Anxiety sensitivity, not uncertainty intolerance, drives cannabis use in college students with excessive worry

Among college students with clinically elevated worry, anxiety sensitivity (fear of anxiety symptoms themselves) was the key predictor of cannabis use frequency and using cannabis to cope, while intolerance of uncertainty was not.

Goldblum, Rachel S et al.·The Journal of nervous and mental disease·2025·Moderate EvidenceCross-Sectional
RTHC-06554Cross SectionalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=220

What This Study Found

Greater anxiety sensitivity was significantly associated with more frequent past-month cannabis use (explaining 4.4% of variance) and stronger coping motives for use (4.9% of variance). Anxiety sensitivity social concerns specifically predicted coping motives (7.1% of variance). Intolerance of uncertainty was not significantly associated with either outcome.

Key Numbers

220 participants with elevated worry. AS predicted cannabis use frequency (4.4% variance) and coping motives (4.9% variance). AS-Social Concerns predicted coping motives (7.1% variance). IU was not significant.

How They Did This

Cross-sectional study of 220 undergraduates with clinically elevated worry (mean age 19.4, 82.3% female, 89.1% White). Self-report measures of anxiety sensitivity, intolerance of uncertainty, cannabis use frequency, and coping motives, controlling for sex and negative affect.

Why This Research Matters

Understanding which anxiety-related traits drive cannabis use helps target interventions. If anxiety sensitivity, not uncertainty intolerance, is the driver, then treatments that reduce fear of anxiety sensations (like interoceptive exposure) may be more effective than those targeting uncertainty.

The Bigger Picture

People with generalized anxiety disorder are at elevated risk for cannabis use disorder. This study helps explain why: it is not the worry itself that drives use, but specifically the fear of experiencing anxiety symptoms, particularly social anxiety sensations.

What This Study Doesn't Tell Us

Predominantly White female college sample limits generalizability. Small effect sizes (4-7% variance explained). Cross-sectional design cannot establish directionality. Self-report measures.

Questions This Raises

  • ?Would reducing anxiety sensitivity through clinical intervention decrease cannabis use in this population?
  • ?Does AS-driven cannabis use lead to worse anxiety outcomes long-term?

Trust & Context

Key Stat:
anxiety sensitivity predicted cannabis coping motives while intolerance of uncertainty did not, pointing to fear of anxiety sensations as the key driver
Evidence Grade:
Well-controlled analysis with specific anxiety constructs, but homogeneous sample, small effects, and cross-sectional design limit strength.
Study Age:
2025 publication.
Original Title:
Examining the Role of Anxiety Sensitivity and Intolerance of Uncertainty in Terms of Cannabis Use and Coping Motives for Cannabis Use in College Students With Clinically Elevated Worry.
Published In:
The Journal of nervous and mental disease, 213(10), 258-263 (2025)
Database ID:
RTHC-06554

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

What is anxiety sensitivity?

Anxiety sensitivity is the fear of anxiety-related sensations themselves. Someone with high AS might fear that a racing heart means they are having a heart attack, or that dizziness means they are losing control. This fear of fear amplifies anxiety disorders.

Why would anxiety sensitivity drive cannabis use?

People who fear anxiety sensations may use cannabis to dampen those physical symptoms. Cannabis can reduce somatic anxiety in the short term, creating a reinforcing cycle where people use it specifically to cope with uncomfortable bodily sensations of anxiety.

Read More on RethinkTHC

Cite This Study

RTHC-06554·https://rethinkthc.com/research/RTHC-06554

APA

Goldblum, Rachel S; O'Bryan, Emily M; Bimstein, Jessica G; McLeish, Alison C. (2025). Examining the Role of Anxiety Sensitivity and Intolerance of Uncertainty in Terms of Cannabis Use and Coping Motives for Cannabis Use in College Students With Clinically Elevated Worry.. The Journal of nervous and mental disease, 213(10), 258-263. https://doi.org/10.1097/NMD.0000000000001850

MLA

Goldblum, Rachel S, et al. "Examining the Role of Anxiety Sensitivity and Intolerance of Uncertainty in Terms of Cannabis Use and Coping Motives for Cannabis Use in College Students With Clinically Elevated Worry.." The Journal of nervous and mental disease, 2025. https://doi.org/10.1097/NMD.0000000000001850

RethinkTHC

RethinkTHC Research Database. "Examining the Role of Anxiety Sensitivity and Intolerance of..." RTHC-06554. Retrieved from https://rethinkthc.com/research/goldblum-2025-examining-the-role-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.