Objective: Attention-deficit/hyperactivity disorder (ADHD) is linked prospectively to cannabis; however, no study has examined mechanisms underlying this comorbidity. We examined 5 cannabis motives (i.e., coping with negative affect, sleep, social anxiety, perceived low risk of cannabis, and altered perception) as mediators of the prospective ADHD-cannabis relation. Method: Veterans reporting lifetime cannabis use (N = 361; 93% male; 80% White) completed three semiannual assessments. Prospective mediation models using structural equation modeling analyzed the indirect effects of baseline ADHD symptoms on 12-month cannabis use and problems via each motive at 6 months. Zero-inflated negative binomial models were employed for both manifest outcomes and ADHD symptoms and motives were each modeled as 1-factor latent variables. Results: Sleep motives was a robust mediator for cannabis use frequency in single mediator models and was marginally significant when examined simultaneously with other motives after accounting for baseline cannabis use, demographics, other substance use, and other psychopathology. Coping with negative affect was the only significant mediator of ADHD symptoms and subsequent cannabis problem severity. Conclusion: Among veterans with ADHD symptoms, sleep disturbance is a salient motive for cannabis use, whereas coping with negative affect is a proximal predictor of cannabis problems. Findings support addressing sleep disturbance in adults with ADHD symptoms and converge with extant literature demonstrating robust associations between coping motives and substance use problems. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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检查从成人注意力缺陷/多动障碍症状到大麻使用的动机途径：退伍军人前瞻性研究的结果。

目的：注意力缺陷/多动障碍 (ADHD) 与大麻前瞻性相关；然而，没有研究检查过这种合并症背后的机制。我们检查了 5 种大麻动机（即应对负面影响、睡眠、社交焦虑、认为大麻的低风险和改变的感知）作为预期 ADHD 与大麻关系的中介。方法：报告终生使用大麻的退伍军人（N = 361；93% 男性；80% 白人）完成了三项半年度评估。使用结构方程模型的前瞻性调解模型分析了基线 ADHD 症状对 12 个月大麻使用的间接影响以及通过每个动机在 6 个月时出现的问题。零膨胀负二项式模型用于表现结果，ADHD 症状和动机均被建模为 1 因子潜在变量。结果：在单一中介模型中，睡眠动机是大麻使用频率的一个强有力的中介，在考虑了基线大麻使用、人口统计、其他物质使用和其他精神病理学后，与其他动机同时检查时，睡眠动机略微显着。应对负面影响是 ADHD 症状和随后的大麻问题严重程度的唯一重要中介。结论：在有 ADHD 症状的退伍军人中，睡眠障碍是使用大麻的一个显着动机，而应对负面影响是大麻问题的近端预测因素。研究结果支持解决患有 ADHD 症状的成年人的睡眠障碍，并与现有文献一致，证明应对动机和物质使用问题之间存在密切关联。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。