Positive Outcomes of Cannabis Use Scale (POCUS)

Abstract

The Positive Outcomes of Cannabis Use Scale (POCUS), developed by Parnes, Prince, and Conner in 2025, is a specialized psychometric instrument designed to quantify the perceived positive consequences associated with cannabis consumption. The scale’s development followed established best practices, incorporating both deductive methods (based on existing literature and theory) and inductive methods (gathering responses directly from individuals who use cannabis), as outlined by Boateng et al. (2018). The resulting 19-item POCUS was initially validated using predominantly White adult samples, consisting of college students and community members in the United States. Comprehensive psychometric properties, including Factor Analysis, Reliability, and Validity results, confirmed the scale’s suitability for assessing perceived benefits across four distinct domains.

The POCUS is crucial for understanding motivational factors in substance use, shifting the focus from solely negative outcomes to the reinforcing nature of perceived positive experiences, such as mood and cognitive enhancement.

Keywords

Incremental Validity, Positive Outcomes, Cannabis Use, Cognitive Enhancement, Social Enhancement, Mood Enhancement, Sexual Enhancement, Drug Usage Attitudes, Consequence, Substance Use and Addiction Measures, Outcome Expectancies.

Authors

Parnes, Jamie E., Prince, Mark A., Conner, Bradley T.

Purpose

The primary purpose of the POCUS scale is to systematically measure and examine the spectrum of subjectively reported positive outcomes that individuals attribute to their cannabis consumption. This tool provides a nuanced perspective on substance use by quantifying the perceived benefits that act as strong reinforcing mechanisms for continued use.

By assessing specific domains of positive experience, the scale helps researchers and clinicians identify the functional reasons why individuals continue using cannabis, which is vital for developing targeted prevention and intervention strategies.

Construct

The POCUS measures the perceived positive consequences of cannabis use, which represents a highly specific form of outcome expectancy related to reinforcement derived from substance use. The scale is structured around a higher-order factor of general positive outcomes, which is manifested through four primary sub-constructs:

• Social Enhancement: Focuses on improved social comfort and interaction.

• Mood Enhancement: Relates to decreased stress, reduced worry, and increased contentment.

• Cognitive Enhancement: Involves perceived improvements in focus, energy, task initiation, and problem-solving.

• Sexual Enhancement: Measures perceived positive changes in sexual experience and willingness.

Validity

The initial validation study confirmed the robust psychometric Validity of the POCUS across several criteria:

• Concurrent Validity: POCUS scores significantly predicted past 30-day cannabis use (b = 0.48, SE = 0.05, p < .001, IRR=1.62), providing evidence that the scale accurately correlates with actual consumption behavior at the time of assessment.

• Convergent Validity: Convergent validity was established through strong correlation with related constructs. Positive expectancies significantly predicted POCUS scores (b = 0.48, SE = 0.04, p < .0001; bivariate correlation r = .42). Furthermore, POCUS scores significantly predicted negative consequences (b = 0.23, SE= 0.05, p < .001, IRR= 1.26), demonstrating that perceived positive outcomes are related to both expected benefits and the burden of negative experiences.

• Incremental Validity: In hierarchical regression analyses designed to assess unique predictive power, the POCUS was a positive predictor of typical use frequency (R2 = .37). The inclusion of the POCUS accounted for a significantly greater proportion of explained outcome variance (Chi-squared (1) = 53.59, p < .001), indicating that the scale provides novel information beyond established predictors.

Reliability

The POCUS demonstrated excellent internal consistency, which is a key component of psychometric Reliability. Internal consistency ensures that items within a factor measure the same underlying construct.

• Internal Consistency: All factors exhibited excellent reliability, with McDonald’s Omega values consistently ranging from .85 to .87. These values are well above the commonly accepted threshold for psychological scales, confirming the consistency and dependability of the four subscales.

Factor Analysis

Rigorous Factor Analysis procedures were employed during the scale development and validation process to confirm its internal structure.

• Exploratory Factor Analysis (EFA): After initial item review and removal, the final EFA strongly supported a four-factor solution. The model fit was excellent, characterized by a Chi-squared (116) = 166.02, p < .001, CFI = .98, and SRMR = 0.02. All factor loadings were acceptable, and no significant cross-loadings were present, confirming the distinct nature of the four enhancement domains.

• Confirmatory Factor Analysis (CFA): Further scale modification led to a final CFA using all 19 items. This model also demonstrated excellent fit statistics: Chi-squared (171) = 2,467.87, p < .001, CFI = .97, and RMSEA = .040 (90% CI: .030–.050). Standardized factor loadings ranged from .61 to .86. Additional CFA provided strong support for a higher-order factor structure, suggesting that the four enhancement domains contribute to a single, global construct of positive outcomes.

Instrument

Test Type: Original psychometric measure

Format: The POCUS is a 19-item instrument utilizing a multi-dimensional Likert-type response scales format. For each item, respondents rate their experience across three separate 5-point scales: frequency of the outcome, valence (positivity/negativity) of the outcome, and influence on future use. The administration method specified is electronic.

Language Available: English

Population Group: Human; Male; Female

Age Group: Adulthood (18 yrs & older)

Population Details: The scale was validated in the United States using samples consisting of predominantly White college students and community adults who engage in cannabis use.

Test Methodology: Test Validity; Concurrent Validity; Convergent Validity; Test Reliability; Internal Consistency; Factor Analysis; Confirmatory Factor Analysis; Exploratory Factor Analysis

Keywords

Psychometrics, Outcome Expectancies, Substance Use Measurement, Social Enhancement, Mood Regulation, Cognitive Function, Sexual Function, Likert-type response scales, Scale Development, Internal Consistency.

Authors

Author ORCID Identifier: Bradley T. Conner: http://orcid.org/0000-0001-6069-4401

Affiliation Email addresses: Jamie E. Parnes: [email protected]

Correspondence Address: Parnes, Jamie E.: Brown University, School of Public Health, Department of Behavioral and Social Sciences, Center for Alcohol & Addiction Studies, 121 South Main Street, Providence, Rhode Island, United States, 02912, [email protected]

Permissions & Fee and Test Year

The scale is available for non-commercial academic use. There are no associated fees for research or teaching purposes.

• Permissions: May use for Research/Teaching

• Fee: No

• Test Year: 2025

• Commercial: No

Reference’s

• Parnes, Jamie E.; Prince, Mark A.; Conner, Bradley T. (2025).

• Boateng et al., 2018

Items of the Positive Outcomes of Cannabis Use Scale (POCUS)

Instructions:
Think about the outcomes you have experienced when using cannabis in the past month. When responding to each item below, please rate:

1. How often the outcome has actually occurred for you after using cannabis in the past month.

2. How positive or negative the outcome typically was for you.

3. How likely it is that the outcome will influence your future cannabis use.

Please respond to each statement based on your experiences after using cannabis.

Items:

After using cannabis…

1. It felt easier than normal to be open with others.

2. I had more energy to stay active.

3. It was easier to ignore things that were already bothering me.

4. A sexual experience felt more enjoyable than when I am sober.

5. I felt calmer than before getting high.

6. It was easier for me to make conversation when I usually would have talked less.

7. It was easier to begin tasks that usually are hard for me to start.

8. It was easier to distract myself from stressful thoughts.

9. I was more willing to have a sexual experience.

10. I had fewer worries than before I got high.

11. It was easier to focus on the task at hand.

12. A sexual experience felt more intense.

13. I solved a problem I had been struggling with.

14. I felt more comfortable in social situations than when I am sober.

15. It was easier for me to have a positive outlook.

16. Masturbation felt more enjoyable.

17. Tasks I usually find boring I felt excited to do.

18. I talked to someone new in a situation where I usually would have kept to myself.

19. I felt more content than I normally do.

Response Scales:

• How often:
  1 = Never
  2 = Rarely
  3 = Sometimes
  4 = Often
  5 = Always / Almost Always
  (Note: This frequency scale is the primary scale.)

• Valence:
  1 = Negative
  2 = Slightly Negative
  3 = Neutral
  4 = Slightly Positive
  5 = Positive
  (Note: This is an optional scale.)

• Influence on future use:
  1 = Not at All Influential
  2 = Slightly Influential
  3 = Somewhat Influential
  4 = Influential
  5 = Highly Influential
  (Note: This is an optional scale.)

(Scale instructions should be adjusted to fit the administered scales.)

Scoring:

A total score is calculated by taking the mean of all items (using the primary frequency scale unless otherwise specified).

Subscale scores are calculated by taking the mean of the items listed below for each subscale:

• Social Enhancement: Items 1, 6, 14, 18

• Mood Enhancement: Items 3, 5, 8, 10, 15, 19

• Cognitive Enhancement: Items 2, 7, 11, 13, 17

• Sexual Enhancement: Items 4, 9, 12, 16