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The currently established mechanisms of change (MOC) that explain functional improvement in cannabis use disorder (CUD) treatments are limited by an exclusive focus on abstinence, rigid definitions, and overgeneralization across populations. We aimed to move beyond these limitations by examining 1) two untested non-abstinent MOC, 2) end-of-treatment (i.e., proximal; EOT) outcomes simultaneously functioning as MOC for follow-up outcomes (i.e., distal), and 3) gender-moderated MOC and treatment progression. Participants (n = 187; 70.1% male; 57.2% White) were community members with CUD between the ages of 18-50 (M = 30.9, SD = 8.9) who participated in a 12-week multi-site pharmacotherapy trial (NCT016756612). We collected self-report data and creatinine-corrected cannabinoid urine concentrations. We tested a longitudinal path analysis to examine 1) if mid-treatment MOC (cravings and use) mediate the relationship between CUD severity at baseline and proximal outcomes (anxiety, depression, and cannabis use problems), 2) if proximal outcomes mediate the relationship between the mid-treatment MOC and a 4-week distal outcome (quality of life), and 3) if gender moderates these effects. We found that cravings are a mid-treatment MOC for the full and men sample. In women, depression functioned as a proximal outcome and a MOC for the distal outcome. Further, mid-treatment use predicted anxiety, depression, and problems at EOT for women. In contrast, mid-treatment cravings predicted depression and problems at EOT for men. The findings provide evidence for unconventional explanations of functional improvements in CUD treatment, suggesting our understanding of CUD treatment may be more complex than the literature currently suggests.

Cannabidiol (CBD) has become a fast-growing avenue for research in psychiatry, and clinicians are challenged with understanding the implications of CBD for treating mental health disorders. The goal of this review is to serve as a guide for mental health professionals by providing an overview of CBD and a synthesis the current evidence within major psychiatric disorders. PubMed and PsycINFO were searched for articles containing the terms "cannabidiol" in addition to major psychiatric disorders and symptoms, yielding 2952 articles. Only randomized controlled trials or within-subject studies investigating CBD as a treatment option for psychiatric disorders (N = 16) were included in the review. Studies were reviewed for psychotic disorders (n = 6), anxiety disorders (n = 3), substance use disorders (tobacco n = 3, cannabis n = 2, opioid n = 1), and insomnia (n = 1). There were no published studies that met inclusion criteria for alcohol or stimulant use disorder, PTSD, ADHD, autism spectrum disorder, or mood disorders. Synthesis of the CBD literature indicates it is generally safe and well tolerated. The most promising preliminary findings are related to the use of CBD in psychotic symptoms and anxiety. There is currently not enough high-quality evidence to suggest the clinical use of CBD for any psychiatric disorder.

The Adolescent Brain Cognitive Development (ABCD) Study is an ongoing, nationwide study of the effects of environmental influences on behavioral and brain development in adolescents. The main objective of the study is to recruit and assess over eleven thousand 9-10-year-olds and follow them over the course of 10 years to characterize normative brain and cognitive development, the many factors that influence brain development, and the effects of those factors on mental health and other outcomes. The study employs state-of-the-art multimodal brain imaging, cognitive and clinical assessments, bioassays, and careful assessment of substance use, environment, psychopathological symptoms, and social functioning. The data is a resource of unprecedented scale and depth for studying typical and atypical development. The aim of this manuscript is to describe the baseline neuroimaging processing and subject-level analysis methods used by ABCD. Processing and analyses include modality-specific corrections for distortions and motion, brain segmentation and cortical surface reconstruction derived from structural magnetic resonance imaging (sMRI), analysis of brain microstructure using diffusion MRI (dMRI), task-related analysis of functional MRI (fMRI), and functional connectivity analysis of resting-state fMRI. This manuscript serves as a methodological reference for users of publicly shared neuroimaging data from the ABCD Study.