The Moderating Role of Cannabis Use in the Relationship Between Trauma Exposure and Depression Among Young Adults in Lebanon

Abstract

Background: Lebanon has experienced repeated wars, political instability and economic collapse over the past decade. Exposure to traumatic events has consistently been associated with higher rates of depression, while the relationship between cannabis use and depression remains unclear. This study examined the association between trauma exposure and depression among young adults in Lebanon and explored whether cannabis use moderated this relationship. Methods: A cross-sectional study was conducted among 158 young adults in Lebanon. Participants completed an online survey that included the Life Events Checklist for DSM-5 (LEC-5), the Cannabis Use Disorders Identification Test (CUDIT), and the Beck Depression Inventory-II (BDI-II). Descriptive statistics, bivariate analyses, multiple linear regression, and ordinal logistic regression models were used to assess the associations between lifetime trauma exposure, past six-months cannabis use, and depressive symptoms while adjusting for demographic characteristics and other substance use. A three-way plot of the main associations stratified by the subgroups of cannabis was also created to visualize the results. Results: Participants reported high levels of lifetime trauma exposure, with a mean score of 5.39 events. The mean depression score was 18.33, and 41.8% of participants reported cannabis use in the past six months. Higher trauma exposure was significantly associated with higher depression scores across all regression models. Compared with non-users, participants with low-risk cannabis use had significantly lower depression scores, whereas participants with likely cannabis dependence had significantly higher depression scores. The interaction term between lifetime trauma exposure and cannabis use was not statistically significant, although the plot suggests a possible moderating effect. Discussion: Lifetime trauma exposure was strongly associated with higher depressive symptoms among young adults in Lebanon. Cannabis use showed mixed associations with depression, with low-risk use associated with lower depression scores and likely cannabis dependence associated with higher depression scores. Although cannabis use did not significantly moderate the relationship between lifetime trauma exposure and depression, the findings suggest that heavier cannabis use may be linked to increased depressive symptoms. Further studies are needed to determine if cannabis use significantly moderates the association between lifetime trauma exposure and depression, and longitudinal studies are needed to determine if low-cannabis use only temporarily lowers depressive symptoms.