Real-Time Risk in Emerging Adults: Daily Dynamics of Positive Urgency and Cannabis Use in Bipolar Spectrum Disorders

Emerging adults with Bipolar Spectrum Disorders (BSD) are a vulnerable population facing risks for cannabis use and impulsivity. Cannabis Use Disorder (CUD) affects up to 36% of individuals with BSD, intensifying the severity of mood symptoms, hospitalization rates, and suicide risk. Yet, the mechanisms underlying this high-risk comorbidity remain poorly understood. One promising yet underexamined factor is positive urgency, a cognitively based affective mechanism of impulsivity in response to intense positive emotions. This study applies the Experience Sampling Method (ESM) to examine real-time associations between positive urgency and cannabis use across three groups: individuals with BSD, individuals with BSD+CUD, and controls. Participants will complete clinician-administered diagnostic interviews, validated self-report measures, and multiple brief ESM over 14 days, capturing mood, impulsivity, and substance use. Our aims are to (1) test trait positive urgency as a risk factor for cannabis use severity, (2) look at day-to-day associations between positive urgency and cannabis use, and (3)take an idiographic (person-specific) perspective on emotion–impulsivity associations. Findings will inform scalable interventions targeting impulsivity-driven cannabis use in serious mood disorders.