DEPRESSION AND ANXIETY 25:862–873 (2008)

Research Article
MARIJUANA COPING MOTIVES INTERACT
WITH MARIJUANA USE FREQUENCY TO PREDICT ANXIOUS
AROUSAL, PANIC RELATED CATASTROPHIC THINKING,
AND WORRY AMONG CURRENT MARIJUANA USERS
Marcel O. Bonn-Miller, B.A.,1 Michael J. Zvolensky, Ph.D.,1 Amit Bernstein, Ph.D.,2 and Timothy R. Stickle, Ph.D.1

The present investigation evaluated whether coping motives for marijuana use
interacted with past 30-day frequency of marijuana use in relation to anxiety-
relevant variables among community-recruited young adult marijuana users
(n 5 149). As expected, after covarying cigarettes per day, alcohol use, and total
years of marijuana use, the interaction between frequency of past 30-day
marijuana use and coping motives predicted anxious arousal symptoms,
agoraphobic cognitions, and worry. Marijuana users who demonstrated high
use frequency and high coping motives demonstrated the highest levels of anxiety
across these anxiety-relevant criterion variables. No such effects were evident, as
expected, for depressive symptoms, offering explanatory specificity for anxiety
relative to depressive factors. These results are discussed in relation to better
understanding the role of marijuana use and coping motives in regard to
anxiety vulnerability. Depression and Anxiety 25:862–873, 2008. Published
y
2007 Wiley-Liss, Inc.

Key words: marijuana; coping; anxiety; addiction; panic

INTRODUCTION
Marijuana is one of the most commonly used
recreational drugs in the world and the most com-
monly used illicit drug in the United States [Patton
et al., 2002]. According to large scale, representative
surveys, approximately 40% (94 million) of Americans
above the age of 12 have tried marijuana at least once in
their lifetime [Substance Abuse and Mental Health
Services Administration (SAMHSA), 2003]. Recent US
epidemiologic data also suggest approximately 25
million people (approximately 8.6%) have used mar-
ijuana in the past year [SAMHSA, 2004]; similar
findings have been reported outside of the United
States [Fergusson and Horwood, 2000; Swift et al.,
2001]. Moreover, over 50,000 adolescents initiate
marijuana use on a yearly basis [Office of Applied
Studies (SAMHSA), 2002] and over 35% of current
marijuana users (up from 30% 10 years ago) meet
criteria for marijuana abuse or dependence [Compton
et al., 2004]. There also are numerous empirically
established negative consequences of various forms of
marijuana use including various medical illness [Bloom
1
Department of Psychology, University of Vermont, Burling-
ton, Vermont
2
Veterans Affairs Palo Alto Health Care System, Palo Alto,
California
Contract grant sponsor: National Institute on Drug Abuse
research grants; Contract grant numbers: 1 R01 DA018734-
01A1, R03 DA16307-01, and 1 R21 DA016227-01; Contract grant
sponsor: National Research Service Award; Contract grant
number: F31 MH073205-01.
Correspondence to: Michael J. Zvolensky, Ph.D., The University
of Vermont, Department of Psychology, 2 Colchester Avenue,
John Dewey Hall, Burlington, VT 05405-0134.
E-mail: Michael.Zvolensky@uvm.edu.
Received for publication 3 October 2006; Revised 18 April 2007;
Accepted 15 June 2007
DOI 10.1002/da.20370
Published online 11 September 2007 in Wiley InterScience (www.
interscience.wiley.com).
y
This article is a US Government work and, as such, is in the
public domain in the United States of America.

Published 2007 Wiley-Liss, Inc.

 Research Article: Marijuana Coping Motives
et al., 1987] and social [Stephens et al., 2002] as well as
occupational problems [Leirer et al., 1991].
Other research has begun to isolate the associations
between patterns of marijuana use and psychological
functioning. The vast majority of this work has focused
on depressive problems [Bovasso, 2001; Brook et al.,
2002; Grant, 1995; Weller and Halikas, 1985], but the
findings have been relatively inconsistent. For example,
some studies have found clear connections between
marijuana use and depression [Diamond et al., 2006;
Patton et al., 2002; Rey et al., 2002], whereas others
have found no such relation after controlling for
common factors [e.g., gender, concurrent substance
use; Harder et al., 2006; Zvolensky et al., 2006a–c].
Compared with depressive factors, there has been less
scientific study of marijuana use and its disorders in
relation to anxiety symptoms and psychopathology. Of
the available work, studies suggest that there may be a
relation between heavier forms of marijuana use and
disorders (abuse and dependence) in terms of certain
anxiety symptoms and problems. For example, more
frequent marijuana use has been concurrently and
prospectively associated with more anxiety symptoms
among adolescents and young adults even after
controlling for the variance attributed to other
theoretically relevant factors [Bonn-Miller et al.,
2005; Brook et al., 2001; Oyefeso, 1991; Zvolensky
et al., 2006a–c]. Studies have also indicated that more
severe problems with marijuana are related to panic
attacks. For instance, after controlling for polysub-
stance use, alcohol abuse, and demographic variables,
marijuana dependence, but not use or abuse, is
significantly related to an increased risk of panic
attacks among representative samples [Zvolensky
et al., 2006a–c]. These investigations collectively
suggest that heavier patterns of marijuana use, or more
severe problems related to such use (e.g., dependence),
are associated with both anxiety symptoms and panic
attacks. Yet, only limited study has examined what
facets of the phenomenological nature of marijuana use
(i.e., use motives, stages of use) may help account for
this marijuana-anxiety comorbidity. Little is therefore
known about the processes or mechanisms explaining
these observed marijuana-anxiety associations. As one
illustrative example, it is presently empirically unclear
how motivational processes related to marijuana use,
although theoretically potentially important to under-
standing such relations [Cooper, 1994] are associated
with such documented linkages.
There is a growing recognition, in fact, that the
reasons or motivational basis1 why some people
use marijuana is central to better understanding
the nature of substance use behavior [Cooper, 1994].
This type of approach recognizes that there are a
number of distinct motives for using marijuana that can
1
We use the terms reasons for use and motivational bases of use
interchangeably in this paper. Both terms reflect the expressed
psychological functions of marijuana use [Cooper, 1994].
863
vary both between and within individuals [Cooper,
1994]. That is, two users may use marijuana for
different reasons, and one individual may use for
multiple reasons. Such motives are theorized to be
related to different patterns of use and risk for
substance use problems [Newcomb et al., 1988] as
well as psychological vulnerability [Bonn-Miller et al.,
2007]. The most well established and widely used
measure of motivation for marijuana use is the
Marijuana Motives Measure [MMM; Simons et al.,
2000, 1998]. Research using the MMM has been
promising and productive, indicating that there are
distinct, replicable, and internally consistent factors of
marijuana use motives. Specifically, the MMM indexes
Enhancement, Conformity, Expansion, Coping, and
Social marijuana use motives [Chabrol et al., 2005].
Research using the MMM has found that each subscale
is related to frequency of marijuana use above and
beyond the variance accounted for by other types of
drug use and history of using marijuana [e.g., age of
onset; Bonn-Miller et al., 2007; Simons et al., 1998,
2000]. Within this emerging literature, initial work
indicates that emotional vulnerability processes among
marijuana users are uniquely related, in particular, to
the Coping Motive subscale [Bonn-Miller et al., 2007].
Current theoretical models of anxiety-marijuana
comorbidity posit that the tendency to use this
substance for coping-oriented reasons may serve to
exacerbate the anxiogenic effects of marijuana use
[Zvolensky et al., 2006a–c]. Specifically, these models
suggest that the combination of a greater frequency of
marijuana use and a greater tendency to use this
substance for coping with emotionally salient stressors
may likely be anxiogenic. Although there have not been
direct tests of this type of interactive model, this type of
perspective is supported indirectly by two key observa-
tions. The first being that more frequent use of
marijuana is related to increased risk of anxiety
symptoms [Brook et al., 2001; Oyefeso, 1991]. Thus,
greater patterns of use, or more severe problems
related to such use, may be related to greater degrees
of anxiety vulnerability. In this context, it is noteworthy
that recent work among polysubstance users suggests
that such effects are relatively specific to anxiety and
much more equivocal for depressive symptoms [Bonn-
Miller et al., 2005; Zvolensky et al., 2006a–c]. The
second being that marijuana use intended to cope with
these distressing emotional states may then fuel an
avoidance-based forward-feeding cycle. Here, coping
with such affective distress by using marijuana can be
conceptualized as a ‘‘short-term’’ emotion regulation
strategy, but over time, this motivation by use cycle
may promote anxiety symptoms. For example, to the
extent a marijuana user does not develop or utilize
more adaptive coping strategies for emotional experi-
ences, they may become ‘‘locked in a pattern’’ of
avoiding distressing symptoms by using marijuana to
ameliorate anxiety-related distress (e.g., to lessen
contact with the anxiety-relevant stimulus, to feel more
Depression and Anxiety
864 Bonn-Miller et al.
secure or less distressed in the face of ongoing
distressing symptoms, or generally protect them in the
event of distressing symptoms). From this emotion
regulatory perspective, coping-based marijuana use is a
method of psychological control for personally threa-
tening stimuli. In this scenario, such coping-based use of
marijuana, regardless of the objective mood-dampening
effects of marijuana, may actually serve to promote
greater anxiety vulnerability, as personally threatening
events (emotionally distressing symptoms) are operating
psychologically as fear-relevant stimuli. There is a large
degree of non-marijuana related theoretical and empiri-
cal work that suggests this avoidant coping style or
maladaptive emotion regulatory strategy is uniquely
related to more severe anxiety symptoms and the future
development of anxiety problems [Buller et al., 1986;
Ehlers, 1995; Spira et al., 2004; White et al., 2006].
Thus, individuals may theoretically actually be at an
increased risk for anxiety symptoms by virtue of their
use patterns and motives for such use [Zvolensky et al.,
2006a–c]. One key next step in the development of our
theoretical and empirical knowledge base related to
marijuana-anxiety relations, then, is to conduct theore-
tical model-driven empirical tests of this use by coping
motive anxiogenic hypothesis.
Together, the overarching aim of the present investi-
gation was to provide an initial empirical test of the
theoretically driven marijuana frequency by coping
motive hypothesis in terms of anxiety-relevant variables.
Participants included community-recruited (current)
adult marijuana users. Young adults were studied, as
opposed to other age groups, as marijuana use and its
disorders represent a common and growing problem
among this population [Compton et al., 2004]. It was
hypothesized that more frequent marijuana use and a
greater tendency to use marijuana for coping-oriented
reasons would be predictive of anxiety variables above
and beyond the variance attributable to the respective
main effects and other theoretically relevant factors (e.g.,
levels of alcohol and tobacco use). As an index of
explanatory specificity, it was also hypothesized that no
such interactive effect would be evident for depressed
affect, suggesting the use by coping motive model,
which is based in avoidance theoretical models and
empirical work [Buller et al., 1986], is primarily
applicable to anxiety states. Overall, these hypotheses
were driven by conceptual models of marijuana-anxiety
comorbidity [Zvolensky et al., 2006a–c] and extant
empirical observations [Bonn-Miller et al., 2007, 2005;
Brook et al., 2001; Oyefeso, 1991] that suggest both use
and the motivational basis for such use are key
explanatory constructs in regard to anxiety vulnerability.
METHOD
PARTICIPANTS
The sample consisted of 149 (82 women) young
adult (current, as defined by use in the past 30 days)
Depression and Anxiety
marijuana users from the greater Burlington, Vermont
community. Individuals were recruited through news-
paper and other local advertisements posted in
university and non-university settings (see Procedure
section for details). The mean age of the sample was
20.84 (SD 5 5.16) years. The racial distribution of the
study sample reflected that of the local population
[State of Vermont Department of Health, 2000]: 96%
of the total sample was Caucasian, 1% Asian, 1%
African American, 1% Hispanic, and 1% other.
Approximately two thirds (67.8%) of the sample
smoked marijuana on at least a weekly basis, and of
this group 22.8% reported smoking more than once
per day. Participants reported first using the drug when
they were 15.10 (SD 5 2.21) years old and considered
themselves regular marijuana smokers by age 16.1
(SD 5 4.11). Approximately 64% of participants
smoked tobacco daily, averaging 9.47 (SD 5 9.31)
cigarettes per day and began cigarette smoking at a
mean age of 16.26 (SD 5 2.33) years. Forty-nine
percent of the participants were regular alcohol users,
drinking an average of 5 or 6 alcoholic beverages
approximately 2 to 3 times per week. Participants were
excluded from the study if they evidenced limited
mental competency or the inability to give informed,
written consent or were not a current marijuana
smoker. Of the 264 individuals who initially responded
to the community-based advertisements, 149 met the
study inclusionary criteria.
MEASURES
Marijuana smoking history and pattern were assessed
with the Marijuana Smoking History Questionnaire
[MSHQ; Bonn-Miller and Zvolensky, 2005]. The
MSHQ is a self-report instrument that includes items
pertaining to marijuana smoking rate (past 30 days),
age of onset at initiation, years of being a regular
marijuana smoker, and other descriptive information
(e.g., number of attempts to discontinue using mar-
ijuana). Past-month frequency was assess using a 0–8
Likert-type rating scale (0 5 no use, 4 5 once per week,
8 5 more than once a day). The MSHQ has performed
well in previous studies [Bonn-Miller et al., 2005;
Zvolensky et al., 2006a–c].
Marijuana motives for use were assessed with the
Marijuana Motives Measure [MMM; Simons et al.,
1998]. The MMM is a 25-item measure in which
respondents indicate on a 5-point Likert-type scale
(1 5 ‘‘almost never/never’’ to 5 5 ‘‘almost always/always’’)
the degree to which they have smoked marijuana for
a variety of possible reasons (e.g. ‘‘to be sociable’’).
Factor analysis of the scale indicates that it has five
first-order factors entitled Enhancement, Conformity,
Expansion, Coping, and Social motives [Simons et al.,
1998]. The MMM has high levels of internal consis-
tency for each of the five factors (range of
a coefficients: 0.86 to 0.93) and has been successfully
used in the past to tap motivation for using marijuana
 Research Article: Marijuana Coping Motives
[Chabrol et al., 2005]. In the current study, only the
Coping subscale of the MMM was used. This subscale
comprises 5-items that target the use of cannabis for
coping with negative affect related feelings (e.g., ‘‘to
forget my worries’’).
Cigarette smoking history and pattern were assessed
with the Smoking History Questionnaire (SHQ). The
SHQ includes items pertaining to smoking rate, age of
onset at initiation, and years of being a regular smoker;
it also has performed well in previous studies [Brown
et al., 2002; Zvolensky et al., 2004, 2005]. The daily
smoking rate item from the SHQ was used as the
primary index of ‘‘smoking exposure’’. Smoking rate, as
opposed to other potential indices of smoking history
(e.g., nicotine dependence), was utilized, as it has been
used in past work on marijuana [Block et al., 1991;
Degenhardt et al., 2001]; therefore, it facilitated
comparability to previous research.
Alcohol consumption was measured with the Alcohol
Assessment [AA; Zvolensky et al., 2006a–c]. The AA is a
three-item measure that includes items examining the
(1) presence/absence of current alcohol use, (2)
frequency (weekly, monthly, and yearly), and (3)
quantity of such use. Frequency and quantity of alcohol
consumption were assessed in a manner used in
previous research [Stewart et al., 1995, 2001]. In regard
to frequency, participants reported the number of
occasions per week on which they normally consumed
alcohol; those who consumed alcohol on less than one
occasion weekly estimated monthly or yearly fre-
quency. In regard to quantity, participants indicated
the average number of alcoholic beverages (e.g., ‘‘1 or
2’’; using standardized conversions) they normally
consumed per drinking occasion. An average alcohol
volume index was computed via the product of the
weekly frequency by quantity items [Wechsler et al.,
1994].
Agoraphobic cognitions were assessed with the
Agoraphobic Cognitions Questionnaire [ACQ; Chambless
et al., 1984]. The ACQ is a 14-item scale measuring
thoughts about the negative consequences of experien-
cing anxiety [Chambless et al., 1984]. Items are rated
on a 5-point Likert scale from (1) thought never occurs to
(5) thought always occurs. The ACQ comprises two
factors: social/behavioral concerns and physical con-
cerns. The ACQ has been shown to have high internal
consistency (Cronbach a 5 .87), moderate test–retest
reliability (r 5 .67 for 1 month) and sensitivity to
changes due to treatment [Chambless et al., 1984]. The
ACQ can also discriminate clinical from non-clinical
groups, especially individuals with anxiety disorders
[Chambless and Gracely, 1989]. The ACQ total score
was used to index anxiety-related cognitions (a
criterion variable). The ACQ also has demonstrated
convergent validity with other established measures
across a range of diverse populations [Arrindell, 1993;
Chambless et al., 1984; Kotov et al., 2005; Warren
et al., 1989, 1990; Yartz et al., 2005]. As in past research
[Yartz et al., 2005], we utilized the ACQ total score as a
865
global index of maladaptive thoughts about anxiety and
panic attack symptoms.
The Mood and Anxiety Symptom Questionnaire
(MASQ) was used to assess anxious arousal and
anhedonic depression. The MASQ is a comprehensive
measure of affective symptoms [Watson et al., 1995].
Participants indicate how much they have experienced
each symptom from 1 (‘‘not at all’’) to 5 (‘‘extremely’’)
during the past week. Factor analysis indicates that this
scale taps key anxiety–depression symptom domains.
The Anxious Arousal scale (MASQ-AA) measures
symptoms of somatic tension and arousal (e.g., ‘‘felt
dizzy’’). The Anhedonic Depression scale (MASQ-AD)
measures a loss of interest in life (e.g., ‘‘felt nothing was
enjoyable’’) and reverse-keyed items measure positive
affect. The General Distress: Depressive Symptoms
scale (MASQ: GDD) measures depressed mood
expected to be non-differentiating relative to anxiety
(e.g., ‘‘felt discouraged’’). The General Distress:
Anxious Symptoms scale (MASQ: GDA) indexes
anxious mood expected to be non-differentiating
relative to depression (e.g., ‘‘felt nervous’’). The MASQ
shows excellent convergence with other measures of
anxiety and depression and good discriminative validity
for anxious versus depressive symptoms via the MASQ-
AA and MASQ-AD scales, respectively [Watson et al.,
1995]. The MASQ-AA and the MASQ-AD subscales
have shown high levels of internal consistency (a range:
coefficients: .86 to .90 and .90 to .93 respectively). In
the present study, the MASQ-AA and MASQ-AD
subscales were used to index anxiety and depressive
symptoms, respectively.
The Penn State Worry Questionnaire [PSWQ; Meyer
et al., 1990] is a 16-item self-report measure that was
used to assess three areas of worry: generality,
excessiveness, and uncontrollability. Items are rated
on a 5-point Likert scale from (1) not at all typical to (5)
very typical. Total scores range from 16 to 80 with
higher scores, indicating greater levels of worry. The
PSWQ is able to distinguish individuals with general-
ized anxiety disorder from other anxiety disorders [e.g.,
social anxiety disorder and posttraumatic stress dis-
order; Brown et al., 1992; Fresco et al., 2003; Meyer
et al., 1990] and has high internal consistency and good
test–retest reliability [Meyer et al., 1990].
PROCEDURE
Potential participants were recruited through news-
paper and other local advertisements (e.g. community-
based flyers and newspaper advertisements). This study
was part of a larger study on emotion whose primary
aim was not the investigation of marijuana use; thus,
advertisements communicated that individuals could
earn a modest monetary reward for their participation
in a research study focused on emotion, rather than
marijuana, at the University of Vermont. Interested
participants who contacted the research team about the
study were given a detailed description of the
Depression and Anxiety
866 Bonn-Miller et al.

investigation and scheduled for a laboratory visit. Upon
arrival, participants provided written informed consent.
Thereafter, participants completed a battery of self-
report measures. After the study, participants were
debriefed and compensated $30 for their time and
effort.
RESULTS
ZERO-ORDER CORRELATIONS FOR
THEORETICALLY RELEVANT VARIABLES
Associations among variables are displayed in Table 1.
The first set of correlations examined relations between
covariates and the dependent variables. Daily tobacco
use was significantly positively associated with MASQ-
AA (r 5 .30, Po.01), MASQ-AD (r 5 .34, Po.01),
agoraphobic cognitions (r 5 .17, Po.05) as well as
worry (r 5 .23, Po.01). Alcohol consumption was
significantly negatively correlated with MASQ-AD
(r 5
.19, Po.05), and did not demonstrate significant
associations with any other dependent measures.
Finally, total number of years of marijuana use was
significantly positively associated with MASQ-AD
(r 5 .23, Po.01), but not the other criterion variables.
The next set of descriptive zero-order correlations
focused on the associations between predictor and
criterion variables. Here, coping motives were sig-
nificantly positively associated with all dependent
measures (MASQ-AA; r 5 .34, Po.01, MASQ-AD;
r 5 .30, Po.01, agoraphobic cognitions; r 5 .38,
Po.01, and worry; r 5 .24, Po.01). Frequency of past
30-day marijuana use was not significantly associated
with any of the criterion variables (MASQ-AA; r 5 .09,
ns, MASQ-AD; r 5 .01, ns, agoraphobic cognitions;
r 5
.01, ns, worry; r 5
.11, ns). Finally, the associa-
tion between the two predictor variables (i.e., coping
motives and frequency of past 30-day marijuana use)
was examined. A moderate, significant positive associa-
tion was observed (r 5 .41, Po.01), such that high
marijuana use is significantly associated with increased
coping motivation for use.
REGRESSION EQUATIONS
The main and interactive relations between marijua-
na coping motives and frequency of past 30-day
marijuana use were evaluated in relation to the primary
dependent variables using a hierarchical multiple
regression procedure [Cohen and Cohen, 1983]; see
Table 2. Separate models were constructed for predict-
ing anxious arousal, anhedonic depressive symptoms,
agoraphobic cognitions, and worry. Number of cigar-
ettes smoked per day, total number of years of
marijuana use, and volume of alcohol consumed were
entered as covariates at level 1 in the model. At the
second level, the main effects for coping motives and
frequency of marijuana use were simultaneously
entered into the model to estimate the amount of
variance accounted for by these main effects individu-
ally after accounting for the variance at level 1. At the
third level, the interaction term between coping
motives and frequency of marijuana use was entered
into the model [Baron and Kenny, 1986]. In such a
procedure, the final level of the model not only
includes the addition of the interaction term that is
being tested, but all other variables that were entered in
prior levels; all variables are simultaneously entered at
the third level. The interaction term was mean
centered before running the regression analyses to
minimize multicollinearity [Aiken and West, 1991].
In terms of anxious arousal symptoms, level 1 of the
model accounted for 10.6% of the variance. Daily
cigarettes (t 5 3.94, b 5 .38, Po.01) was the only
significant predictor. After controlling for variance
accounted for by level 1 of the model, there was a
significant main effect for coping motives in predicting
anxious arousal symptoms at level 2 (t 5 3.29, b 5 .29,
Po.01), but not for frequency of past 30-day marijuana
use (t 5
1.08, b 5
.09, ns). The addition of the main

TABLE 1. Descriptive data and zero-order relations among theoretically relevant variables

Cig/day Years smoked VAC 30 day use Coping MASQ-AA MASQ-AD ACQ PSWQ Mean (SD)

Cig/day 1 .51
.02 .28 .27 .30 .34 .17 .23 9.47 (9.3)
Years smoked 1
.13 .12 .12 .02 .23
.09 .10 5.22 (6.0)
VAC 1 .14 .07 .04
.19
.06
.14 8.18 (4.6)
30-day use 1 .41 .09 .01
.01
.11 4.87 (2.6)
Coping 1 .34 .30 .38 .24 2.46 (1.1)
MASQ-AA 1 .42 .60 .50 26.60 (9.0)
MASQ-AD 1 .44 .59 55.06 (13.8)
ACQ 1 .52 1.50 (.45)
PSWQ 1 31.19 (15.27)
Po.05; Po.01; Cig/day, daily cigarettes; years smoked, total number of years smoked marijuana; VAC, volume of alcohol consumed; 30-day
use, frequency of past 30-day marijuana use; Coping, Marijuana Motives Measure, Coping Subscale [Simons et al., 1998]; MASQ-AA, Mood and
Anxiety Symptom Questionnaire – Anxious Arousal [Watson et al., 1995]; MASQ-AD, Mood and Anxiety Symptom Questionnaire – Anhedonic
Depression [Watson et al., 1995]; ACQ, Agoraphobic Cognitions Questionnaire [Chambless et al., 1984]; PSWQ, Penn State Worry
Questionnaire – Total Score [Meyer et al., 1990].

Depression and Anxiety

 Research Article: Marijuana Coping Motives 867

TABLE 2. Frequency of past-30 day marijuana use by coping motives predicting anxious arousal, agoraphobic
cognitions, worry, and anhedonic depression

DR2 T (each predictor) b Sr2 P

Criterion variable: anxious arousal

Step 1 .11 o.01
Years smoked marijuana
1.73
.17 .02 ns
Volume of alcohol consumed
.03
.00 .00 ns
Daily cigarettes 3.94 .38 .10 o.01
Step 2 .07 o.01
Marijuana use (30 day)
1.08
.09 .01 ns
Coping motives 3.29 .29 .08 o.01
Step 3 .03 o.05
Marijuana use  coping motives 2.21 .65 .04 o.05

Criterion variable: agoraphobic cognitions

Step 1 .08 o.05
Years smoked marijuana
2.47
.24 .04 o.05
Volume of alcohol consumed
1.43
.12 .02 ns
Daily cigarettes 2.83 .28 .06 o.01
Step 2 .15 o.01
Marijuana use (30 day)
2.13
.18 .03 o.05
Coping motives 4.85 .41 .15 o.01
Step 3 .07 o.01
Marijuana use  coping motives 3.44 .97 .08 o.01

Criterion variable: worry

Step 1 .06 o.05
Years smoked marijuana
.37
.04 .00 ns
Volume of alcohol consumed
1.64
.14 .02 ns
Daily cigarettes 2.31 .23 .04 o.05
Step 2 .12 o.01
Marijuana use (30 day)
3.27
.28 .08 o.01
Coping motives 3.80 .33 .10 o.01
Step 3 .07 o.01
Marijuana use  coping motives 3.56 1.02 .09 o.01

Criterion variable: anhedonic depression

Step 1 .17 o.01
Years smoked marijuana .46 .04 .00 ns
Volume of alcohol consumed
2.72
.22 .05 o.01
Daily cigarettes 3.41 .32 .08 o.01
Step 2 .09 o.01
Marijuana use (30 day)
2.08
.17 .03 o.05
Coping motives 3.78 .31 .10 o.01
Step 3 .02 ns
Marijuana use  coping motives 1.88 .53 .03 ns

Not all variables in each step are represented in the above table, as each step includes all variables entered in prior steps; only the novel variables
that were entered at each step are presented. b, standardized b weight; sr2, squared partial correlation.

effects at level two accounted for an additional 6.9% of
the variance in anxious arousal symptoms. As hypothe-
sized, the interaction term was a significant predictor at
level 3 (t 5 2.21, b 5 .65, Po.05), accounting for an
additional 3% of variance in anxious arousal symptoms.
In terms of agoraphobic cognitions, the first level
accounted for 7.5% of the variance. Both daily
cigarettes (t 5 2.83, b 5 .28, Po.01) and total number
of years of marijuana use (t 5
2.47, b 5
.24, Po.05)
were significant predictors. A main effect for both
coping motives (t 5 4.85, b 5 .41, Po.01) and past
30-day marijuana use (t 5
2.13, b 5
.18, Po.05) was
found at level 2 of the model, accounting for an
additional 14.6% of variance. As hypothesized, the
interaction between coping motives and frequency of
marijuana use significantly predicted agoraphobic
cognitions at level three of the model; it accounted
for 6.6% of unique variance (t 5 3.44, b 5 .97, Po.01).
Regarding worry, the first level accounted for 6.3%
of the variance. Daily cigarettes (t 5 2.31, b 5 .23,
Po.05) was the only significant predictor. A main effect
for frequency of marijuana use (t 5
3.27, b 5
.28,
Depression and Anxiety
868 Bonn-Miller et al.

Po.01) as well as coping motives (t 5 3.80, b 5 .33,

Po.01) was found at level 2 of the model, accounting
for an additional 12.3% of variance; again, it is
noteworthy that greater marijuana use in the past 30
days was associated with less worry. As hypothesized,
the interaction between coping motives and frequency
of marijuana use significantly predicted worry at level 3
of the model; it accounted for approximately 7.3% of
unique variance (t 5 3.56, b 5 1.02, Po.01).
In regard to depressive symptoms, level 1 of the
model accounted for 16.5% of the variance in this
criterion variable, with alcohol consumption
(t 5
2.72, b 5
.22, Po.01) and daily cigarettes
(t 5 3.41, b 5 .32, Po.01) as significant predictors.
Level 2 of the model accounted for an additional
8.9% of variance, with both main effects being
significant predictors (coping; t 5 3.78, b 5 .31,
Po.01, marijuana use; t 5
2.08, b 5
.17, Po.05). It
is again important to note that marijuana use demon-
strated a significant, although, negative association
Figure 1. Interaction between frequency of past 30-day mar-
with depressive symptoms. After controlling for the ijuana use and marijuana coping motives predicting anxious
variance accounted for by levels 1 and 2 of the model, arousal. On the X-axis, ‘‘high’’ frequency marijuana use refers to
the interaction term was not a significant predictor of .5 standard deviations above the mean marijuana use level in the
depressive symptoms at level 3 (t 5 1.88, b 5 .53, entire sample; similarly, ‘‘low’’ frequency marijuana use refers to
P 5.06), although a trend was evident.2 .5 standard deviations below the mean marijuana use level in the
Interactions were examined both graphically [see entire sample. The same analytic format was used for coping
Cohen and Cohen, 1983; for a review] and analytically motives.
[Holmbeck, 2002] to determine direction and signifi-
cance. First, based on recommendations of Cohen and
Cohen [1983, pp. 323, 419], the form of these
interactions were examined by inserting specific values
for each predictor variable into the regression equa-
tions associated with the described analysis. As can be
seen in Figures 1–3, the form of the interactions
generally, but not uniformly, supported the hypotheses.
Specifically, regardless of frequency of marijuana use,
high coping motives were associated with high anxious
arousal (see Fig. 1), agoraphobic cognitions (see Fig. 2),

2
Regression equations were also completed with all of the other
marijuana use motives (i.e., conformity, social, expansion, and
enhancement) included at level 1 of the model, in addition to the
other covariates, to ensure that the hypothesized effects were specific
to coping motives above and beyond shared variance with other
motives. Initial zero-order correlations revealed Coping motives for
marijuana use to be significantly positively related to Enhancement
(r 5 .46, Po.01), Social (r 5 .49, Po.01), and Expansion (r 5 .40,
Po.01) motives, while not significantly related to Conformity
motives (r 5 .16, P 5.06). Results indicated an identical pattern to
the one observed without these variables added, without a trend seen
for anhedonic depressive symptoms. Thus, it is likely that the trend
toward an interaction effect for anhedonic depressive symptoms may
be a product of the collinearity between marijuana use motives. This Figure 2. Interaction between frequency of past 30-day mar-
test, then, provides further support for the exclusion of other ijuana use and marijuana coping motives predicting agoraphobic
marijuana use motives in the primary analyses as, in such a case, cognitions. On the X-axis, ‘‘high’’ frequency marijuana use refers
shared variance amongst marijuana motives is unable to hinder the to .5 standard deviations above the mean marijuana use level in
ability of coping motives and the interaction term to account for the the entire sample; similarly, ‘‘low’’ frequency marijuana use
variance of the criterion variables. These analyses are not reported in refers to .5 standard deviations below the mean marijuana use
full in the manuscript because they were not part of the theoretical level in the entire sample. The same analytic format was used for
model being evaluated on an a priori basis. coping motives.

Depression and Anxiety

 Research Article: Marijuana Coping Motives
Figure 3. Interaction between frequency of past 30-day mar-
ijuana use and marijuana coping motives predicting worry. On
the X-axis, ‘‘high’’ frequency marijuana use refers to .5 standard
deviations above the mean marijuana use level in the entire
sample; similarly, ‘‘low’’ frequency marijuana use refers to .5
standard deviations below the mean marijuana use level in the
entire sample. The same analytic format was used for coping
motives.
and worry (see Fig. 3). Consistent with predictions,
marijuana users who demonstrated high use frequency
and high coping motives demonstrated the highest
levels of anxiety across these (separate) criterion
variables. Yet, although high coping motives were
uniformly associated with elevated anxiety across the
dependent measures, high-level marijuana users who
have low coping use motives demonstrated generally
similar levels of anxious arousal compared with low-
level marijuana users with low or high coping motives
(see Fig. 1). In the case of agoraphobic cognitions and
worry, figures indicate that high-frequency marijuana
users with low coping motives reported less anxiety
than any of the other groups (see Figs. 2 and 3). In all
three anxiety outcomes, however, high-frequency
marijuana users with low, relative to high, coping
motives demonstrated significantly lower levels of
anxiety (see Figs. 1–3). Furthermore, based on recom-
mendations of Holmbeck [2002], post-hoc probing
analyses were conducted on the data to examine the
significance of the simple slopes and interactions. In all
three cases, the relation between frequency of past 30-
day marijuana use and the outcome variables (i.e.,
anxious arousal, agoraphobic cognitions, or worry) was
significant when coping was low (t 5
2.03, b 5
.21,
Po.05, t 5
3.36, b 5
.34, Po.01 and t 5
4.29,
b 5
.45, Po.01, respectively), such that the outcome
variable (e.g., worry) is lower at higher levels of use
when coping is low. To probe further into the large
869
positive association between frequency of marijuana
use and marijuana coping motives, sample sizes were
subsequently examined for each of the four groups
(identified by .5 standard deviation cut-offs) to
determine possible explanations for the collinearity of
the two predictor variables. In the total sample of
marijuana users (n 5 149), 22 people were considered
high marijuana users who also had high levels of coping
motivation. Conversely, 29 people were in the low
marijuana using, low coping motivated group. Next,
the high marijuana using group who were low in
coping motives consisted of 13 people, while the low
marijuana using group who were high in coping
motives consisted of six people.
DISCUSSION
Although many young adults regularly use marijuana
on a regular basis [Compton et al., 2004], there is little
work linking such drug use to anxiety symptoms. This
neglect of study on marijuana-anxiety associations is
unfortunate, as there is emerging empirical work,
indicating that marijuana use and coping motives are
related to anxiety symptoms [Bonn-Miller et al., 2005;
Simons et al., 1998]. The purpose of the present
investigation was to provide a novel test of a model
evaluating whether marijuana users who use more
frequently and who use to cope with negative affect will
report elevated levels of anxiety vulnerability.
Consistent with expectation, marijuana users who
demonstrated the highest levels of use frequency and
coping motives reported the highest levels of anxious
arousal, worry, and agoraphobic cognition. This
interaction effect was consistent with theory regarding
the specific conditions under which marijuana use may
be related to anxiety vulnerability [Zvolensky et al.,
2006a–c]. This significant interaction explained from 3
to 7% of unique variance after accounting for the
variables entered at the earlier levels in the model.
Thus, the observed effects were of a possible clinically
relevant effect size using traditional standards [Cohen
and Cohen, 1983], cannot be alternatively explained by
co-occurring substance use factors, and are a reflection
of the associations between marijuana use, coping
motives, and the studied anxiety criterion variables.
Although no specific hypothesis was posited in terms of
the conditions for the lowest levels of anxiety among
marijuana users, the form of the interaction revealed an
interesting effect in this regard that further illustrates
the importance of understanding marijuana use and
anxiety relations in terms of use motives. Namely,
marijuana users who reported the lowest levels of
anxious arousal symptoms, panic-related catastrophic
thinking, and worry, endorsed low levels of coping
motives but were high-level users. This finding, in
conjunction with the other observed effects, highlights
the potential complexities involved with understanding
the emotional-related linkages of marijuana use. In
short, tests simply focusing on parameters of frequency
Depression and Anxiety
870 Bonn-Miller et al.
of use without also integrating, at a minimum, motives
for use, may shed light on only a limited aspect of
possible effects. As the basic literature grows on
marijuana anxiety and mood associations, further
insight into the nature of possible relations should
become increasingly evident.
Though comparative analyses were employed that
focused on the marijuana use and coping motive
interaction predicting depressive symptoms, only slight
evidence of explanatory specificity was shown as the
effect was not quite significant for depressive symptoms
(P 5.06). This pattern of interactive effects provides an
important initial step in a test of discriminant validity.
Specifically, higher levels of marijuana use and coping
motives for such use appear to be apparent for anxiety,
but not depressive, variables. These findings suggest
that marijuana use and motives are tied to anxiety-
relevant learning processes, a position supported
indirectly by non-marijuana-oriented anxiety research
[Buller et al., 1986; Spira et al., 2004; White et al.,
2006]. It should be expressly noted, however, that the
overall level of discriminative validity is rather limited.
The interactive effect, specifically, just fell short of
traditional statistical significance and is nearly the same
sized effect as that observed for the anxiety variables
(see Table 2). In view of the present data, future work
could usefully and more rigorously test discriminant
associations for anxiety and depressive symptoms by
incorporating prospective measurement paradigms.
For example, researchers could benefit by examining
whether marijuana use and coping motives uniquely
predict increased risk for anxiety, but not depressive,
symptoms over time. An alternative approach would be
to use laboratory-based provocation strategies to
induce various emotional states (e.g., anxiety, sadness,
anger) and evaluate specificity of a use and coping
motive interaction in differentially predicting anxiety
and depressive factors. Ultimately, this type of work
will help refine marijuana-anxiety models and thereby
enhance efforts to translate such knowledge to cutting-
edge clinical strategies.
Outside of the observed interaction effects, at least
three other issues warrant comment. First, and con-
sistent with theory regarding marijuana-anxiety rela-
tions [Zvolensky et al., 2006a–c], individuals who use
marijuana in order to cope uniformly reported greater
degrees of anxiety and depressive symptoms. These
data indicate that coping-oriented reasons for mar-
ijuana use are indeed relevant to better understanding
emotional vulnerability among this population [Bonn-
Miller et al., in press; Mitchell et al., in press]. Second,
frequency of marijuana use was not significantly
correlated at the zero-order level with the anxiety
criterion variables. Also, after co-varying for the effect
of coping motives within the regression, marijuana use
frequency demonstrated significant negative associa-
tions with panic-related catastrophic thinking and
worry. Although inconsistent with expectation, the
observed effects, both at the zero-order level and
Depression and Anxiety
within the regression model, indicate that simple
indices of use are not necessarily related to anxiety
factors. To a certain extent, these findings are
consistent with a broader marijuana literature that
suggests that only certain severe forms of marijuana
use, specifically dependence, are uniquely associated
with anxiety vulnerability and problems [Zvolensky
et al., 2006a–c]. To understand better the nature of
marijuana use relations with anxiety factors and
problems, future work would benefit by incorporating
a research test that evaluates these questions directly.
For example, researchers could test whether marijuana-
dependent users are more apt to respond with anxiety
to stressors compared with non-users as well as those
who use or abuse the drug. This type of work would
more definitively clarify the role of various marijuana
use patterns and anxiety-relevant processes. Finally,
examination of sample sizes for the extreme groups
(i.e., high and low) of the use by coping interaction
revealed that very few people were considered low
marijuana users who were high in coping motives
relative to the other three groups. Further, the second
lowest group was high marijuana users who were low in
coping motives. This finding is important in that it
indicates that those who are high in coping motives are
much more likely to be high marijuana users than low
marijuana users. This distinction also is important in
that it provides some evidence that those who use
marijuana for coping reasons use marijuana often and
those who do not use marijuana to cope, use the drug
less often, as is indicated by the positive correlation
between use and coping motives. This finding makes
sense theoretically, in that the demands for coping with
regulation of negative emotional states are naturally
likely to be much more frequent than other use motives
(e.g., to conform or enhance), especially among
emotionally vulnerable individuals. Future research
may benefit from prospective studies that are intended
to better explicate the phenomenological nature of
marijuana use patterns, motives, and anxiety as they
unfold in real time.
The present findings may have important implica-
tions for emerging theory regarding marijuana-anxiety
comorbidity and relations, as well as for clinical
advances focused on addressing these phenomena. In
terms of theory, for example, the present pattern of
observed findings, albeit preliminary, make clear that,
like other substance-anxiety associations, marijuana-
anxiety comorbidity is at least in part likely a product of
complex interactive relations between certain use
patterns and the psychological motives driving use.
The present findings also may have translational
implications for clinical advances related to marijua-
na-anxiety comorbidity. For instance, the results
suggest that therapeutic strategies not necessarily focus
on decreasing levels of marijuana use frequency
generally speaking, but rather apply a more targeted
strategy focusing on the coping motives underlying use
patterns.
 Research Article: Marijuana Coping Motives
There are a number of interpretative caveats to the
present investigation that should be noted. First, the
present cross-sectional design is unable to inform
causal or directional inferences regarding the observed
associations. For example, due to the correlational
nature of these data, we are not able to infer the
directionality of relations between use and coping
motives, nor are we able to delimit the directionality of
relations between the anxiety criterion variables and
the marijuana-related predictors. For example, it is
theoretically possible that individuals high in marijuana
use and anxiety symptoms are more apt to be using
marijuana for coping-oriented reasons. Future study,
utilizing prospective and laboratory-based methodol-
ogy and designs may therefore be an important avenue
for conducting more rigorous tests of marijuana-
anxiety theory. This work will be most convincing
when it is completed in a sequenced fashion involving
multiple types of methodologies. Second, given that
the present sample, by virtue of the selection criteria,
was composed of young adult marijuana users, the
findings are not generalizable to all marijuana users. To
enhance further the generalizability of the study
results, future work may benefit by sampling from a
more diverse population. Third, an ongoing challenge
to marijuana research is attaining reliable and valid
assessments of the parameters of this drug behavior
[Stephens, 1999]. In the present investigation, we
followed contemporary standards and examined mar-
ijuana use and frequency of such use. However, it was
not possible to attain an assessment of quantity of use
due to the wide degree of variability in marijuana types
(i.e., potency) and problems related to reliance on
participants’ recall of amount used (i.e., memory
distortions). Although there is no consensus regarding
how to unambiguously address this issue, utilization of
biochemical methods would be helpful in further
corroborating a distinction of at least ‘‘use versus
non-use’’ of marijuana. And finally, self-report mea-
sures were utilized as the primary assessment metho-
dology. The utilization of self-report methods does not
fully protect against reporting errors and may be
influenced by shared method variance. Thus, future
studies could build upon the present work by utilizing
alternative assessment instruments such as tasks from
cognitive science that tap implicit and automatic types
of health and smoking-related processes.
Together, the findings of the present investigation
suggest more frequent marijuana use and a greater
tendency to use marijuana for coping-oriented reasons
are predictive of anxiety symptoms. These data add to a
growing literature, suggesting that marijuana may be
related to anxiety vulnerability; moreover, motivational
aspects of use are central in better understanding the
nature of such processes. By continuing to explicate the
nature of marijuana and anxiety associations, it may
ultimately be possible to use this information to
develop targeted prevention and treatment programs
for high-risk youth and young adults.
871
Acknowledgments. This paper was supported by
National Institute on Drug Abuse research grants
(1 R01 DA018734-01A1, R03 DA16307-01, and 1 R21
DA016227-01) awarded to Dr. Zvolensky. This work
also was supported by a National Research Service
Award (F31 MH073205-01) granted to Amit Bernstein.
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