Julia Hooker

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




Joseph Ditre



Subject Categories

Clinical Psychology | Psychology | Social and Behavioral Sciences


The prevalence of cannabis use is substantially higher among individuals with chronic pain. Pain and cannabis use are posited to interrelate in the manner of a positive feedback loop, leading to greater pain and heavier cannabis use over time. Although analgesic and pain-coping outcome expectancies are hypothesized to play a central role in bidirectional pain-cannabis use processes, research in this domain has been limited by the absence of psychometrically-validated instruments designed to assess expectancies regarding the effects of cannabis on pain. The goals of the present study were to (1) develop a new Cannabis Pain Expectancies Scale (CPES), (2) assess scale factor structure, and (3) generate initial reliability and validity data. In Study 1, 58 scale items were generated and refined down to 32 items based on expert judge ratings. In Study 2, the 32 CPES items retained from Study 1 were administered to a sample of 277 current cannabis users with chronic pain via online survey. Exploratory factor analysis indicated a two-factor structure with 14 items total. In Study 3, the 14-item CPES was administered to a different sample of 314 current cannabis users with chronic pain. Confirmatory factor analysis supported the previously indicated two-factor structure (Factor 1: Cannabis for Reducing Pain and Functional Interference; Factor 2: Cannabis for Pain-Coping). The CPES further demonstrated excellent internal consistency reliability (α = .93) and evidence of convergent validity via positive covariation with indices of cannabis use frequency, general cannabis expectancies, pain relief motives for cannabis use, chronic pain-related interference, and characteristic pain intensity (ps < .01). Future research is needed to corroborate these findings and evaluate the predictive utility of CPES scores in relation to pain and cannabis use trajectories.


Open Access