In the mediation model a non-significant total-effect was demonstrated between anxious-depressive symptoms and cannabis use frequency. Therefore, indirect effects were not estimated on this relationship. Existing findings reported significant, positive and weak associations between anxious-depressive symptoms and cannabis use . However, the studies in the literature largely vary how they measure cannabis use and which confounding variables they control for. These can influence the association between cannabis use and anxious-depressive symptoms .These indirect effects can be categorized into three groups based on the similarities in the mediational mechanisms between them. First, higher levels of anxious-depressive symptoms were associated with lower levels of CRSE and CPBS which subsequently contributed to higher levels of harmful cannabis use. In line with these single mediation pathways, previous studies also reported negative relationships between cannabis use outcomes and CRSE, and between cannabis use outcomes and CPBS .
However, to the best of the Authors’ knowledge, less empirical evidence is available on the links between anxious-depressive symptoms and CRSE, and between anxious depressive symptoms and CPBS. This is the first time that the mediating effects of CRSE and CPBS were tested and supported between anxious-depressive symptoms and outcomes of cannabis use. The single mediation pathway via CRSE matches and extends previous gambling-related findings which suggested the mediating role of refusal self-efficacy on the relationship between depressive symptoms and negative gambling outcomes . The single mediation pathway via CPBS shows similarities with previous studies, which demonstrated mediating effects via APBS between anxious-depressive symptoms and alcohol use outcomes . These single mediation pathways might suggest that limited self-regulation capacities that are related to distressful and negative affective states can account for the negative links of anxious-depressive symptoms with CRSE and CPBS . Alternatively,outdoor cannabis grow it might be possible that those with more harmful cannabis use patterns have more negative self-views on their ability to successfully control and regulate their behavior when experiencing distressful and negative affective states . However, these assumptions should be interpreted cautiously as the present study did not test these explanations. Moreover, double-mediation pathways indicated that anxious-depressive symptoms had a positive effect on reflection which in turn was positively associated with CPBS and CRSE which subsequently contributed to lower levels of harmful cannabis use.
Previous studies also reported that higher levels of depressive symptoms are associated with increased levels of reflection, in addition to findings showing that CPBS are positively correlated with more adaptive ER strategies and negatively with outcomes of cannabis use . Although existing literature findings also reported negative relationships between cannabis use outcomes and CRSE , they did not investigate the associations between CRSE and ER processes. To the best of the Authors’ knowledge, this is the first time that the double mediating effects via reflection and CPBS as well as via reflection and CRSE were supported between anxious-depressive symptoms and outcomes of cannabis use. The double-mediation pathway via reflection and CPBS is in line with previous findings which suggested the mediating function of APBS on the effects of adaptive ER on alcohol use outcomes . However,cannabis grow equipment the present sequential mediating effect might contribute to broaden the existing knowledge on the link between ER and protective behavioral strategies by testing for cannabis use for the first time and by controlling for the effects of anxious-depressive symptoms and different rumination dimensions in the mediation model.
In the context of refusal self-efficacy, previous studies reported that difficulties in ER are inversely related to DRSE . Therefore, the double-mediating effect via reflection and refusal self-efficacy was not only tested and supported for the first time for cannabis use, but it also provides new empirical data on the associations of substance use refusal self-efficacy with more adaptive ER processes and with rumination. A possible explanation for these double mediating effects can be that some elements of reflection indicate a more active, problem- and goal-focused orientation which might lead to a more adaptive and pre-planned regulation of cannabis use. Finally, in a double mediation pathway, higher levels of anxious-depressive symptoms were associated with increased rates of NU which in turn had a negative effect on CRSE which subsequently contributed to less harmful cannabis use.