in schizophrenia: review, integration and a proposed model. Clin. Psychol. Rev., 20, 207–234CrossRefGoogle Scholar
(1994). Motivations for alcohol use among adolescents: development and validation of a four factor model. Psychol. Assessment, 6, 117–128CrossRefGoogle Scholar
, , and (1992). Development and validation of a three-dimensional measure of drinking motives. Psychol. Assessment, 4, 123–132CrossRefGoogle Scholar
and (1988). A motivational model of alcohol use. J. Abnormal Psychol., 97, 168–180CrossRefGoogle ScholarPubMed
and (2001). The association between psychosis and problematic drug use among Australian adults: findings from the National Survey of Mental Health and Well-being. Psychol. Med., 31, 659–668CrossRefGoogle Scholar
Derogatis, L. R. (1993). Brief Symptom Inventory (BSI). Minneapolis: National Computer Systems
, , , and (1991). Drug abuse in schizophrenic patients: clinical correlates and reasons for use. Am. J. Psychiatry, 148, 224Google ScholarPubMed
and (1997). Construct validity of negative symptoms: an empirical overview. Clin. Psychol. Rev., 17, 167–189CrossRefGoogle Scholar
, , and (1998). Patterns of current and lifetime substance abuse in schizophrenia. Schizophr. Bull., 24, 443–445CrossRefGoogle Scholar
and (1999). Substance abuse in people with schizophrenia: readiness to change, reasons for use, and neurocognitive functioning. Schizophr. Res., 36, 40Google Scholar
, , et al. (1995). The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90, 607–614CrossRefGoogle ScholarPubMed
(1998). The role of dysfunctional beliefs in individuals who experience psychosis and use substances: implications for cognitive therapy and medication adherence. Behav. Cognitive Psychother., 26, 193–208Google Scholar
Heinssen, R. K. Jr and Glass, C. R. (1990). Social skills, social anxiety, and cognitive factors in schizophrenia. In Handbook of Social and Evaluation Anxiety, ed. H. Leitenberg. New York: Plenum PressCrossRef
Jackson, H. J., McGorry, P. D., Edwards, J. and Hulbert, C. (1996). Cognitively oriented psychotherapy for early psychosis (COPE). In Early Intervention and Prevention in Mental Health, ed. P. Cotton and H. Jackson, pp. 131–153. Victoria, Australia: Australian Psychological Society Ltd
and . (1986). Why do the nation's students use drugs and alcohol? Self reported reasons from nine national surveys. J. Drug Issues, 16, 29–66CrossRefGoogle Scholar
Kavanagh, D., Saunders, J., Young, R., Jenner, L. and Clair, A. (1998) Start Over and Survive Treatment Manual. Evaluation of a Brief Intervention for Substance Abuse in Early Psychosis. Brisbane, Australia: University of Queensland
Kay, S. R., Opler, L. A. and Fiszbein, A. (1992). Positive and Negative Syndrome Scale (PANSS) Manual. Toronto: Multi-Health Systems
(1985). The self medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. Am. J. Psychiatry, 142, 1259Google ScholarPubMed
(1997). The self medication hypothesis of substance use disorders: a reconsideration and recent applications. Harvard Rev. Psychiatry, 4, 231–244CrossRefGoogle ScholarPubMed
Marlatt, G. A. and Gordon, J. R. (1985). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviour. London: Guildford Press
Miller, W. and Rollnick, S. (1991). Motivational Interviewing: Preparing People to Change Addictive Behaviours. New York: Guildford
, and (1994). Psychosis and schizophrenia in alcohol and drug dependence. Psychiatr. Ann., 24, 418–423CrossRefGoogle Scholar
, , , and (1995). Expectations and motives for substance use in schizophrenia. Schizophr. Bull., 21, 367–378CrossRefGoogle Scholar
, , and (1988). Cognitive motivations for drug use among adolescents: longitudinal tests of gender differences and predictors of change in drug use. J. Counsel. Psychol., 35, 426–438CrossRefGoogle Scholar
and (1991). Marijuana and cocaine effect expectancies and drug use patterns. J. Consult. Clin. Psychol., 59, 558–565CrossRefGoogle ScholarPubMed
, , and (1998). Validating a five factor marijuana motives measure: relations with use, problems and alcohol motives. J. Counsel. Psychol., 45, 265–273CrossRefGoogle Scholar
, and (2000). A comparison of motives for marijuana and alcohol use among experienced users. Addict. Behav., 25, 153–160CrossRefGoogle ScholarPubMed
, and (2002). Motivations that maintain substance use among individuals with psychotic disorders. Schizophr. Bull., 28, 23–247CrossRefGoogle ScholarPubMed
, and (1996). Examination of a three-dimensional drinking motives questionaire in a young adult university sample. Behav. Res. Ther., 34, 61–67CrossRefGoogle Scholar
, , and (1994). Substance use in psychotic disorders: associations with affective syndromes. Schizophr. Res., 14, 73–81CrossRefGoogle ScholarPubMed
, , and (1989). Substance abuse in young adults with schizophrenic disorders. Schizophr. Bull., 15, 465–476CrossRefGoogle Scholar
, , et al. (1994). Substance use among the mentally ill: prevalence, reasons for use and effects on illness. Am. J. Orthopsychiatry, 64, 30–39CrossRefGoogle ScholarPubMed