Cannabis-Related Impairment and Social Anxiety: The Role of Use to Manage Negative and Positive Affect in Social Situations

Background and Objectives: Individuals with elevated social anxiety are thought to be at high risk for developing cannabis-related problems because they use cannabis to cope with anxiety-provoking social situations. Social anxiety is unique among the anxiety conditions in that it is characterized by both elevated negative affect (NA) and lower positive affect (PA). Yet it is unclear whether persons with elevated social anxiety use cannabis to decrease their NA or to increase their PA. Methods: This study examined the role of PA and NA (including cannabis use to increase PA and to decrease NA in social situations) on cannabis use frequency and related problems among current (past three-month) cannabis users (N = 278). Results: Social anxiety was significantly correlated with NA, PA, cannabis use to decrease NA, and use to increase PA. Serial mediation analyses tested the paths between social anxiety, affect, use to manage affect, typical cannabis use frequency, and cannabis use-related problems. Contrary to prediction, social anxiety was not indirectly related to use frequency or related problems via NA or PA generally. Rather, social anxiety was indirectly related to cannabis problems via the serial effect of use to cope with NA and typical use frequency and via the serial effect of use to increase PA and typical use frequency. Conclusions/Importance: Social anxiety may be associated with using cannabis to decrease NA and increase PA specifically in social situations, which increases cannabis use frequency and thus, problem risk.