The present findings have at least four noteworthy clinical implications that might be examined in future work. First, as DT is a cognitive-affective mechanism related to both PTS symptom severity and coping oriented marijuana use, it could be promising to target DT in the context of treatment for co-occurring PTS and marijuana use problems (e.g., distress tolerance module of dialectical behavior therapy, Linehan, 1993). Increased DT skills might potentially improve such individuals’ ability to cope with posttraumatic stress and related negative mood states without the use of marijuana. Second, it might be fruitful to examine the role of DT in the relations between other aspects of trauma-relevant sequelae (e.g., panic attacks) and coping motives for marijuana use. Third, it may be useful to explore the relation between DT and other processes associated with problematic marijuana use, such as emotion regulation or mindfulness and acceptance (Bonn-Miller, Vujanovic, & Zvolensky, 2008; Shafil, Lavely, & Jaffe, 1974; Twohig, Shoenberger, & Hayes, 2007). Fourth, DT may similarly be associated with other emotionally-salient aspects of problematic marijuana use (e.g., withdrawal symptoms, duration of ability to maintain abstinence, probability of relapse), beyond those observed in the present study.
