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Study breakdown

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

Cross SectionalModerate evidence
The takeaway

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.

College mental health clinicians, anxiety disorder researchers, and substance use prevention specialists.

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Well-controlled analysis with specific anxiety constructs, but homogeneous sample, small effects, and cross-sectional design limit strength.

When this study was published

2025 publication.

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.

Questions still open

  • 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?

Common 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 the original research

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

Citation

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

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