{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:13:12Z","timestamp":1790867592422,"version":"4.1.0"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"Importance<\/jats:title>Adolescent cannabis use has been consistently posited to contribute to the onset and progression of psychosis. However, alternative causal models may account for observed associations between cannabis use and psychosis risk, including shared vulnerability for both cannabis use and psychosis or efforts to self-medicate distress from psychosis spectrum symptomology.<\/jats:p><\/jats:sec>Objective<\/jats:title>To test 3 hypotheses that may explain cannabis\u2013psychosis risk associations by modeling psychosis spectrum symptom trajectories prior to and after cannabis initiation across adolescent development (approximately 10-15 years of age).<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study used data from 5 waves across 4 years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. The ABCD study is an ongoing large-scale, longitudinal study of brain development and mental and physical health of children in the US launched in June 2016. Data are collected from 21 research sites. The study included data from 11\u202f868 adolescents aged 9 to 10 years at baseline. Three participants were excluded from the present analysis owing to missing data. Data analysis was performed from September 2023 to July 2024.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Discontinuous growth curve modeling was used to assess trajectories of psychosis spectrum symptoms before and after cannabis initiation. Control variables considered for this investigation were age, sex, internalizing and externalizing symptoms, socioeconomic status, parental mental health, and other substance use.<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 11\u202f858 participants at wave 1, the mean (SD) age was 9.5 (0.5) years; 6182 (52%) participants were male. Consistent with a shared vulnerability hypothesis, adolescents who used cannabis at any point during the study period reported a greater number of psychosis spectrum symptoms (B, 0.86; 95% CI, 0.68-1.04) and more distress (B, 1.17; 95% CI, 0.96-1.39) from psychosis spectrum symptoms relative to those who never used cannabis. Additionally, consistent with a self-medication hypothesis, the number of psychosis spectrum symptoms (B, 0.16; 95% CI, 0.12-0.20) and distress (B, 0.23; 95% CI, 0.21-0.26) from psychosis spectrum symptoms increased in the time leading up to cannabis initiation. We observed mixed evidence for an increase in psychosis symptoms after cannabis initiation (ie, contributing risk hypothesis).<\/jats:p><\/jats:sec>Conclusion and Relevance<\/jats:title>The findings underscore the importance of accounting for shared vulnerability and self-medication effects when modeling cannabis\u2013psychosis risk associations.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2024.3525","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T16:01:04Z","timestamp":1730908864000},"page":"181","source":"Crossref","is-referenced-by-count":17,"title":["Psychosis Spectrum Symptoms Before and After Adolescent Cannabis Use Initiation"],"prefix":"10.1001","volume":"82","author":[{"given":"K. Juston","family":"Osborne","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna M.","family":"Barch","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis, St Louis, Missouri"},{"name":"Department of Psychological & Brain Sciences, Washington University in St Louis, St Louis, Missouri"},{"name":"Department of Radiology, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua J.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Psychological & Brain Sciences, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole R.","family":"Karcher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Washington University in St Louis, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"yoi240069r1","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s00406-019-01068-z","article-title":"Cannabis use and psychosis: a review of reviews.","volume":"270","author":"Hasan","year":"2020","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"issue":"5","key":"yoi240069r2","doi-asserted-by":"publisher","first-page":"1262","DOI":"10.1093\/schbul\/sbw003","article-title":"Meta-analysis of the association between the level of cannabis use and risk of psychosis.","volume":"42","author":"Marconi","year":"2016","journal-title":"Schizophr Bull"},{"issue":"9","key":"yoi240069r3","doi-asserted-by":"publisher","first-page":"3858","DOI":"10.1017\/S0033291722000502","article-title":"Risk-thresholds for the association between frequency of cannabis use and the development of psychosis: a systematic review and meta-analysis.","volume":"53","author":"Robinson","year":"2023","journal-title":"Psychol Med"},{"issue":"4","key":"yoi240069r4","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1080\/08897077.2021.1876200","article-title":"Cannabis use in adolescence and risk of psychosis: are there factors that moderate this relationship? a systematic review and meta-analysis.","volume":"42","author":"Kiburi","year":"2021","journal-title":"Subst Abus"},{"issue":"7374","key":"yoi240069r5","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1136\/bmj.325.7374.1212","article-title":"Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study.","volume":"325","author":"Arseneault","year":"2002","journal-title":"BMJ"},{"issue":"5","key":"yoi240069r6","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1001\/archgenpsychiatry.2010.6","article-title":"Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults.","volume":"67","author":"McGrath","year":"2010","journal-title":"Arch Gen Psychiatry"},{"issue":"4","key":"yoi240069r7","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1080\/08897077.2014.995332","article-title":"Adolescent initiation of cannabis use and early-onset psychosis.","volume":"36","author":"Bagot","year":"2015","journal-title":"Subst Abus"},{"issue":"2-3","key":"yoi240069r8","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.schres.2009.04.005","article-title":"Cannabis use in children and adolescents with first episode psychosis: influence on psychopathology and short-term outcome (CAFEPS study).","volume":"113","author":"Baeza","year":"2009","journal-title":"Schizophr Res"},{"issue":"6","key":"yoi240069r9","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1093\/schbul\/sbt181","article-title":"Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.","volume":"40","author":"Di Forti","year":"2014","journal-title":"Schizophr Bull"},{"issue":"8","key":"yoi240069r10","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.1016\/j.neubiorev.2011.04.007","article-title":"Cannabis use in young people: the risk for schizophrenia.","volume":"35","author":"Casadio","year":"2011","journal-title":"Neurosci Biobehav Rev"},{"issue":"1","key":"yoi240069r13","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1176\/appi.ajp.2021.21111126","article-title":"Cannabis and Psychosis: recent epidemiological findings continuing the \u201ccausality debate\u201d.","volume":"179","author":"Ganesh","year":"2022","journal-title":"Am J Psychiatry"},{"issue":"8","key":"yoi240069r14","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1001\/jamapsychiatry.2020.0339","article-title":"Will legalization and commercialization of cannabis use increase the incidence and prevalence of psychosis?","volume":"77","author":"Murray","year":"2020","journal-title":"JAMA Psychiatry"},{"issue":"3","key":"yoi240069r15","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.pneurobio.2010.06.010","article-title":"Adolescent brain maturation, the endogenous cannabinoid system and the neurobiology of cannabis-induced schizophrenia.","volume":"92","author":"Bossong","year":"2010","journal-title":"Prog Neurobiol"},{"issue":"3","key":"yoi240069r16","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1093\/schbul\/sbab019","article-title":"Schizophrenia and the environment: within-person analyses may be required to yield evidence of unconfounded and causal association-the example of cannabis and psychosis.","volume":"47","author":"van Os","year":"2021","journal-title":"Schizophr Bull"},{"issue":"3","key":"yoi240069r17","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1111\/j.1476-5381.2010.00721.x","article-title":"Adolescent cannabis use and psychosis: epidemiology and neurodevelopmental models.","volume":"160","author":"Malone","year":"2010","journal-title":"Br J Pharmacol"},{"issue":"2","key":"yoi240069r18","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.biopsych.2020.06.028","article-title":"Adolescent neurodevelopment and vulnerability to psychosis.","volume":"89","author":"Patel","year":"2021","journal-title":"Biol Psychiatry"},{"key":"yoi240069r19","doi-asserted-by":"publisher","first-page":"129","DOI":"10.3389\/fpsyt.2013.00129","article-title":"Cannabis use during adolescent development: susceptibility to psychiatric illness.","volume":"4","author":"Chadwick","year":"2013","journal-title":"Front Psychiatry"},{"issue":"2","key":"yoi240069r20","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s11920-015-0657-y","article-title":"Cannabis and psychosis: a critical overview of the relationship.","volume":"18","author":"Ksir","year":"2016","journal-title":"Curr Psychiatry Rep"},{"issue":"11","key":"yoi240069r21","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1038\/mp.2014.51","article-title":"Genetic predisposition to schizophrenia associated with increased use of cannabis.","volume":"19","author":"Power","year":"2014","journal-title":"Mol Psychiatry"},{"issue":"6","key":"yoi240069r22","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1192\/bjp.bp.114.159079","article-title":"Association between stressful life events and psychotic experiences in adolescence: evidence for gene-environment correlations.","volume":"208","author":"Shakoor","year":"2016","journal-title":"Br J Psychiatry"},{"issue":"1","key":"yoi240069r23","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1001\/jamapsychiatry.2018.2546","article-title":"Genetic predisposition vs individual-specific processes in the association between psychotic-like experiences and cannabis use.","volume":"76","author":"Karcher","year":"2019","journal-title":"JAMA Psychiatry"},{"issue":"3","key":"yoi240069r24","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.ijdevneu.2010.11.006","article-title":"Why do patients with psychosis use cannabis and are they ready to change their use?","volume":"29","author":"Kolliakou","year":"2011","journal-title":"Int J Dev Neurosci"},{"issue":"2","key":"yoi240069r25","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1037\/a0025487","article-title":"Error monitoring dysfunction across the illness course of schizophrenia.","volume":"121","author":"Perez","year":"2012","journal-title":"J Abnorm Psychol"},{"issue":"1-2","key":"yoi240069r26","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.psychres.2015.07.070","article-title":"Relationship between cannabis and psychosis: reasons for use and associated clinical variables.","volume":"229","author":"Man\u00e9","year":"2015","journal-title":"Psychiatry Res"},{"key":"yoi240069r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2023.107937","article-title":"Do anxiety symptoms and coping motives serially mediate the association between psychotic-like experiences and cannabis-related problems in undergraduate recent cannabis users?","volume":"151","author":"Bernusky","year":"2024","journal-title":"Addict Behav"},{"issue":"15","key":"yoi240069r28","doi-asserted-by":"publisher","first-page":"7418","DOI":"10.1017\/S0033291723001071","article-title":"The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study.","volume":"53","author":"Spinazzola","year":"2023","journal-title":"Psychol Med"},{"issue":"3","key":"yoi240069r29","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1093\/schbul\/sbi027","article-title":"The environment and schizophrenia: the role of cannabis use.","volume":"31","author":"Henquet","year":"2005","journal-title":"Schizophr Bull"},{"issue":"3","key":"yoi240069r30","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1111\/j.1360-0443.2005.01001.x","article-title":"Tests of causal linkages between cannabis use and psychotic symptoms.","volume":"100","author":"Fergusson","year":"2005","journal-title":"Addiction"},{"issue":"2","key":"yoi240069r31","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1111\/add.13557","article-title":"Trajectories of cannabis use disorder: risk factors, clinical characteristics and outcomes.","volume":"112","author":"Kosty","year":"2017","journal-title":"Addiction"},{"issue":"3","key":"yoi240069r32","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1037\/adb0000103","article-title":"Chronic adolescent marijuana use as a risk factor for physical and mental health problems in young adult men.","volume":"29","author":"Bechtold","year":"2015","journal-title":"Psychol Addict Behav"},{"issue":"5","key":"yoi240069r33","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1017\/S003329171200205X","article-title":"Adolescent bullying, cannabis use and emerging psychotic experiences: a longitudinal general population study.","volume":"43","author":"Mackie","year":"2013","journal-title":"Psychol Med"},{"issue":"1","key":"yoi240069r34","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1017\/S0033291710000449","article-title":"Developmental trajectories of psychotic-like experiences across adolescence: impact of victimization and substance use.","volume":"41","author":"Mackie","year":"2011","journal-title":"Psychol Med"},{"issue":"12","key":"yoi240069r35","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1111\/jcpp.12765","article-title":"Cannabis use and psychotic-like experiences trajectories during early adolescence: the coevolution and potential mediators.","volume":"58","author":"Bourque","year":"2017","journal-title":"J Child Psychol Psychiatry"},{"issue":"4","key":"yoi240069r36","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1111\/add.12050","article-title":"Cannabis use and vulnerability for psychosis in early adolescence\u2014a TRAILS study.","volume":"108","author":"Griffith-Lendering","year":"2013","journal-title":"Addiction"},{"issue":"4","key":"yoi240069r37","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1037\/pspp0000196","article-title":"Transactions between life events and personality traits across the adult lifespan.","volume":"116","author":"Denissen","year":"2019","journal-title":"J Pers Soc Psychol"},{"issue":"3","key":"yoi240069r38","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1037\/a0025948","article-title":"Subjective well-being and adaptation to life events: a meta-analysis.","volume":"102","author":"Luhmann","year":"2012","journal-title":"J Pers Soc Psychol"},{"issue":"1","key":"yoi240069r39","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/jora.12379","article-title":"Adolescent brain development: implications for understanding risk and resilience processes through neuroimaging research.","volume":"28","author":"Morris","year":"2018","journal-title":"J Res Adolesc"},{"key":"yoi240069r40","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.dcn.2017.10.002","article-title":"The conception of the ABCD study: from substance use to a broad NIH collaboration.","volume":"32","author":"Volkow","year":"2018","journal-title":"Dev Cogn Neurosci"},{"key":"yoi240069r41","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.dcn.2017.10.010","article-title":"Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description.","volume":"32","author":"Barch","year":"2018","journal-title":"Dev Cogn Neurosci"},{"key":"yoi240069r42","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.dcn.2018.04.004","article-title":"Recruiting the ABCD sample: design considerations and procedures.","volume":"32","author":"Garavan","year":"2018","journal-title":"Dev Cogn Neurosci"},{"key":"yoi240069r43","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.dcn.2018.02.007","article-title":"Adolescent brain cognitive development (ABCD) study: overview of substance use assessment methods.","volume":"32","author":"Lisdahl","year":"2018","journal-title":"Dev Cogn Neurosci"},{"issue":"8","key":"yoi240069r44","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1001\/jamapsychiatry.2018.1334","article-title":"Assessment of the Prodromal Questionnaire\u2013Brief Child Version for measurement of self-reported psychoticlike experiences in childhood.","volume":"75","author":"Karcher","year":"2018","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"yoi240069r45","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.schres.2011.03.029","article-title":"Psychosis risk screening with the Prodromal Questionnaire\u2013Brief Version (PQ-B).","volume":"129","author":"Loewy","year":"2011","journal-title":"Schizophr Res"},{"issue":"8","key":"yoi240069r46","doi-asserted-by":"publisher","first-page":"3322","DOI":"10.1017\/S0033291721005304","article-title":"Brain morphometry points to emerging patterns of psychosis, depression, and anxiety vulnerability over a 2-year period in childhood.","volume":"53","author":"Vargas","year":"2023","journal-title":"Psychol Med"},{"issue":"3","key":"yoi240069r47","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1038\/s41380-021-01373-x","article-title":"Persistent and distressing psychotic-like experiences using adolescent brain cognitive development study data.","volume":"27","author":"Karcher","year":"2022","journal-title":"Mol Psychiatry"},{"issue":"8","key":"yoi240069r48","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1542\/pir.21.8.265","article-title":"The Child Behavior Checklist and related forms for assessing behavioral\/emotional problems and competencies.","volume":"21","author":"Achenbach","year":"2000","journal-title":"Pediatr Rev"},{"issue":"1","key":"yoi240069r49","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4.","volume":"67","author":"Bates","year":"2015","journal-title":"J Stat Softw"},{"issue":"5","key":"yoi240069r52","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1111\/add.14145","article-title":"The associations between psychotic experiences and substance use and substance use disorders: findings from the World Health Organization World Mental Health surveys.","volume":"113","author":"Degenhardt","year":"2018","journal-title":"Addiction"},{"issue":"4","key":"yoi240069r53","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1017\/S0033291715002329","article-title":"Cannabis use and transition to psychosis in individuals at ultra-high risk: review and meta-analysis.","volume":"46","author":"Kraan","year":"2016","journal-title":"Psychol Med"},{"key":"yoi240069r54","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2023.100214","article-title":"Lifetime use of alcohol and cannabis among U.S. adolescents across age: exploring differential patterns by sex and race\/ethnicity using the 2019 NSDUH data.","volume":"10","author":"Farokhnia","year":"2023","journal-title":"Drug Alcohol Depend Rep"},{"issue":"Pt 2","key":"yoi240069r55","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1348\/014466505X29611","article-title":"The incidence and outcome of subclinical psychotic experiences in the general population.","volume":"44","author":"Hanssen","year":"2005","journal-title":"Br J Clin Psychol"},{"issue":"6","key":"yoi240069r56","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1093\/schbul\/sby087","article-title":"Psychotic experiences and related distress: a cross-national comparison and network analysis based on 7141 participants from 13 countries.","volume":"44","author":"W\u00fcsten","year":"2018","journal-title":"Schizophr Bull"},{"key":"yoi240069r51","volume-title":"Hierarchical Linear Modeling: Guide and Applications","author":"Luhmann","year":"2013"},{"key":"yoi240069r11","unstructured":"Substance Abuse and Mental Health Services Administration. 2019 NSDUH annual national report. Accessed April 8, 2024. https:\/\/www.samhsa.gov\/data\/report\/2019-nsduh-annual-national-report"},{"key":"yoi240069r12","unstructured":"Substance Abuse and Mental Health Services Administration. 2022 NSDUH annual national report. Accessed April 8, 2024. https:\/\/www.samhsa.gov\/data\/report\/2022-nsduh-annual-national-report"},{"key":"yoi240069r50","unstructured":"Osborne? KJ, Barch? DM, Jackson? JJ, Karcher? NR. A longitudinal investigation of psychosis spectrum symptoms before and after adolescent cannabis use initiation. Last updated October 2024. https:\/\/osf.io\/c2m45\/?view_only=8558ed22d7794d81957bdb09f137aaf8"}],"container-title":["JAMA Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/articlepdf\/2825423\/jamapsychiatry_osborne_2024_oi_240069_1738174986.98367.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T16:01:31Z","timestamp":1738771291000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2825423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,1]]},"references-count":56,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapsychiatry.2024.3525","relation":{},"ISSN":["2168-622X"],"issn-type":[{"value":"2168-622X","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2,1]]}}}