Development and validation of the Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ) in adult cannabis users in treatment

Background: There are few valid clinical assessment instruments for cannabis. Self-efficacy, or the ability of users to resist temptation, is a central feature of social cognitive theory. This study outlines the development and validation of the Cannabis Refusal Self-Efficacy Questionnaire (CRSEQ), which measures the situational confidence to refuse cannabis. Method: One thousand two hundred and forty-six patients referred for cannabis assessment completed the CRSEQ including measures of cannabis consumption and dependence severity (Severity of Dependence Scale-Cannabis, SDS-C). The CRSEQ was subject to independent exploratory (n = 621, mean age 26.88, 78.6% male) and confirmatory (n = 625, mean age 27.51, 76.8% male) factor analysis. Results: Three factors: Emotional Relief, Opportunistic and Social Facilitation were identified. They provided a good statistical and conceptual fit for the data. Emotional Relief cannabis refusal self-efficacy was identified as most predictive of cannabis dependence, after controlling for cannabis consumption. Conclusions: The CRSEQ is recommended as a psychometrically sound and clinically useful measure for cannabis misuse treatment planning and assessment. (c) 2012 Elsevier Ireland Ltd. All rights reserved.