The Cannabis Research Image Database (CRESIDA): A standardized and validated image set for studying cannabis cue reactivity

BACKGROUND AND AIMS: Cannabis cue reactivity paradigms are instrumental in studying the behavioral and neurocognitive mechanisms of cannabis use and cannabis use disorders; however, image sets used for cannabis cue reactivity paradigms vary between studies, and the lack of reliability and validity assessment hinders the quality of evidence they generate. The main aim of this study was to create a novel, open access, standardized and representative database of cannabis use-related images including control images matched by resolution, luminosity and complexity: The Cannabis Research Image Database (CRESIDA). The secondary aim was to examine whether subjective cannabis cue-induced craving was associated with cannabis use severity and whether this relationship was moderated by image type. As an illustrative example of how our open data can be used and how sample characteristics can shape cue reactivity, we also explored the role of cannabis-tobacco mixing by comparing cannabis cue induced cannabis and tobacco craving between individuals who did and did not mix the substances. DESIGN: An online survey was administered to participants recruited via online platforms, community advertisement and snowballing. SETTING: USA, the Netherlands and Australia. PARTICIPANTS/CASES: 689 participants who consumed cannabis monthly to daily (385 men, 298 women, 6 other) were recruited between January 2022 and May 2024. MEASUREMENTS: Out of 93 cannabis images and 93 matched neutral images, participants each rated 31 image pairs for cannabis craving (the primary outcome), arousal, valence and tobacco craving. Participants were characterized for socio-demographic data, level of cannabis use and related problems and mixing cannabis and tobacco. A subset of 78 images was selected for further analysis based on cannabis craving results. Image ratings were evaluated for internal consistency (α). Furthermore, we examined the association between cannabis cravings and cannabis use characteristics, and explored if cannabis craving ratings were affected by image type (i.e. product, paraphernalia and actions) and by using cannabis alone vs. mixing cannabis and tobacco. FINDINGS: The database showed excellent reliability (α = 0.995-0.965). Cannabis craving, valence and arousal discriminated cannabis and control images. More cannabis use days [unstandardized beta (β) = 0.162, P < 0.001] and cannabis use-related problems (β = 0.268, P < 0.001) were statistically significantly associated with higher image-related cannabis craving. Mixing cannabis with tobacco, compared with using cannabis alone, was associated with the presence of tobacco craving in relation to cannabis images, and with greater cannabis craving in relation to cannabis images (β = -0.457, P < 0.001). CONCLUSIONS: Images in the open access Cannabis Research Image Database (CRESIDA, https://osf.io/dc9nz/) appear to be reliable and valid for the scientific study of cue reactivity internationally, providing a broad range of free to use cannabis and control images.