MBRIEF

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Addict Behav. 2012 May ; 37(5): 613–621. doi:10.1016/j.addbeh.2012.01.008.
Dimensions and Severity of Marijuana Consequences:

Development and Validation of the Marijuana Consequences
Questionnaire (MACQ)
Jeffrey S. Simons1, Robert D. Dvorak1, Jennifer E. Merrill2, and Jennifer P. Read2
1The University of South Dakota
2State University of New York at Buffalo
Abstract
The Marijuana Consequences Questionnaire (MACQ) is a 50-item self-report measure modeled
after the Young Adult Alcohol Consequences Questionnaire (YAACQ). College students (n =
315) completed questionnaires online. A confirmatory factor analysis supported the hypothesized
8-factor structure. The results indicate good convergent and discriminant validity of the MACQ. A
brief, unidimensional, 21-item version (B-MACQ) was developed by a Rasch model. Comparison
of item severity estimates of the B-MACQ items and the corresponding items from the YAACQ
indicate that the severity of alcohol- and marijuana- problems is defined by a relatively unique
pattern of consequences. The MACQ and B-MACQ provide promising new alternatives to
assessing marijuana-related problems.
Keywords
marijuana; young adults; substance abuse; assessment
Marijuana is the most common illicit drug used in the US. Results of several national
surveys indicate that approximately half of young adults 18–25 have used marijuana in their
lifetime (CORE Institute, 2010; Johnston et al., 2010a; Substance Abuse and Mental Health
Service Administration, 2010). Lifetime prevalence rates among adolescents indicate a
steady progression of initiation through high school and into young adulthood and college
years with approximately 16% of 8th graders, 32% of 10th graders and 42% of 12th graders
reporting using marijuana in their lifetime (Johnston et al., 2010b). The prevalence of
© 2012 Elsevier Ltd. All rights reserved.

Jeffrey S. Simons, Ph.D., Department of Psychology, The University of South Dakota, 414 E. Clark Street, Vermillion, SD 57069,
Office: (605) 677-5353, Fax: (605) 677-3195, jsimons@usd.edu.
Author Disclosure
Statement 1: Role of Funding Sources
This research was supported in part by the National Institute on Alcohol Abuse and Alcoholism Grants AA017433 to Jeffrey S.
Simons and AA018242 to Robert D. Dvorak, and a National Institute on Drug Abuse Grant R01DA018993 to Jennifer P Read.
Statement 2: Contributors
All authors contributed the collection of the data. Dr. Simons designed the study and prepared the first draft of the manuscript. Mr.
Dvorak conducted the majority of the data analyses and prepared results. All authors contributed to and approved the final manuscript.
Statement 3: Conflict of Interest
The authors have no conflicts of interest.
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Simons et al. Page 2
marijuana use is high, in part, because the perceived risk of marijuana use is low (CORE
Institute, 2010; Johnston et al., 2010a; Substance Abuse and Mental Health Service
Administration, 2010). For example, results from the 2009 NHSDUH indicate that 18–23%
of 19–26 year olds consider occasional marijuana use to be of “great risk” and for regular
use, roughly 43–46% reported great risk.
Though the risk of marijuana may be relatively low compared to other drugs such as
alcohol, nicotine, or cocaine; marijuana use is not without its consequences. Marijuana use
is associated with respiratory problems including lung cancer (Aldington et al., 2008;
Aldington et al., 2007; Earleywine & Barnwell, 2007; Hall & Degenhardt, 2009; Looby &
Earleywine, 2007), deficits in cognitive functioning (Hanson et al., 2010; Lane et al., 2007),
mental health-related problems (Buckner et al., 2010; Looby & Earleywine, 2007), and
impaired impulse control and error monitoring (Hester et al., 2009; Lane et al., 2005;
McDonald et al., 2003). Other deleterious outcomes associated with marijuana use are
sexual risk behavior (Griffin et al., 2006; Simons et al., 2010b), traffic accidents (Hall &
Degenhardt, 2009), poor academic performance (Buckner et al., 2010), and a broad range
psychosocial problems (Copeland et al., 2005; Simons & Carey, 2006b). Among young
adult college students 18–22, 6.2% met criteria for a past year marijuana use disorder in
2009 (Substance Abuse and Mental Health Service Administration, 2010). There has been
increased recognition of problems with marijuana dependence and an emphasis on the
development and evaluation of empirically supported treatments in recent years (Buckner &
Carroll, 2010; Stephens et al., 2002).
The alcohol literature benefits from a wide array of relatively brief screening instruments
(AUDIT; Saunders et al., 1993; SMAST; Selzer et al., 1975), measures of dependence
symptoms (ADS; Skinner & Horn, 1984), broad measures of psychosocial consequences
(YAAPST; Hurlbut & Sher, 1992; RAPI; White & Labouvie, 1989), and multi-factor scales
that assess impairment in multiple domains (DrInC; Miller et al., 1995; YAACQ; Read et
al., 2006). Although marijuana use and associated consequences are common among young
adults, there has been relatively limited research on the development of assessment
instruments for marijuana consequences.
Commonly used instruments for young adults include the Marijuana Problem Index (a
variant of the RAPI; (Johnson & White, 1989; White & Labouvie, 1989) and the Marijuana
Problem Scale (Stephens et al., 2000). Recently, Stein et al., (2010) developed the Risk and
Consequences Questionnaire for use with incarcerated adolescents, which assesses
consequences associated with both alcohol and marijuana. Each of these provides a broad
assessment of the extent of consequences stemming from marijuana use. In addition, there
are a number of brief screening instruments for marijuana-related problems including the
Cannabis Use Disorders Identification Test, Cannabis Abuse Screening Test, and
Problematic Use of Marijuana (For a review, see Piontek et al., 2008). Finally, Copeland et
al., (2005) developed a 3-factor scale that assesses physical, psychological, and social
problems stemming from marijuana use. None of the available marijuana problem scales
provide as comprehensive assessment of problems in multiple domains as the Young Adult
Alcohol Consequences Questionnaire does for alcohol (discussed below).
In recent years, there has been increased emphasis on utilizing item-response methods to
refine instruments and clarify the severity of individual consequences (Hagman et al., 2009;
Kahler et al., 2005; Kahler et al., 2004; Neal et al., 2006). Item response methods evaluate
the extent of coverage of problem severity over a range. These methods can be used to
ensure that a scale can adequately differentiate substance use impairment at low, moderate,
and severe levels. In addition, they provide information regarding discrete symptoms as
indicators of relative severity of the disorder. Information regarding the type of problems

that individuals experience across the continuum of severity of a disorder can inform
understanding of the disorder and the meaning of presenting problems. There has been some
research applying these methods to marijuana related problems, however this has been
limited primarily to brief screening instruments and indicators of DSM cannabis abuse and
dependence indicators (Annaheim et al., 2010; Compton et al., 2009; Martin et al., 2006;
Wu et al., 2009).
Negative consequences associated with marijuana and alcohol use overlap. For example,
each drug may be associated with impairment in socio-occupational functioning, risk-taking
behaviors, and affect interpersonal functioning. In contrast, symptoms of heavy use (e.g.,
blackouts, vomiting, paranoia) and withdrawal symptoms may be unique to alcohol or
marijuana. Similarly, chronic marijuana users may exhibit some unique features such as
apathy that is often considered a feature of marijuana use in the popular media, though
empirical evidence for this is limited (Barnwell et al., 2006; Zimmer & Morgan, 1997).
Despite similarities of consequences across alcohol and marijuana, endorsement of a
symptom may indicate a different level of severity for each drug. For this reason, it is
important, to systematically evaluate marijuana consequences utilizing item-response
analysis. Understanding of both alcohol and marijuana consequences can be enhanced by
having comparable scales for each. There are enough similarities in the type of
consequences that establishing alternate forms of instruments to evaluate alcohol and
marijuana consequences can be informative. For example, this would facilitate identifying
unique patterns of consequences for each drug.
The Young Adult Alcohol Consequences Questionnaire (YAACQ) is a 48-item

questionnaire assessing alcohol problems among young adults (Read et al., 2006). The scale
has 8 factors; Social-Interpersonal Consequences, Impaired Control, Self-Perception, Self-
Care, Risky Behaviors, Academic/Occupational Consequences, Physical Dependence, and
Blackout Drinking. In addition, a brief 24-item unidimensional version exists that was
developed using item-response analysis and orders items along a single continuum of
severity (Kahler et al., 2005). These scales have excellent psychometric properties and
benefit from being able to be used to examine either problem severity across a continuum or
to assess functioning in discrete domains (Devos-Comby & Lange, 2008; Kahler et al.,
2005; Read et al., 2006; Read et al., 2007).
The present study modified the YAACQ to assess marijuana consequences (the Marijuana
Consequences Questionnaire, MACQ). The revised scale maximizes comparability across
the measures, yet incorporates necessary modifications reflecting unique features of
marijuana consequences. We fit a confirmatory factor analysis model to test whether the
scale exhibits a factor structure comparable to the YAACQ. Subsequently, we utilize item
response modeling to develop a brief measure (the B-MACQ) and to evaluate the items as
indicators of problem severity. To our knowledge, this has not been done with as extensive a
measure of marijuana-related consequences. We compare the functioning of the items as
indicators of alcohol versus marijuana use problem severity. Finally, we present evidence of
criterion validity of the scales and test-retest reliability.
Methods
Participants
The total sample consisted of 2,151 college students from two universities in the
Midwestern and Northeastern parts of the U.S. The analysis sample (n = 315 (14.6%)) was
comprised of participants who reported using marijuana at least once per month over the last
six months. The analysis sample consisted of 51.10% women and ranged in age from 18–29
(M = 20.52, SD = 1.62). The racial composition was 88.64% Caucasian, 2.21% Asian,

2.21% African American, 0.95% Alaskan Native/Native American, 0.32% Native Hawaiian
or Pacific Islander, 5.05% multiracial. Four individuals reported “other” or “do not wish to
respond.” Twelve participants (4.53%) reported they were of Hispanic or Latino/Latina
origin.
Measures
Marijuana use—Marijuana use frequency in the last 6 months was assessed by a 9 point
rating scale (0 = none at all to 8 = more than once a day). Marijuana use intensity was
assessed by a 1-week grid with 4, 6-hour, periods per day. Participants indicated the number
of time periods that they consumed marijuana in a typical week in the past 6 months. These
measures of marijuana use have demonstrated good criterion validity and stability over 6-
month intervals in previous research (Simons & Carey, 2006a; Simons et al., 2005; Williams
et al., 2000).
Marijuana problems—The present study modified the YAACQ to assess marijuana

consequences (the Marijuana Consequences Questionnaire, MACQ). The majority of items
were left unchanged aside from referring to marijuana rather than alcohol to enhance
comparability across the scales. Items related to withdrawal symptoms were modified to
reflect symptoms of marijuana withdrawal (Hasin et al., 2008) and descriptions of
“hangover” were modified to better reflect effects of marijuana. In addition, we added two
items to reflect deficits in motivation and paranoia. The MACQ is a 50-item scale assessing
marijuana problems over the past 6 months. A 6-month time frame was chosen to adequately
capture potential infrequent consequences among marijuana users. Each item is rated
dichotomously (yes/no) to indicate whether the marijuana-related problem occurred in the
last 6 months. The problems were hypothesized to load onto the 8 factors established for the
YAACQ (Social-interpersonal Consequences, Impaired Control, Self-Perception, Self-Care,
Risk Behaviors, Academic/Occupational Consequences, Physical Dependence, and
Blackouts). In addition, the Marijuana Problems Index was included to assess criterion
validity of the new scale (Johnson & White, 1989). The MPI is a 23-item scale similar to the
RAPI (White & Labouvie, 1989) and has good criterion validity and stability over 6-month
intervals in young adult samples (Simons & Carey, 2006a; Simons et al., 2005).
Alcohol Consumption—Alcohol consumption in the past 6 months was measured with

the Modified Daily Drinking Questionnaire (DDQ-M; Dimeff et al., 1999). Participants
indicate the typical number of standard alcoholic drinks consumed and number of hours of
drinking for each day of the week on a grid. Previous research has shown adequate test-
retest reliability over a seven day period (r = .93; Miller et al., 1998).
Alcohol problems—Alcohol problems in the past 6 months were assessed with the
Young Adult Alcohol Consequences Questionnaire (YAACQ; Read et al., 2006). The
YAACQ provides a measure of alcohol problems across 8 domains as well as a total score.
The YAACQ has shown excellent test-retest reliability and convergent validity with alcohol
use and other measures of alcohol problems (Read et al, 2007; Read et al., 2006).
Procedure
Participants from two state universities completed all questionnaires online. All participants
provided informed consent and were recruited through an online university research pool.
Participants were told that all responses would be anonymous and that participation would
include answering questions regarding substance use and problems. Participants received
either course credit (Midwest U.S. site) or a gift card up to $35 (Northeastern U.S. site) for
participation. The reliability and validity of online assessments of substance use is well
supported (Miller et al., 2002; Simons et al., 2009). All participants were treated in

accordance with APA ethical guidelines for research and the studies were approved by the
respective Institutional Review Boards (Sales & Folkman, 2000). Thirty-seven of the
participants at the Midwest site were taking part in another study (Simons et al., 2010a) and
their data were used to examine test-retest reliability. Participants at the Northeastern site
were part of an ongoing study of associations between traumatic stress and substance use
among college students (Read, Ouimette, Colder, White, & Farrow, 2011; Read, Colder,
Merrill, Ouimette, White, & Swarthout, 2011).
Results
Descriptive Statistics
Marijuana use frequency in the analysis sample (scale M = 4.24, SD = 1.85) ranged from 2
(once a month) to 8 (more than once a day), with the mode (n = 100; 31.75% of sample)
using 2 –3 times a month. Fifty-two percent of the analysis sample reported using marijuana
at least once a week, 25% nearly every day or more, and 14% at least once a day. Typical
weekly marijuana use intensity ranged from 0 to 28 times per week (M = 6.92, SD = 6.53).
The total number of marijuana problems endorsed on the MACQ ranged from 0 – 44 (M =
8.36, SD = 8.59). Marijuana use frequency and intensity did not differ by gender or
university (p’s = .08 – .59). Number of marijuana related problems endorsed on the MACQ
did not differ by gender (t(313) = −1.18, p = .24). There was a small difference in number of
problems across university (t(313) = −2.09, p = .037, Cohen’s d = 0.25).
Confirmatory Factor Analysis

All responses for marijuana problems were binary, thus we utilized the mean- and variance-
adjusted weighted least squares estimator (WLSMV) in MPlus 6.1 (Muthén & Muthén,
2010). A CFI greater than or equal to .96, and a weighted root-mean-square residual
(WRMR) of approximately 1.0 indicate good fit with categorical data (Yu, 2002). Chi-
square difference testing was performed using the DIFFTEST function of Mplus 6.1
(Muthén & Muthén, 2010).
We first specified an 8-factor model of marijuana problems modeled after the 8-factor
YAACQ. This model was an excellent fit to the data, χ2(1147) = 1347.44, p < .001, CFI = .
97, TLI = .97, RMSEA = .024 (90% CI = .018 – .029), WRMR = .98. Examination of the
model indicated high correlations between some of the latent variables (rs = .57 (Physical
Dependence with Self-Perception) - .91 (Risk Behaviors with Social-Interpersonal
Consequences). Thus, we specified an alternative single factor unidimensional model. This
model showed reasonable fit to the data, χ2(1175) = 1553.53, p < .001, CFI = .94, TLI = .94,
RMSEA = .032 (90% CI = .028 – .036), WRMR = 1.17. However, a chi-square difference
test indicated the initial 8-factor model was a better fit to the data than the 1-factor model, Δ
χ2(28) = 220.03, p < .001.
Next, we tested an alternative model in which the 8-latent marijuana problems loaded on a
higher-order marijuana problems factor. This model also showed good fit to the data,
χ2(1167) = 1417.66, p < .001, CFI = .96, TLI = .96, RMSEA = .026 (90% CI = .021 – .031),
WRMR = 1.05. Standardized factor loadings ranged from .78 (Self-Perception) to .92 (Risk
Behaviors) and the R2 for the lower-order factors ranged from .61 (Self-Perception) to .85
(Risk Behaviors). However, a chi-square difference test indicated the initial 8-factor model
was a better fit to the data than the higher-order factor model, Δχ2(20) = 85.79, p < .001.
Thus, we retained the original 8-factor model (see Table 1). Table 2 presents means, internal
consistency, and correlations for the manifest MACQ scales.

Rasch Model
In the CFA analysis, both a unidimensional and a higher-order factor structure fit the data
well. Thus, we sought to derive a brief measure of marijuana problems that would assess the
severity of problems along a unidimensional continuum. To do this, we utilized Rasch

modeling to identify items of progressive problem severity. The Rasch analysis was
conducted using Winsteps® 3.71.0 (Linacre, 2011). We proceeded by initially examining all
items and iteratively removing items with poor model fit as indicated by infit and outfit
statistics, and/or multidimensionality assessed by high residual loadings on extraneous
factors (Bond & Fox, 2007; Linacre, 2002). Criteria for item elimination by infit/outfit were
items falling outside the range of 0.5–1.5 (Bond & Fox, 2007). We then examined
differential item functioning (DIF) across items by gender and university. Next we
conducted a principal components analysis of the residual variance of each item to examine
multidimensionality. Finally, we tested the fit of the Rasch model in Mplus 6.1.
No items had infit statistics outside the .5 to 1.5 range. However, 29 items had outfit
statistics outside this range, and were thus removed. Next, we examined differential item
functioning (DIF) by gender and university. None of the remaining 21 items showed DIF by
gender; however, two items (MACQ items #15 and #25) showed DIF by university, and
were removed. Finally, we examined multidimensionality of items via the loadings of
residual variances on additional factors in a principal components analysis of item residuals.
The first principal component (i.e., first contrast) had an eigenvalue of 1.8. Examination of
the indicators with the highest loadings on this component did not reveal any meaningful
conceptual theme. Thus, no additional items were eliminated. This process resulted in the
retention of 19 items.
Examination of these 19 items revealed a lack of measurement at low levels of problems,

resulting in reduced reliability. Thus, we added two additional items that had been
previously removed due to high outfit statistics (MACQ items #4 and #5). Previous research
has shown that some fit indices in Rasch (e.g., infit/oufit) may be biased in skewed samples
(Hidalgo & López-Pina, 2011). Considering our sample was not normally distributed, we let
overall model fit dictate the retention of these two items. Despite outfit statistics > 1.50,
these items increased the overall person reliability (PR) of the scale (19-item PR = .51; 21-
item PR = .67), increased person separation (19-item = 1.57; 21-item = 1.72), increased the
overall variance accounted for by the measure (19-item = 33.1%; 21-item = 38.8%), and
reduced the variance accounted for in the 1st principal component (19-item = 6.4%; 21 item
= 5.3%). Although these individual items did not offer ideal statistical fit to the Rasch
framework, they improved overall performance of the brief measure. Table 3 presents the
model statistics for the 21-item brief measure with items ordered in terms of severity. In
addition, we added the relative severity of comparative alcohol problems from the YAACQ
to examine differences in indicators of problem severity by substance. Severity estimates are

in reference to the latent continuum of substance use problem severity. A higher severity
estimate indicates that the item is endorsed by individuals with greater problems, but does
not necessarily indicate that the specific consequence is a more significant or severe
behavioral risk relative to an item with a lower severity estimate (Kahler et al., 2005). Thus,
whereas, impaired academic performance or interpersonal conflict may be equally
problematic regardless of whether they stem from drinking or using marijuana, the presence
of such consequences may convey different information regarding level of substance use
disorder.
The final Rasch model contained several non-variable cases (i.e., cases with no problems).
This presents a difficulty as the exact location on the theta ruler for these people cannot be
accurately identified. Consequently, the reliability of the scale, which includes non-variable
cases, is bound to be reduced. A further complication is the fairly low base rate of problems

in this population. Thus, we present data on the reliability of the scale for all those that could
be located on theta, as well as the reliability for the entire sample. For the entire sample (n =
315) person reliability was .67 and person separation was 1.42, this included 65 individuals
with no variability in scores. The lack of variability among these individuals was due to all
zero scores (i.e., they did not acknowledge any of the 21 B-MACQ items). There were no
individuals acknowledging all 21 items. Among individuals with variable scores (n = 250)
the scale performed much better. The scale was more reliable (PR = .75) and had adequate
power to accurately categorize high and low problem users (person separation = 1.72).
Cronbach’s alpha calculated from tetrachoric correlations also indicated good internal
consistency (α = .95). The final 21-item scale accounted for 38.8% of the variance,
indicating a moderately strong measurement dimension (Linacre, 2006). We fit the 21-item
Rasch model in Mplus 6.1 using Theta parameterization with the WLSMV estimator. The
model showed good fit to the data: χ2(209) = 321.33, p < .01, RMSEA = .04 (90% CI = .03
– .05), CFI = .96, TLI = .96, WRMR = 1.32.
The raw score distribution is presented in Table 4. The B-MACQ score is the total number
of items endorsed. The B-MACQ can range from 0 (no consequences endorsed, least severe)
– 21 (every consequence endorsed, most severe). Appendix 1 includes the B-MACQ and
scoring instructions. Each score may be expressed in equal interval logit units along a latent
continuum of marijuana problem severity. Comparison of the score severity estimates to the
item severity estimates in Table 3 indicates the type of problems individuals along the
severity continuum are likely to have. For example, a score of 7 on the B-MACQ reflects a
severity score of −0.85. This indicates that the individual would have approximately a 50%
probability of endorsing item 21 on the B-MACQ, which has an item severity of −0.86. The
probability of endorsing items with severity estimates less than −0.85 (i.e., items 2, 3, 9, &
20) would be greater than 50% with the probability increasing as the item severity decreases.
Similarly, an individual with a score of 7 on the B-MACQ would be relatively unlikely to
endorse items 1, 8, 5, or 14, which have severity estimates of > 0.99. Thus, the total score
not only quantifies the severity of marijuana problems, but also provides information
regarding the type of problems individuals along the continuum are likely to experience. A
comparison of the mean person level severity estimates to the mean item severity estimates
(standardized to 0), indicated the current sample of marijuana users had considerably lower
mean severity levels (mean person severity = −2.49 logits; SD = 1.50). Thus, the B-MACQ
items are targeting a level of problem severity that is higher than the severity of problems
experienced by users in this sample.
Validity and Test-Retest Reliability

Table 5 presents correlations between the MACQ scales and other measures of marijuana
and alcohol use and problems. The significant positive correlations between the MACQ
scales and marijuana frequency, use intensity, and the Marijuana Problems Index support the
convergent validity of the scales. Correlations between the marijuana use indicators and the
subscales ranged from non-significant associations with Self-Perception to strong positive
associations with the Physical Dependence scale. The MACQ total score and the B-MACQ
demonstrate substantially higher correlations with the marijuana use indices than with drinks
per week, providing evidence of discriminant validity. Similarly, the MACQ and B-MACQ
exhibited substantially stronger associations with the Marijuana Problems Index than with
the YAACQ. Thirty-seven participants took the MACQ a second time (test-retest interval
range 1 – 19 days, M = 6.24, SD = 4.31). Scores on the MACQ were comparable to the full
sample (M = 8.57, SD = 10.28). Test-retest intra-class correlations were .75 for the MACQ
total score and .80 for the B-MACQ, thus demonstrating good test-retest reliability over a
brief interval.

Discussion
Marijuana and alcohol are the most common drugs of abuse among young adults (Substance
Abuse and Mental Health Service Administration, 2010). There has been less research on
measurement of marijuana-related consequences relative to alcohol consequences. Though
specific health risks may vary across drugs of abuse, problematic use may be defined by a
common set of indicators reflecting symptoms of dependence and impairment in
intrapersonal, behavioral, social, and occupational functioning (American Psychiatric
Association, 2000). Comparable versions of measurement instruments that assess problems
stemming from alcohol and marijuana use can help advance research on the etiology and
treatment of substance related problems as well as contribute to refining understanding of
the constructs and associated taxons. We developed the MACQ to provide a marijuana
version of the YAACQ.
MACQ
The hypothesized 8-factor structure of the MACQ was a good fit to the data, yielding 8
subscales: Social-Interpersonal Consequences, Self-perception, Self-care, Academic-
Occupational Consequences, Blackout Use, Impaired Control, and Physical Dependence.
Although factors were moderately-to-strongly correlated, the hypothesized 8-factor structure
was a better fit to the data than a unidimensional structure. The Physical Dependence scale
exhibited the strongest associations with marijuana use. Similar to findings with the
YAACQ, feelings of guilt and other internalizing symptoms assessed by the Self-Perception
scale were not associated with marijuana use. Intermediate between these extremes were
subscales assessing involvement in risk behaviors, self-control, and impaired functioning in
social and occupational domains.
The pattern of associations between the subscales and marijuana use is consistent with
research indicating the role of situational and dispositional factors contributing to substance-
related problems (Simons et al., 2009; Simons et al., 2010a; Wills et al., 2008). Whereas
physical dependence is strongly associated with drug intake, the extent to which individuals
engage in risk behaviors, experience interpersonal problems, or have difficulty meeting
social obligations may be influenced by factors extrinsic to the drug. The Blackout scale
includes items assessing acute consequences of over-consumption. Although some of these
items seem more relevant to alcohol consumption than marijuana (e.g., vomiting), the scale
mean indicates these were as commonly endorsed as some of the other scales (e.g., Social-
Interpersonal Consequences). The relatively low association with marijuana use may reflect
the fact that the use indicators do not provide a good assessment of quantity used or level of
intoxication. Alternatively, if individuals are using heavy amounts of both alcohol and
marijuana simultaneously, it may be difficult to attribute the consequence to one drug.
As discussed above, there are both statistical and theoretical justifications for utilizing the
subscales. In addition, the subscales may be useful in clinical applications to provide
specific feedback regarding problem areas. However, both a unidimensional structure as
well as a model with a higher-order general consequences factor were an adequate fit to the
data. Thus, there is also justification for utilizing the MACQ total score, and this may be
determined by the goals of the assessment.
B-MACQ
Given that substance use problems may be described by a continuum defined by items of
increasing severity (Kahler et al., 2005; Kahler et al., 2004), we utilized a Rasch model
analysis to develop the B-MACQ. The B-MACQ provides two advantages. On a practical
level, the 21-item scale provides a more efficient assessment of marijuana problem severity

relative to the 50-item MACQ. This is accomplished with no loss of criterion validity. It
correlated at .95 with the full scale, exhibited slightly stronger associations with marijuana
use and the MPI, and had better discriminant validity in respect to associations with alcohol
measures. On a theoretical level, the Rasch model provides an index of item severity, which
can provide insight into the nature of marijuana problems and allows evaluation of the
extent to which the instrument can adequately differentiate individuals at varying levels of
problematic marijuana involvement. In addition, the B-MACQ minimizes gender bias. In the
current sample, the B-MACQ provides good coverage along the continuum of severity,
indicating that it can adequately differentiate individuals at all points of the continuum. The
model indicates that problems such as lack of energy and being less physically active are
relatively common and reflect minor levels of marijuana-related problems. In contrast,
interpersonal conflicts (e.g., reports of physical fights or being rude and obnoxious) are
relatively rare and may reflect more severe problems associated with marijuana use.
Difficulty with sleeping after cutting down marijuana use and memory loss for the previous
evening lie along the middle of the continuum, reflecting moderate problems.
Marijuana and Alcohol Consequences: Relative severity

Though marijuana and alcohol use share similar types of negative consequences, a given
consequence related to one’s marijuana vs. alcohol use may indicate a different level of
problem severity. This may occur due to differences in pharmacological properties of the
drugs, the meaning of the consequence in the socio-cultural context, and/or differences in
psychological-behavioral response profiles associated with the drug. For example, reports of
being “rude or obnoxious” when under the influence were commonly endorsed for alcohol
and reflected low severity whereas this consequence was relatively rare for marijuana use
and indicated more severe use related problems. Similarly, memory loss for the previous
evening and impulsive behavior were among the least severe of the items in respect to
alcohol problem severity, whereas for marijuana these items reflected moderate severity.
Needing to use marijuana in the morning, one of the Physical Dependence indicators, was a
moderate marijuana-related consequence, whereas this was among the most severe alcohol
items. Similarly, indicators of withdrawal were among the most severe alcohol items, yet
seemed to indicate more moderate marijuana problems. Both of these items were changed to
reflect a withdrawal symptom that was more appropriate for marijuana. For example, item
22 of the MACQ refers to sleeping problems associated with withdrawal whereas item 22 on
the YAACQ, refers to having “the shakes.” Thus, the alcohol symptoms assessed appear to
be more severe withdrawal symptoms, reflecting a higher degree of alcohol use disorder.
Concern about use and efforts to cut down or stop appear to reflect a lower level of problems
for marijuana relative to alcohol in this sample. This may reflect differences in the social
acceptance of these drugs.
The severity ranking of some items was fairly comparable across drugs. For example,
feeling unhappy about use and reporting weight gain were among the upper 1/3 of items and
hangovers were among the least severe. Driving while high was the least severe marijuana
item, endorsed by 58% of the sample. The comparable item assessing drinking and driving
on the YAACQ indicated somewhat higher severity. However, the wording of the two items
is slightly different, assessing driving when “high” vs. “had too much to drink to drive
safely.” This does not indicate that driving under the influence of marijuana is a less serious
risk behavior, but that, relative to alcohol, individuals with fewer substance-related problems
tend to engage in the behavior.
Differences in the meaning of negative consequences across drugs in respect to severity of

drug use disorder suggest that drug use disorder is a complex psychosocial phenomenon
embedded within a cultural context whereby the likelihood and severity of individual

consequences varies as a function of both pharmacological properties of the drugs as well as

psychosocial context. Such differences have important implications for interpreting
assessment results. That is, despite being similar behaviors, some items reflect potential
different degrees of use disorder.
Limitations and Future Directions

The results should be interpreted in light of limitations of the research. Sample
characteristics are a notable limitation. The sample provided a wide range of marijuana use
and associated problems. However, mean use level and associated problems were relatively
low. Further research validating the findings in a heavier using sample is needed. It is
possible that the distribution of participants’ level of consequences impacted decisions to
drop items that may be informative in a heavier use sample. For example, a sample with
more severe problems (e.g., an inpatient sample in a substance use treatment facility) may
reduce the outfit of items with extremely low response rates in the current sample, ultimately
leading to retention of items we have removed here. Thus, the B-MACQ may not fully
capture the range of severity among those with higher rates of problems. Similarly,
validating the scale in populations with different age, education, and ethnic/racial
characteristics would be beneficial. The two measures of marijuana use assess frequency and
intensity of use. However, they do not provide a clear measure of quantity, level of
intoxication, or peak consumption. These variables are likely important indicators of
problematic use. Understanding of marijuana related consequences may be advanced by
examining associations between the MACQ scales and measures that better capture level of
intoxication. Research that incorporated more detailed assessment of marijuana use via
interview or other valid assessment among young adults not enrolled in college would be
useful to provide additional validation evidence for the B-MACQ.
Although drinks per week and marijuana use frequency were not significantly correlated in
this sample of marijuana users, alcohol and marijuana are commonly used simultaneously
(Midanik et al., 2007). Individuals may have difficulty determining whether some target
consequences were the result of alcohol or marijuana use. The pattern of correlations
supports the discriminant validity of the scales, however individual use patterns will limit
the ability to accurately discriminate consequences stemming from individual drugs.
Similarly, the ability to discriminate sources of problems may vary depending on the target
consequence. For example, the Physical Dependence scale is moderately to strongly
associated with marijuana use and not significantly associated with drinks per week. In
contrast, other subscales such as Academic-Occupational consequences and Risk Behaviors
exhibit more comparable correlations with both marijuana and alcohol use. This may be
because consequences such as failure to fulfill social role responsibilities are determined in
part by dispositional factors or alternatively, that individuals have difficulty determining if
these consequences stem from their marijuana or alcohol use.
Finally, the YAACQ items were used as the basis for the MACQ and few items were
modified or added to be unique to marijuana related problems. It is thus possible that there
exist problems that are particularly unique to marijuana use (e.g., respiratory problems) that
the MACQ does not capture. We modified or added some key items (e.g., paranoia,
descriptions of hangover, withdrawal, lack of motivation) and believe there is sufficient
commonality in the types of problems associated with the two drugs that the benefits of
having comparable alcohol and marijuana scales outweigh the limitations. For example, due
to our approach we were able to compare item severity across the drugs. This provides new
information regarding the pattern of consequences that individuals experience and provides
some insight into the meaning of the consequences vis-à-vis indicators of severity of use
disorder.

Summary
In summary, the MACQ is an 8-factor scale assessing problems associated with marijuana
consumption. The scale covers a broad range of associated problems including risk
behaviors, problems with intra- and interpersonal functioning, acute adverse effects, social
role functioning, and indictors of difficulty controlling use and signs of physical
dependence. The results support the criterion validity of the MACQ, providing evidence of
convergent and discriminant validity. The MACQ subscales may be useful in clinical or
research applications where assessment of discrete problem areas is desired. The B-MACQ
is recommended as an efficient unidimensional measure of marijuana problem severity that
minimizes gender bias. Examination of indices of item severity indicates variation in the
meaning of individual marijuana and alcohol consequences in respect to the problem
severity continuum. For alcohol and marijuana, not all consequences are created equal.
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Highlights
• We evaluate an 8-factor marijuana consequences questionnaire.
• We test the factor structure, convergent and divergent validity, and test-retest
reliability.
• We developed a short unidimensional version via a Rasch model.
• We present item severity estimates.
• We compare severity estimates of alcohol and marijuana consequences.

Table 1
Factor loadings and endorsement for MACQ items
Items ordered by factor Factor Loading % Endorsed
Social-Interpersonal Consequences
1. While using marijuana I have said or done embarrassing things. .67 37.26
11. My marijuana use has created problems between myself and my boyfriend/girlfriend/spouse/parents, or .93 7.99
other near relatives.
17. I have become very rude, obnoxious, or insulting after using marijuana. .80 6.03
23. My boyfriend/girlfriend/spouse/parents have complained to me about my marijuana use. .75 11.86
33. While using marijuana I have said harsh or cruel things to someone. .91 8.89
36. I have said things while using marijuana that I later regretted. .92 11.43
Impaired Control
10. I often used more marijuana than I originally had planned. .59 32.15
14. I have spent too much time using marijuana. .85 22.68
28. I often have ended up using marijuana on nights when I had planned not to use marijuana. .57 37.50
30. I often have found it difficult to limit how much marijuana I use. .97 15.02
41. I have tried to quit using marijuana because I thought I was using too much. .86 16.29
45. I often have thought about needing to cut down or to stop using marijuana. .80 25.00
Self-Perception
3. I have felt badly about myself because of my marijuana use. .80 19.29
12. I have been unhappy because of my marijuana use. .90 11.18
18. I have felt guilty about my marijuana use. .68 24.04
48. Using marijuana has made me feel depressed or sad. .86 11.54
49. I have felt panicked or paranoid after using marijuana. .64 38.22
Self-Care
20. Because of my marijuana use, I have not eaten properly. .63 27.16
21. I have been less physically active because of my marijuana use. .80 29.71
34. Because of my marijuana use, I have not slept properly. .83 9.90
35. My physical appearance has been harmed by my marijuana use. .83 7.99
38. I have been overweight because of my marijuana use. .68 7.94
39. I haven’t been as sharp mentally because of my marijuana use. .74 21.15
43. I have not had as much time to pursue activities or recreation because of my marijuana use. .85 9.97
46. I have had less energy or felt tired because of my marijuana use. .80 36.31
50. I have lost motivation to do things because of my marijuana use. .80 26.37
Risk Behaviors
4. I have driven a car when I was high. .59 58.15
7. I have taken foolish risks when I have been high. .83 15.87
13. I have gotten into physical fights because of my marijuana use. .79 2.88
19. I have damaged property or done something disruptive like setting off a fire alarm, or other things like .84 4.15
that after using marijuana.
26. As a result of marijuana use, I neglected to protect myself or partner from an STD or unwanted .93 4.17
pregnancy.
29. When using marijuana I have done impulsive things that I regretted later. .82 12.10
31. My marijuana use has gotten me into sexual situations I have later regretted. .80 5.71

Items ordered by factor Factor Loading % Endorsed
44. I have injured someone else while using marijuana or high. .90 3.19
Academic/Occupational Consequences
2. The quality of my work or schoolwork has suffered because of my marijuana use. .86 9.35
9. I have gotten into trouble at work or school because of marijuana use. .76 3.53
15. I have not gone to work, or have missed classes or school because of using marijuana, being high, or .90 11.11
after effects (feeling hung-over).
27. I have neglected obligations to family, work, or school because of my marijuana use. .90 12.50
40. I have received a lower grade on an exam or paper than I ordinarily could have because of marijuana .91 9.94
use.
Physical Dependence
16. I have felt like I needed a hit of marijuana after I’d gotten up (that is, before breakfast). .84 16.61
22. I have had trouble sleeping after stopping or cutting down on marijuana use. .83 14.74
25. I have found that I needed larger amounts of marijuana to feel any effect, or that I could no longer get .84 27.80
high on the same amount that used to get me high.
42. I have felt anxious, irritable, lost my appetite or had stomach pains after stopping or cutting down on .87 12.46
marijuana use.
Blackout Use
5. I have felt in a fog, sluggish, tired, or dazed the morning after using marijuana. .60 39.17
6. I have passed out from marijuana use. .53 20.06

8. I have felt very sick to my stomach or thrown up after using marijuana. .41 11.11
24. I have woken up in an unexpected place after using marijuana. .88 4.14
32. I have not been able to remember large stretches of time while using marijuana. .95 9.24
37. I have awakened the day after using marijuana and found I could not remember a part of the evening .73 14.38
before.
47. I have had a blackout after using marijuana heavily (i.e. could not remember hours at a time). .78 5.71
Note. Italicized variables are latent constructs. All factor loadings significant at p < .001. Items are administered in numeric order.

NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
Table 2
Means, internal consistency, and correlations of MACQ scales
α M(SD) Range 1 2 3 4 5 6 7 8 9
Simons et al.
1. Soc.-Interper. .88 0.83(1.21) 0–6 -

2. Impaired Con. .89 1.47(1.71) 0–6 .55 -
3. Self-Per. .86 1.03(1.30) 0–5 .54 .54 -
4. Self-Care .90 1.75(2.10) 0–8 .57 .66 .55 -
5. Risk Beh. .93 1.06(1.32) 0–8 .71 .54 .43 .52 -
6. Ac.- Occ. .92 0.46(1.04) 0–5 .54 .48 .41 .60 .61 -
7. Phys. Dep. .90 0.71(1.13) 0–4 .47 .61 .37 .59 .53 .53 -
8. Blackout .84 1.03(1.31) 0–6 .63 .46 .41 .50 .55 .43 .40 -
9. MACQ - Total .98 8.36(8.59) 0–44 .80 .81 .70 .85 .78 .73 .73 .71 -
10. B-MACQ .95 4.02(4.23) 0–19 .68 .78 .61 .87 .70 .71 .77 .63 .95
Note. N = 315. Variables are observed scores. All correlations significant at p < .0001. Alpha was calculated based on the tetrachoric correlations. Soc.-Interper. = Social-Interpersonal Consequences,
Impaired Con. = Impaired Control, Self-Per. = Self-Perception, Risk-Beh. = Risk Behaviors, Ac.-Occ. = Academic-Occupational Consequences, Phys. Dep. = Physical Dependence. B-MACQ = Brief
Marijuana Consequences Questionnaire

Page 18
Table 3
B-MACQ item severity & comparison with alcohol items
B-MACQ Items Item Severity SE Infit Outfit Alcohol Severity*

Simons et al.
2. I have driven a car when I was high. −3.27 0.16 1.25 1.67 −0.55
3. I have felt in a fog, sluggish, tired, or dazed the morning after using marijuana.d5 −1.83 0.15 1.39 1.83 −4.76
20. I have had less energy or felt tired because of my marijuana use. −1.61 0.15 0.90 0.96 −0.30
9. I have been less physically active because of my marijuana use. −1.12 0.16 0.99 0.92 0.31
21. I have lost motivation to do things because of my marijuana use. −0.86 0.16 0.91 0.82 n/a
19. I often have thought about needing to cut down or to stop using marijuana. −0.72 0.17 0.98 0.99 0.46
6. I have spent too much time using marijuana. −0.54 0.17 0.86 0.70 −0.09
15. I haven’t been as sharp mentally because of my marijuana use. −0.39 0.17 1.00 0.96 0.59
7. I have felt like I needed a hit of marijuana after I’d gotten up (that is, before breakfast). 0.07 0.19 0.95 0.92 1.58
17. I have tried to quit using marijuana because I thought I was using too much. 0.10 0.19 0.93 0.80 1.19
10. I have had trouble sleeping after stopping or cutting down on marijuana use.d22 0.27 0.19 0.92 0.83 1.83
13. I have awakened the day after using marijuana and found I could not remember a part of the evening before. 0.28 0.19 1.19 1.03 −2.42
18. I have felt anxious, irritable, lost my appetite or had stomach pains after stopping or cutting down on marijuana use.d45 0.52 0.20 0.86 0.55 1.83
11. I have neglected obligations to family, work, or school because of my marijuana use. 0.52 0.20 0.94 0.67 0.28
12. When using marijuana I have done impulsive things that I regretted later. 0.59 0.21 0.96 1.27 −1.48
4. I have been unhappy because of my marijuana use. 0.70 0.21 1.03 0.71 0.61
16. I have received a lower grade on an exam or paper than I ordinarily would have because of marijuana use. 0.89 0.22 0.85 0.64 0.30
1. The quality of my work or schoolwork has suffered because of my marijuana use. 0.99 0.23 0.94 0.78 −0.16
14. I have been overweight because of my marijuana use. 1.23 0.24 1.14 0.73 1.29

8. I have become very rude, obnoxious, or insulting after using marijuana. 1.62 0.27 0.96 0.96 −1.05
5. I have gotten into physical fights because of my marijuana use. 2.56 0.36 0.99 1.26 0.53
Note.
*
Alcohol severity refers to the severity of the comparable item from the YAACQ computed by Rasch analysis on this group of items. The YAACQ was only given in one site (N = 206) and thus the sample
for the B-MACQ items and YAACQ items differ. However, the severity estimates for the B-MACQ were consistent across site. Except where noted, the items are identical aside from alcohol or marijuana
being the referent drug. dItems marked with a superscript were changed to better reflect specific marijuana consequences, and hence are not strictly comparable.
d5 YAACQ- I have had a hangover (headache, sick stomach) the morning after drinking.
D22 YAACQ- I have had “the shakes” after stopping or cutting down on drinking.
Page 19
d45 YAACQ- I have felt anxious, agitated, or restless after stopping or cutting down on drinking. n/a – New item added to the MACQ, no equivalent on the YAACQ Simons et al.

Page 20
Table 4
B-MACQ raw score totals
Total Score Severity SE Frequency % of Sample Cumulative Frequency

Simons et al.
0 −5.14 1.89 64 20.3 64

1 −3.77 1.11 54 17.1 118
2 −2.87 .83 35 11.1 153
3 −2.29 .71 28 8.9 181
4 −1.84 .63 27 8.6 208
5 −1.47 .59 22 7.0 230
6 −1.14 .55 16 5.1 246
7 −.85 .53 9 2.9 255
8 −.58 .51 6 1.9 261
9 −.32 .50 14 4.4 275
10 −.07 .50 8 2.5 283
11 .17 .49 6 1.9 289
12 .42 .50 6 1.9 295
13 .67 .50 6 1.9 301
14 .93 .52 3 1.0 304
15 1.20 .53 5 1.6 309
16 1.50 .56 1 0.3 310
17 1.84 .61 3 1.0 313
18 2.25 .67 1 0.3 314

19 2.77 .79 1 0.3 315
20 3.59 1.06 0 0 315
21 4.89 1.86 0 0 315
Page 21
Table 5
Correlations between the MACQ scales and marijuana and alcohol use and problems
Scale MJ use frequency MJ use intensity MPI DDQ YAACQ

Simons et al.
B-MACQ .41 .39 .59 .14 .30

MACQ - Total .31 .30 .58 .18 .39
MACQ - Subscales
Soc.-Interpersonal .17 .17 .51 .12ns .31
Impaired Control .31 .24 .51 .17 .29
Self-Perception −.00ns .05ns .39 −.00ns .29
Self-Care .28 .25 .51 .10ns .30
Risk Behaviors .26 .24 .33 .21 .34
Ac.-Occupational .23 .26 .48 .23 .31
Phys. Dependence .51 .48 .45 .09ns .21
Blackout .12 .18 .34 .18 .32
Note. MJ = marijuana, Soc. = social, Ac. = academic, Phys. = physical, MPI= Marijuana Problem Index, DDQ= Daily Drinking Questionnaire, YAACQ= Young Adult Alcohol Consequences
Questionnaire. N = 315 for correlations with marijuana use frequency and intensity. The MPI (N = 206, M = 5.16, SD = 5.04), DDQ (N = 209, M = 18.51, SD = 15.22), and YAACQ (N = 206, M = 15.21,
SD = 11.97) were only administered at one university. Thus, the correlations with the MPI, DDQ, and YAACQ are based on a subset of the full sample used to calculate correlations with MJ use frequency
and intensity. However, the pattern in respect to convergent and discriminant validity is comparable, thus the correlations from the full sample for marijuana use frequency and intensity are presented. All
correlations significant at p < .05 unless otherwise noted, ns = non-significant.

Page 22
Appendix 1
The Brief Marijuana Consequences Questionnaire - BMACQ
INSTRUCTIONS: The following is a list of things that sometimes happen to people either during, or after they have been using
marijuana. Select either YES or NO to indicate whether that item describes something that has happened to you IN THE PAST 6
MONTHS.
Yes No
1. The quality of my work or schoolwork has suffered because of my marijuana use.
2. I have driven a car when I was high.
3. I have felt in a fog, sluggish, tired, or dazed the morning after using marijuana.
4. I have been unhappy because of my marijuana use.
5. I have gotten into physical fights because of my marijuana use.
6. I have spent too much time using marijuana.

7. I have felt like I needed a hit of marijuana after I’d gotten up.
8. I have become very rude, obnoxious, or insulting after using marijuana.
9. I have been less physically active because of my marijuana use.
10. I have had trouble sleeping after stopping or cutting down on marijuana use.
11. I have neglected obligations to family, work, or school because of my marijuana use.
12. When using marijuana I have done impulsive things that I regretted later.
13. I have awakened the day after using marijuana and found I could not remember a part of the evening
before.
14. I have been overweight because of my marijuana use.
15. I haven’t been as sharp mentally because of my marijuana use.
16. I have received a lower grade on an exam or paper than I ordinarily could have because of marijuana
use.
17. I have tried to quit using marijuana because I thought I was using too much.
18. I have felt anxious, irritable, lost my appetite or had stomach pains after stopping or cutting down on
marijuana use.
19. I often have thought about needing to cut down or to stop using marijuana.
20. I have had less energy or felt tired because of my marijuana use.
21. I have lost motivation to do things because of my marijuana use.


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Addict Behav. 2012 May ; 37(5): 613–621. doi:10.1016/j.addbeh.2012.01.008.

Dimensions and Severity of Marijuana Consequences:

2State University of New York at Buffalo

© 2012 Elsevier Ltd. All rights reserved.

Carroll, 2010; Stephens et al., 2002).

Addict Behav. Author manuscript; available in PMC 2013 May 1.

unique patterns of consequences for each drug.

The Young Adult Alcohol Consequences Questionnaire (YAACQ) is a 48-item

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Marijuana problems—The present study modified the YAACQ to assess marijuana

Alcohol Consumption—Alcohol consumption in the past 6 months was measured with

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Confirmatory Factor Analysis

χ2(28) = 220.03, p < .001.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

severity of problems along a unidimensional continuum. To do this, we utilized Rasch

Examination of these 19 items revealed a lack of measurement at low levels of problems,

to examine differences in indicators of problem severity by substance. Severity estimates are

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Validity and Test-Retest Reliability

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Marijuana and Alcohol Consequences: Relative severity

Differences in the meaning of negative consequences across drugs in respect to severity of

Addict Behav. Author manuscript; available in PMC 2013 May 1.

consequences varies as a function of both pharmacological properties of the drugs as well as

different degrees of use disorder.

Limitations and Future Directions

these consequences stem from their marijuana or alcohol use.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

non-treatment seeking men-who-have-sex-with-men: evidence for a shortened 10-item SIP-AD.

1383–1391. [PubMed: 19837255]

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Items ordered by factor Factor Loading % Endorsed

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Items ordered by factor Factor Loading % Endorsed

6. I have passed out from marijuana use. .53 20.06

Addict Behav. Author manuscript; available in PMC 2013 May 1.

1. Soc.-Interper. .88 0.83(1.21) 0–6 -

Addict Behav. Author manuscript; available in PMC 2013 May 1.

B-MACQ Items Item Severity SE Infit Outfit Alcohol Severity*

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Total Score Severity SE Frequency % of Sample Cumulative Frequency

0 −5.14 1.89 64 20.3 64

Addict Behav. Author manuscript; available in PMC 2013 May 1.

Scale MJ use frequency MJ use intensity MPI DDQ YAACQ

B-MACQ .41 .39 .59 .14 .30

Addict Behav. Author manuscript; available in PMC 2013 May 1.

1. The quality of my work or schoolwork has suffered because of my marijuana use.

2. I have driven a car when I was high.

4. I have been unhappy because of my marijuana use.

5. I have gotten into physical fights because of my marijuana use.

6. I have spent too much time using marijuana.