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Chunk #29 — 4. Discussion

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The relationship between cannabis involvement and suicidal thoughts and behaviors.
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The present study has some limitations. First, as age of onset of CUD symptoms was not queried and age of onset of STBs was limited to SI and attempt, it is not possible to make causal inferences. Second, with self-report data, participants could be unwilling to report or unable to recall cannabis use and CUD symptoms or STB. Third, the most severely affected (i.e., those completing suicide) are not represented. Fourth, an abbreviated version of the CUD assessment was used. When analyses were conducted with the full CUD assessment in sample 2 and the abbreviated assessment in sample 1, results remained largely unchanged (available upon request). Fifth, we utilized a sample of twins for epidemiological analyses. However, it is important to note that twins, after statistical accommodation of the clustered nature of their data (as done in this study), are representative of the general population (Kendler et al., 1995; Pulkkinen et al., 2003). Finally, despite the statistically significant association with suicide ideation as well as SANP, cannabis involvement was not the strongest correlate of STBs. In addition to cannabis involvement,