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Writing Activity #3

Shateria Hughey

Lynn University

Intro to the Study of Psychology

November 15, 2021

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The study of young adults has expressed a significant link between the use of cannabis

and schizotypal behavioral traits. The relevance of this association is emphasized by the

realization that schizotypal distinctions and cannabis consumption tend to be risk factors for

schizophrenia development in young individuals. However, researchers have shown conflicting

results on the same association; in one provision, they claim that the emergence of schizotypal

traits comes before the relevance of cannabis use. In the other provision, they claim that cannabis

use precedes the development of schizotypal traits. Researchers have realized that cannabis

consumption attracts the concept of borderline and schizotypal traits (Raynal et al., 2016).

Furthermore, depressive symptoms are significantly associated with borderline traits, cannabis

use, and schizotypal traits. Also, the influence of gender in this perspective has been presumed to

be significant as cannabis use implications to mental well-being is concerned.

Based on the study results, a significant association between borderline and schizotypal

traits implies that borderline traits could influence the association between cannabis consumption

and schizotypal qualities. Therefore, it expresses the need to focus on borderline traits to evaluate

the association between cannabis use and schizotypal traits. It is also implicated that cannabis

use is less influenced by schizotypal traits (Raynal et al., 2016). Also, the study results show that

only schizotypal traits are uniquely and significantly connected to problematic symptoms of

cannabis use. This critically tends to indicate that schizotypal qualities are not an influential

initiating factor but may tend to be a significant factor towards enhancement of problematic

cannabis use, often through self-medication.

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Reference

Raynal, P., & Chabrol, H. (2016). Association between schizotypal and borderline personality

disorder traits, and cannabis use in young adults. Addictive behaviors, 60, 144-147.

Addictive Behaviors 60 (2016) 144–147

Contents lists available at ScienceDirect

Addictive Behaviors

journal homepage: www.elsevier.com/locate/addictbeh

Short Communication

Association between schizotypal and borderline personality disorder traits, and cannabis use in young adults

Patrick Raynal, Henri Chabrol ⁎ CERPPS, Université de Toulouse, UT2J, France

H I G H L I G H T S

• No study focused on cannabis use, borderline and schizotypal traits. • These relationships were explored in a sample of college students. • Cannabis use, borderline and schizotypal traits were significantly correlated. • Only borderline traits were uniquely associated to cannabis use versus non-use. • Only schizotypal traits were uniquely associated to problematic cannabis use.

⁎ Corresponding author at: Laboratoire CERPPS, Univ Maison de la Recherche, 5 Allées Antonio Machado, 31058

E-mail address: [email protected] (H. Chabrol).

http://dx.doi.org/10.1016/j.addbeh.2016.04.018 0306-4603/© 2016 Elsevier Ltd. All rights reserved.

a b s t r a c t

Article history: Received 13 November 2015 Received in revised form 23 March 2016 Accepted 20 April 2016 Available online 22 April 2016

The aim of the study was to examine the association of schizotypal and borderline personality traits to cannabis use. Participants were 476 college students (95 males; 381 females; mean age of males = 21; mean age of females = 20.7) who completed self-report questionnaires assessing cannabis use, schizotypal and borderline personality traits. Problematic cannabis use, depressive symptoms, borderline and schizotypal traits were signif- icantly inter-correlated. A logistic regression analysis showed that only borderline traits contributed significantly to cannabis use in the total sample. A multiple regression analysis showed that only schizotypal traits were positively and uniquely associated to problematic cannabis use symptoms among users. These results may imply that schizotypal traits are not a risk factor for initiating use, but may facilitate the development of problem- atic use symptoms among users. This study showed the necessity of taking into account schizotypal traits when exploring the relationships between depressive symptoms, borderline traits and cannabis use.

© 2016 Elsevier Ltd. All rights reserved.

Keywords: Problematic cannabis use Young adults Schizotypal traits Borderline traits

1. Introduction

Cannabis use has been found to be associated to schizotypal person- ality traits in young adults (Dumas et al., 2002; Skosnik, Spatz-Glenn, & Park, 2001). Young adults with high scores on schizotypal traits report- ed much greater frequencies of cannabis use and cannabis-related problems (Cohen, Buckner, Najolia, & Stewart, 2011). The importance of this association is linked to the finding that both cannabis use and schizotypal traits are risks factors for the development of schizophrenia in young people (e.g., McGrath et al., 2010). Prospective researches displayed conflicting results on the relationships between schizotypal traits and cannabis use: Schiffman, Nakamura, Earleywine, and LaBrie (2005) found that the onset of schizotypal traits precedes the onset of cannabis use whereas Anglin et al.'s study (2012) supported a strong

ersité de Toulouse-Jean Jaurès, Toulouse Cedex 9, France.

association of early cannabis use with the development of schizotypal symptoms. The examination of the relationships between schizotypal traits and cannabis use may be obscured by the association of borderline personality disorder (BPD) traits to both schizotypal traits (e.g., Fonseca-Pedrero, Lemos-Giráldez, Paino, Sierra-Baigrie, & Muñiz, 2012) and cannabis use (e.g., Chabrol, Ducongé, Casas, Roura, & Carey, 2005). Borderline traits are the personality disorder traits having the greatest effects on the development of substance use disorder in adoles- cents (Cohen, Chen, Crawford, Brook, & Gordon, 2007).

Few studies have investigated the association between schizotypal traits, borderline traits and cannabis use. Williams, Wellman, and Rawlins (1996) observed that cannabis users showed higher scores on schizotypal and borderline traits than non-users. In a small sample of high-school students, Chabrol, Melioli, and Goutaudier (2015) exam- ined the relationships between cannabis use and the personality disor- ders traits identified as associated to adolescent substance use by previous studies, that is, borderline, antisocial, narcissistic, schizotypal, schizoid, avoidant and passive-aggressive personality disorder traits:

145P. Raynal, H. Chabrol / Addictive Behaviors 60 (2016) 144–147

only schizotypal and borderline traits were positively and independent- ly associated to problematic cannabis use symptoms after adjustment for anxious and depressive symptoms.

Depressive symptoms have been found to be associated to cannabis use, borderline and schizotypal traits (e.g., Chabrol et al., 2005, 2015; Schwinn, Schinke, & Trent, 2010).

Some studies reported gender differences in the relationships be- tween mental health and cannabis use, and more specifically between depressive and borderline traits, and cannabis use or problematic use (e.g., Chabrol et al., 2005) but other studies did not find evidence of the influence of gender (e.g., Schwinn et al., 2010). No study explored the influence of gender on the association between schizotypal traits and cannabis use.

Consequently, the aim of this study was to examine the relationships between depressive symptoms, borderline and schizotypal traits, and cannabis use and the influence of gender on these relationships.

2. Method

2.1. Participants and procedure

The sample consisted of 476 college students (95 males; 381 fe- males; mean age of males = 21 ± 2.3; mean age of females = 20.7 ± 1.9; p = 0.32). Participants were recruited through student groups active in social networks and affiliated to universities in France. The sample was composed of individuals aged between 18 and 25 and who answered N95% of the items. The study procedures were approved by the ethics committee of the research ward. The study followed the ethical guidelines of the Helsinki Declaration. Participants provided their willingness to participate through a consent form and no compensation was offered. The questionnaires were anonymous.

2.2. Measures

Cannabis use was assessed using the French version of the Canna- bis Use Disorders Identification Test (CUDIT) (Annaheim, Rehm, & Gmel, 2008; Guillem et al., 2011) which is a self-reported question- naire that evaluates the cannabis consumption over the previous 6 months and identifies problematic or harmful cannabis use. Guillem et al. found a cut-off score of 10 for the CUDIT when screening for problematic use.

Schizotypal traits were assessed with the Schizotypal Personality Questionnaire Brief Form (SPQ-B; Fonseca-Pedrero, Paino-Pineiro, Lemos-Giraldez, Villazon-Garcia, & Muniz, 2009). The SPQ-B is a 22- item (true/false) self-report for assessment of schizotypal personality disorder. Borderline traits were measured using the French version of the BPD scale of the Personality Diagnostic Questionnaire, Fourth Edi- tion (PDQ-4+; Hyler, 1994; Bouvard, 2002). The borderline scale is composed of 9 items corresponding to the DSM-IV criteria for BPD. De- pressive symptoms were assessed using the short version of the Center for Epidemiologic Studies-Depression scale (CES-D-10; Andresen, Malmgren, Carter, & Patrick, 1994). Cronbach alphas and potential ranges are presented in Table 1.

Table 1 Comparisons between cannabis users and non-users and between cannabis users with and wi

Variable α Range Non-users (n = 332) M (SD)

Users (n = 142) M (SD)

t (472)

CUDIT 0.87 0–40 0.15 (0.87) 7.18 (7.26) −17.37 Depressive symptoms 0.81 0–30 12.58 (4.02) 13.16 (4.21) −1.44 Schizotypal traits 0.78 0–22 8.24 (4.44) 8.95 (4.36) −1.60 Borderline traits 0.84 0–54 20.70 (10.82) 26.34 (12.15) −5.01

Note: CUDIT = Cannabis Use Disorders Identification Test; problematic users scored ≥10 on C

2.3. Statistical analyses

Student's t-tests were used to compare cannabis users and non- users, and problematic users and non-problematic users. Bivariate rela- tionships between variables were assessed with Pearson's r. The associ- ation of personality traits with cannabis use was examined in a logistic regression analysis predicting cannabis use versus non-use, entering gender, depressive symptoms, borderline and schizotypal traits. Results were reported with standardized regression coefficients of the explana- tory variables (B) and p values. Predictors were standardized to get standardized regression coefficients. The association of personality traits to the CUDIT scores was tested with a hierarchical multiple regres- sion analysis including all independent variables. The proportion of var- iance explained at each step was evaluated by the incremental F ratio. The unique association of each independent variable was reported with standardized regression coefficient (β) and p value. To determine whether gender moderated the relationship between psychopathologi- cal variables and problematic cannabis use, interaction terms (gender × depressive symptoms, gender × borderline traits, gender × schizotypal traits) were included in the last step of the multi- ple regression analysis. All variables mean centered with the exception of gender which was coded as −1 for females, and 1 for males. All sta- tistical analyses were performed using STATISTICA, Version 10.

3. Results

3.1. Descriptive statistics

In the total sample, 32% of males (n = 30, age = 21.5 ± 2.5) and 30% of females (n = 112, age = 20.6 ± 1.3) reported having used cannabis at least once during the last 6 months (p = 0.91). Among cannabis users, CUDIT total score did not differ between males and females (7.6 ± 7.1 vs 7.1 ± 7.3, t = 0.16, p b 0.87). Similarly, the proportion of users with problematic cannabis use (CUDIT scores ≥10) did not differ between males and females (27% versus 29%, p = 0.84). Users had higher scores on borderline traits than non-users. Problematic users had higher scores on schizotypal and borderline traits than non- problematic users (Table 1).

3.2. Correlations between variables in the total sample

The CUDIT score was weakly associated to depressive symptoms (r = 0.11, p b 0.05), moderately associated to borderline traits (r = 0.28, p b 0.05) and more weakly to schizotypal traits (r = 0.18, p b 0.05). The relationship between schizotypal traits and borderline traits was moderate (r = 0.58, p b 0.05). Depressive symptoms were moderately associated to borderline traits (r = 0.61, p b 0.05) and schizotypal traits (r = 0.51, p b 0.05).

3.3. Logistic regression analysis predicting cannabis use versus non-use in the total sample

The predictors reliably distinguished between users and non-users, χ2 (4) = 28.5, p b 0.0001. Borderline traits were the only significant independent predictor of cannabis use (B = 0.70, p b 0.0001). Gender

thout problematic use.

p Non-problematic users (n = 102) M (SD)

Problematic users (n = 40) M (SD)

t (140) p

b0.001 3.27 (1.71) 17.13 (6.45) −20.07 b0.001 0.15 12.82 (4.05) 14.03 (4.53) −1.54 0.13 0.11 8.14 (3.89) 11.03 (4.85) −3.70 b0.001

b0.001 24.14 (11.05) 31.95 (13.13) −3.59 b0.001

UDIT; non-problematic users scored b10.

146 P. Raynal, H. Chabrol / Addictive Behaviors 60 (2016) 144–147

was not a significant predictor (B = 0.08, p b 0.75), nor depressive symptoms (B = −0.20, p = 0.14) and schizotypal traits (B = −0.15, p = 0.27).

3.4. Multiple regression analysis predicting CUDIT scores in the sub-sample of cannabis users

Gender and depressive symptoms were entered in the first step (Table 2). Depressive symptoms were the only significant predictor.

In the second step, borderline traits were added, accounting for a sig- nificant increase of explained variance. Borderline traits was the only significant predictor. Depressive symptoms were no more a significant predictor.

In the third step, the addition of schizotypal traits significantly increased the explained variance. Schizotypal traits were the only significant predictor, while borderline traits symptoms were no more a significant predictor.

The last step tested for the moderating effect of gender. It included interaction terms between gender and depressive symptoms, border- line, and schizotypal traits. None of the interaction term was significant. Gender did not appear to moderate the association of depressive symp- toms, borderline, and schizotypal traits with problematic cannabis use.

4. Discussion

In our sample, the strong positive relationships between schizotypal and borderline traits confirmed the possibility that borderline traits may contribute to the association between schizotypal traits and canna- bis use and the interest of taking into account borderline traits in exam- ining the relationships between schizotypal traits and cannabis use.

Logistic regression analysis showed that only borderline traits were uniquely associated to cannabis use in the total sample. Schizotypal traits did not appear to contribute to cannabis use in the total sample. Among cannabis users, multiple regression analysis found that only schizotypal traits were significantly and uniquely associated to prob- lematic cannabis use symptoms. These results are compatible with the possibility that schizotypal traits are not a risk factor for initiating use, but may facilitate the development of problematic use among users. Schizotypal traits may lead to problematic use through self- medication: cannabis can temporarily alleviate schizotypal or psychotic symptoms while worsening them secondarily, leading to increased need for use (e.g., Ferdinand et al., 2005).

Table 2 Hierarchical multiple regression analyses predicting CUDIT scores in users (n = 142).

ΔR2 β p

Step 1 0.04 Gender −0.04 0.62 Depressive symptoms 0.19 0.02

Step 2 0.06⁎

Gender −0.02 0.79 Depressive symptoms 0.01 0.93 Borderline traits 0.31 0.002

Step 3 0.03⁎

Gender −0.01 0.89 Depressive symptoms 0.04 0.72 Borderline traits 0.18 0.12 Schizotypal traits 0.24 0.02

Step 4 0.002 Gender −0.01 0.91 Depressive symptoms −0.05 0.68 Borderline traits 0.15 0.31 Schizotypal traits 0.29 0.03 Gender × depressive symptoms 0.03 0.83 Gender × borderline traits 0.04 0.80 Gender × schizotypal traits −0.08 0.55

Total R2 0.13

Note: CUDIT = Cannabis Use Disorders Identification Test. ⁎ p b 0.01.

Depressive symptoms were not uniquely associated to cannabis use and problematic use when controlling for borderline traits, in concor- dance with Chabrol et al. (2005), highlighting the necessity of taking into account borderline traits when studying the relationship between depressive symptoms and cannabis use in adolescents and young adults.

Gender did not moderate any of the associations between depres- sive symptoms, borderline, and schizotypal traits and problematic can- nabis use, in concordance with the study by Schwinn et al. (2010) which did not found evidence of a moderating effect of gender on the relation- ship between mental health and substance use.

This study has several limitations. Mainly, the cross-sectional design prevents from inferring causal relationships. Longitudinal studies are needed to clarify the causal relationships between borderline and schizotypal traits and problematic use. The relationships suggested by our study could be considered as support for potential pathways to be further explored in longitudinal studies. However, this study suggests the importance of evaluating borderline and schizotypal traits, in stud- ies of risk factors or consequences of cannabis use.

Role of funding sources This study received no funding.

Contributors Patrick Raynal and Henri Chabrol designed the study and conducted the statistical

analyses. Henri Chabrol wrote the first draft of the manuscript and both authors contrib- uted to and have approved the final manuscript.

Declaration of interest The authors report no conflicts of interest.

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