Cannabis Effects Expectancy Questionnaire-Medical (CEEQ-M)

Abstract

The Cannabis Effects Expectancy Questionnaire-Medical (CEEQ-M; Weiss et al., 2023) is a 17-item self-report measure designed to assess individuals’ beliefs about the effects of cannabis on various medical symptoms. This instrument is the first longitudinally validated measure of cannabis use expectancies specifically for medical purposes, developed through a rigorous four-study process. The initial item pool of 21 questions was primarily derived from Reinarman et al. (2011), which surveyed patients in medical cannabis clinics about their motivations for use. The CEEQ-M was administered to U.S. adults who were considering using cannabis for symptoms related to pain, sleep disorders, depression, or anxiety. The development process involved both exploratory and confirmatory factor analyses, ultimately resulting in a 17-item measure with a two-factor structure. The psychometric properties, including internal consistency and scalar invariance across demographic groups and over time, have been reported, indicating its reliability and validity for assessing cannabis expectancies in a medical context.

Keywords

Atypical Beliefs; Cannabis Effects Beliefs; Cannabis Use; Medical Effects of Cannabis; Medical Symptoms; Symptom Relief

Authors

Weiss, Jakob H.; Tervo-Clemmens, Brenden; Potter, Kevin W.; Evins, A. Eden; Gilman, Jodi M.

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Purpose

The primary purpose of the Cannabis Effects Expectancy Questionnaire-Medical (CEEQ-M) is to comprehensively assess an individual’s expectancies regarding the therapeutic effects of cannabis for various medical symptoms. This instrument aims to quantify beliefs about how cannabis might alleviate conditions such as pain, sleep disorders, depression, and anxiety, providing valuable insights into the motivations and anticipated outcomes of medical cannabis use.

Validity

The CEEQ-M demonstrates strong validity, particularly concerning its measurement invariance. Invariance testing of the measurement model confirmed scalar invariance across several crucial variables: randomization group, age (categorized as 18–25 years and 26–65 years), sex, and two successive questionnaire administrations (at baseline and the 1-month visit time points). This indicates that the CEEQ-M reliably measures the same construct across different subgroups and over time, ensuring that observed differences in scores reflect true differences in cannabis expectancies rather than measurement bias.

Reliability

The reliability of the CEEQ-M has been established through strong internal consistency for its two factors. For the “Symptom relief” factor, internal consistency was excellent, with a Cronbach’s alpha of 0.906 and McDonald’s ω of 0.907. The “Atypical beliefs” factor also demonstrated good internal consistency, with a Cronbach’s alpha of 0.779 and McDonald’s ω of 0.772. These high values indicate that the items within each factor are highly correlated and consistently measure their respective constructs.

Factor Analysis

The development of the CEEQ-M involved both exploratory and confirmatory factor analyses to establish its underlying structure.

Exploratory Factor Analysis: An exploratory factor analysis indicated a clear two-factor structure for the instrument. Following factor extraction using principal axis factoring, 17 items were retained from the original pool. The “Symptom relief” factor accounted for 31.0% of the total variance, while the “Atypical beliefs” factor accounted for 13.9% of the total variance among the 17 items that comprise the final factor structure. This suggests that these two distinct dimensions capture a substantial portion of the variability in cannabis expectancies for medical symptoms.

Confirmatory Factor Analysis: A confirmatory factor analysis (CFA) of the two-factor, 17-item measurement model for all respondents at the 1-month timepoint demonstrated good model fit. The fit indices, including the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and standardized root-mean-square residual (SRMR), indicated a strong fit of the model to the data. While the Root Mean Square Error of Approximation (RMSEA) suggested adequate fit, overall, the CFA results support the proposed two-factor structure of the CEEQ-M.

Instrument

Test Type: Original Inventory/Questionnaire

Format: Items are rated on a 10-point Likert scale. The response options range from “strongly disagree” (1 and 2) to “disagree” (3 and 4), “neutral” (5 and 6), “agree” (7 and 8), and “strongly agree” (9 and 10).

Language Available: English

Population Group: Human (Male and Female)

Age Group: The measure is applicable to Adulthood (18 years and older), including Young Adulthood (18-29 years), Thirties (30-39 years), Middle Age (40-64 years), and Aged (65 years and older).

Population Details: The study participants were adults located in the United States who were considering cannabis use for medical symptoms, specifically pain, sleep disorders, depression, or anxiety.

Test Methodology: The development and validation of the CEEQ-M involved a comprehensive methodological approach including: Test Reliability, Internal Consistency, Factor Analysis, Confirmatory Factor Analysis, Exploratory Factor Analysis, and Measurement Invariance testing.

Keywords

Client Attitudes; Drug Therapy; Drug Usage Attitudes; Expectations; Psychiatric Symptoms; Treatment Outcomes; Symptoms Based Treatment; Treatment Process and Outcome Measures; Medical Marijuana; Cannabis Use

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Authors

• Weiss, Jakob H.

  • Author ORCID Identifier: http://orcid.org/0000-0002-3879-0568

  • Affiliation: Massachusetts General Hospital Center for Addiction Medicine, Department of Psychiatry

• Tervo-Clemmens, Brenden

  • Affiliation: Massachusetts General Hospital Center for Addiction Medicine, Department of Psychiatry

• Potter, Kevin W.

  • Affiliation: Massachusetts General Hospital Center for Addiction Medicine, Department of Psychiatry

• Evins, A. Eden

  • Affiliation: Massachusetts General Hospital Center for Addiction Medicine, Department of Psychiatry

• Gilman, Jodi M.

  • Author ORCID Identifier: http://orcid.org/0000-0001-5180-6694

  • Affiliation: Massachusetts General Hospital Center for Addiction Medicine, Department of Psychiatry

  • Email addresses: [email protected]

  • Correspondence Address: Massachusetts General Hospital, Center for Addiction Medicine, Department of Psychiatry, 101 Merrimac Street, Suite 320, Boston, Massachusetts, United States, 02114, [email protected]

Permissions & Fee and Test Year

• Permissions: The CEEQ-M may be used for Research and Teaching purposes.

• Fee: No fee is required for its use.

• Test Year: 2023

References

Weiss, J. H., Tervo-Clemmens, B., Potter, K. W., Evins, A. E., & Gilman, J. M. (2023). The Cannabis Effects Expectancy Questionnaire–Medical (CEEQ-M): Preliminary psychometric properties and longitudinal validation within a clinical trial. Psychological Assessment, 35(8), 659–673. https://doi.org/10.1037/pas0001244

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Items of the Cannabis Effects Expectancy Questionnaire-Medical (CEEQ-M)

The CEEQ-M consists of 17 items, organized into two distinct factors:

Factors:

1. Symptom relief: This factor pertains to beliefs about cannabis’s ability to alleviate various medical symptoms.

2. Atypical beliefs: This factor captures less common or unusual beliefs regarding the effects of cannabis.

Number of Items: This measure consists of 17 items.

Test Items Available: Yes. No data is Available regarding the exact items; however, they are available in the supplemental material at Test Location: 2023-78778-001, Supplemental Material, Page 10.