Alyssa Nelson

Tobacco and cannabis use are highly prevalent among individuals with psychotic disorders. Tobacco use has been consistently linked to poorer clinical and cognitive outcomes, whereas findings regarding cannabis use remain mixed. The present study leveraged a large multi-site psychosis spectrum sample with comprehensive cognitive and clinical assessments to more precisely characterize how tobacco or cannabis use, co-use, and non-use differentially relate to function. The final sample included 323 healthy controls and 884 individuals with psychotic disorders. Individuals with psychosis, regardless of substance use status, exhibited significantly worse cognitive performance across cognitive domains compared to healthy individuals. Among individuals with psychosis, exclusive tobacco use was associated with the highest symptom burden and the greatest cognitive impairment. In contrast, cannabis use showed more nuanced associations. Greater cannabis use was tied to worse general psychosis symptoms for current tobacco users but fewer general symptoms for those who never used tobacco. Further, more cannabis use was linked to better cognitive performance for current tobacco users but was not linked to working memory for prior users of tobacco. Taken together, these findings highlight tobacco use as a potential marker of greater disease severity and cognitive impairment among individuals with psychosis, while also demonstrating the importance of considering patterns of co-occurring use of substances such as cannabis.

A high percentage of students enter college with prior trauma, and trauma-informed practices are increasingly recognized as valuable in higher education. We examined if the tone of a syllabus would interact with levels of trauma or stress to impact participants’ perceptions of the instructor, willingness to seek help, and self-efficacy. We tested a 2 (tone: warm vs. cold) X 2 (trauma: low vs. high) experimental design and a 2 (tone: warm vs. cold) X 2 (stress: low vs. high) experimental design. College students read a syllabus, varying in tone, and then indicated their willingness to communicate with the instructor, as well as perceptions of their classroom self-efficacy and instructor attributes. Results revealed that in the high trauma condition, students attributed the most positive attributes to the warm-syllabus instructor and the most negative attributes to the cold-syllabus instructor. Student trauma did not interact with syllabus tone to predict perceived self-efficacy or willingness to communicate. Student stress did not interact with syllabus tone to predict instructor attributes or perceived self-efficacy; however, in the warm condition, high stress students revealed the greatest willingness to communicate with the instructor. The use of a warm syllabus as a tool to create a supportive learning environment benefits all college students, but particularly those experiencing high levels of stress or trauma.