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Katz-Saltzman, ShiriCAREGIVING AMONG FAMILIES OF WOMEN WITH SUBSTANCE USE OR DUAL DISORDERS: PREDICTORS OF CAREGIVER INVOLVEMENT AND THE ROLE OF CAREGIVER – CARE-RECIPIENT QUALITY OF RELATIONSHIP
Doctor of Philosophy, Case Western Reserve University, 2008, Social Welfare
The objective of this study is to enhance understanding of the caregiving stress process among families of women with substance use or co-occurring substance and mental disorders (anxiety, PTSD, depression, or dysthymia). Two central aims direct the study’s inquiry. First, based on the caregiving stress model, the study aims to examine the relationship of primary caregiving stressors and caregivers’ well-being on family caregivers’ involvement with women with substance or dual disorders. Second, this study aims to evaluate the moderating role of the quality of caregiver-care recipient relationship in the caregiving stress process. This study addresses significant gaps in the literature. Few studies have focused on co-morbidity between substance use disorders and mental disorders among women, and very few studies focused on the role of families of persons with dual disorders. Furthermore, little attention has been paid in the caregiving literature to the possible role of the caregiver-care recipient relationship quality on the caregiving process and its outcomes. This study is a secondary data analysis, utilizing data collected by through a NIDA funded grant. This study utilized a non-experimental cross-sectional survey design. The subjects of the current study are 82 family members (caregivers) of women clients in a residential or outpatient substance abuse treatment program. Results indicated that while subjective burden (i.e., well-being) had a direct effect on involvement (i.e., supervision); neither subjective burden or depressive symptomatology mediated the relationship between caregivers’ primary stressors and caregivers’ involvement with the client. However, subjective burden had a complete mediation effect on the relationship between caregivers’ objective burden and supervision. No moderation effects were found for negative quality of relationship between the three domains of the caregiving process: caregivers’ stressors, caregivers’ well being, and caregivers’ involvement with the client. However, positive quality of relationship buffered the negative effect of care-recipients’ behavioral problems and care-recipients’ emotional and substance use problems (i.e., stressors) on frequency of contact. Furthermore, positive quality of relationship moderated the effect of caregivers’ depressive symptomatology (i.e., well-being) on caregivers’ supervision (i.e., involvement). The study’s implications for practice, service delivery and future research are discussed.

Committee:

DAVID BIEGEL (Advisor)

Keywords:

CAREGIVER; DUAL DISORDERS; WOMEN; RELATIONSHIP QUALITY; SUBSTANCE USE; MENTAL HEALTH

Stevenson, Lauren DeMarcoThe Influence of Treatment Motivation, Treatment Status and Social Networks on Perceived Social Support of Women with Substance Use or Co-Occurring Disorders
Doctor of Philosophy, Case Western Reserve University, 2009, Social Welfare

This study examined predictors of perceived social support and support forrecovery of women with substance use disorders or co-occurring substance use and mental disorders. The sample consisted of 136 adult women; 86 women were engaged in inpatient and outpatient substance abuse treatment programs, and 50 women were recruited from a study of mothers with cocaine exposed infants.

The women in the study were predominantly African American (82.4%) and of low income status with 80% of the women reporting an annual family income below $15,000. All of the women had a current substance use disorder and 77 (56.6%) of the women also had a co-occurring mental disorder including: Major Depression, Post Traumatic Stress Disorder, Mania, Generalized Anxiety Disorder, Hypomania, and Dysthymia. On average, women reported having a social network comprised of 10.73 members.

A significant relationship was found between critical members (those who provide negative support) within women’s social networks and perceived social support, with a higher percent of critical network members predicting lower perceived social support. Perceived social support scores were also significantly lower for women with a co-occurring mental disorder. Indirect relationships were found for women’s perceived social support. The percent of professionals within women’s social networks moderated the relationships between women’s treatment motivation and treatment status with perceived social support. The percent of substance users in women’s networks moderated the relationship between treatment motivation and perceived social support.

A sub sample analysis of 86 women in substance abuse treatment explored predictors of support for recovery. A significant relationship was found between the percent of members who support sobriety and support for recovery. This finding provides construct validity for the support for recovery measure.

Practice implications as well as directions for future research are included in this study. Findings suggest that clinicians should work with social network members and clients on improving communication and eliminating critical support to improve social support. Future research should focus on the impact of social relationships on treatment outcomes.

Committee:

Elizabeth Tracy, PhD (Committee Chair); David Biegel, PhD (Committee Member); Kathryn Adams, PhD (Committee Member); Sonia Minnes, PhD (Committee Member)

Subjects:

Social Research; Social Work

Keywords:

Social Support Networks; Social Support; Substance Use Disorders; Dual Disorders; Co-Occurring Disorders; Treatment Motivation; Social Networks; Substance Abuse; Women