Women Experiencing Partner Violence Were More Likely to Use Cannabis on Days With Higher PTSD Symptoms | Research

The takeaway

An ecological momentary assessment study of 145 women experiencing intimate partner violence found that externalizing behavior and dysphoric arousal PTSD symptoms were associated with same-period cannabis use, but did not predict later use.

PTSD researchers, domestic violence service providers, mental health clinicians working with trauma survivors.

Externalizing and arousal PTSD symptoms linked to real-time cannabis use in IPV survivors

What the researchers found

Externalizing behavior (OR 1.37) and dysphoric arousal (OR 1.27) PTSD symptom clusters were associated with cannabis use reported in the same survey period. However, lagged analyses found no proximal association, meaning elevated PTSD symptoms did not predict cannabis use in the next survey period. Other PTSD clusters (re-experiencing, avoidance, negative cognitions) were not associated with cannabis use.

Why it matters

This is one of the first studies to use real-time data collection to examine which specific PTSD symptoms co-occur with cannabis use in women experiencing IPV. Finding that externalizing and arousal symptoms, but not other clusters, are linked to cannabis use helps identify when women may be most vulnerable to coping-motivated use.

The numbers in context

145 women. 3 surveys/day for 30 days. Mean age 40.66. 41.6% white, 31.4% Black, 10.9% Hispanic. Externalizing behavior: OR 1.37 (95% CI 1.15-1.65). Dysphoric arousal: OR 1.27 (95% CI 1.09-1.49). No significant lagged effects.

How the study worked

Ecological momentary assessment (experience sampling) with 145 community women experiencing IPV who completed three surveys daily for 30 days. Multilevel models examined concurrent and lagged associations between PTSD symptom clusters and cannabis use.

What this study cannot tell us

Cannot determine directionality from concurrent associations. Self-reported substance use may be underreported. Sample is community women experiencing IPV, limiting generalizability. Cannabis use frequency and amount not captured in detail.

How to read the evidence

Ecological momentary assessment provides strong temporal data but concurrent-only associations limit causal inference.

When this study was published

Published 2023.

The bigger picture

The concurrent but not lagged association suggests cannabis use and certain PTSD symptoms co-occur in the moment rather than one driving the other over time. This has implications for intervention design: rather than trying to prevent future use based on earlier symptoms, interventions may need to target acute coping in real time.

Questions still open

Are women using cannabis to manage externalizing and arousal symptoms specifically, or do these symptoms simply co-occur with use contexts?
Would real-time interventions during high-arousal moments reduce cannabis coping in IPV survivors?

Common questions

Do women with PTSD from partner violence use cannabis to cope?

This study found that on days with higher externalizing behavior and arousal PTSD symptoms, women were more likely to use cannabis at the same time, consistent with coping-motivated use.

Did PTSD symptoms predict later cannabis use?

No. The association was concurrent only. Elevated PTSD symptoms did not predict cannabis use in the next survey period.

Read the original research

Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence.

Drug and alcohol dependence, 250, 110905

View on PubMed ↗Publisher’s paper ↗

Citation

Newberger, Noam G; Forkus, Shannon R; Thomas, Emmanuel D; Goldstein, Silvi C; Ferguson, Jewelia J; Sullivan, Tami P; Weiss, Nicole H. (2023). Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence.. Drug and alcohol dependence, 250, 110905. https://doi.org/10.1016/j.drugalcdep.2023.110905