Digital Intervention for Positive Valence System Dysfunction in Depression and Cannabis Use: A Pilot and Feasibility Study

The comorbidity of major depressive disorder and cannabis use disorder is highly prevalent. Existing treatments for depression and cannabis use, including cognitive behavioral therapy for depression and motivation enhancement therapy for cannabis use, often target one diagnosis and not both concurrently. Treating co-occurring depression and cannabis use independently can result in worse treatment outcomes; thus, treatments that target transdiagnostic mechanisms may be effective in treating the comorbidities together, including reward dysfunction in the positive valence system.

Positive affect treatments have been developed to address dysfunction in the positive valence system and demonstrate promising outcomes for depression and substance use disorders. However, in-person psychological interventions can be difficult to obtain due to their high costs and long waitlists. Fortunately, digital interventions have been developed to address the difficulties with obtaining in-person treatments. Although there are existing digital interventions that target depression or cannabis use, there are few digital interventions that are designed to target both co-occurring disorders, particularly through the lens of the positive valence system. Given the promise of positive affect treatments in treating individuals with co-occurring depression and substance use disorders, and the need for more evidence-based digital interventions, the current project aims to develop a positive affect treatment digital intervention and test its feasibility and acceptability for co-occurring depression and cannabis use.

The current project will implement an “expert-by-experience” or “lived experience” approach to develop the positive affect treatment digital intervention in an iterative format. We will recruit individuals with depressive symptoms and cannabis use who are interested in receiving treatment to conduct qualitative interviews with. The qualitative interviews will involve three phases with participants, including receiving feedback on the initial design, revising the intervention, and testing the feasibility, acceptance, usability of the intervention. The overall goal for this project is to create a digital intervention, based on components of positive affect treatments, that is developed with the target population in mind and involves feedback from persons with lived experience in the creation of the intervention. Moreover, the current project could result in a cost-effective digital intervention for treating co-occurring depression and cannabis use through the lens of the positive valence system, reducing patient cost and wait time.