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Blevins, Wendy M.Factors Related to the Outcomes of a Residential Substance Abuse Treatment Program for Women
Doctor of Philosophy (PhD), Ohio University, 2008, Counselor Education (Education)
This study investigated certain demographic and treatment variables. The sample used included 125 successful completers of a residential substance abuse program with an average length of stay of 60 days. The program is located in Athens County, OH and serves adult women and allows them the opportunity to participate in treatment with their children. The research question asked in this study was: Is there a relationship between or among residential substance abuse treatment outcomes and selected demographic and treatment variables (i.e., housing status, education level, income level, single substance abuse diagnosis versus dual diagnosis, parent/child/pregnant participation/residence in treatment and employment status at the time of residential substance abuse treatment admission)? The results of this study indicated that pretreatment employment status was the only significant variable of those included in this study that is significant to treatment outcomes.

Committee:

Jerry Olsheski, Dr. (Committee Chair); Gordon Brooks, Dr. (Committee Member); Tracy Leinbaugh, Dr. (Committee Member); Mona Robinson, Dr. (Committee Member)

Subjects:

Mental Health

Keywords:

Women's Residential Substance Abuse Treatment; substance abuse; substance abuse treatment variables

Hunt, Susan C.The Prevalence of Delinquency in Depressed and Substance Abusing Adolescent Girls
Psy. D., Antioch University, 2008, Antioch Seattle: Clinical Psychology
Research conducted on the role of depression in delinquency among adolescent girls has found that depression can predict delinquency. It has been indicated that research should be conducted on how substance use and abuse play a role in depression and delinquency. Several studies have been conducted on adolescent girls in juvenile delinquent centres and institutions. Few studies have sampled subjects from community-based resources, i.e., street youth clinics, youth programs, or alternative schools. The central goal of the study was to explore delinquency in a group of depressed and substance-abusing adolescent girls in community-based settings including street clinics, youth programs, and alternative schools. Specific questions focused on examining the relationship among depression, delinquency, and substance use for adolescent girls, and the prevalence of 12 risk factors (i.e., thought problems, ADHD, rule behaviours, anxiety, aggression, attitude problems, externalized behaviours, self-esteem, social problems, and somatic complaints). Using a cross-sectional research design, the relationship among depression, substance use, and delinquency, as well as risk factors were examined for adolescent girls from community-based agencies and alternative schools. The participants included 100 adolescent girls, aged 13 to 18 years (mean age = 16.5 years). The data collection instruments that were used included the Children's Depression Inventory (CDI) (Kovacs, 1992), the Achenbach Youth Self-Report (YSR) for Ages 11-18 (ASEBA) (Achenbach, 2001), Adaptation of the Self-Reported Delinquency and Drug-Use Items as Employed in the National Youth Survey (Elliott & Ageton, 1980), and an Adolescent Self-Report Questionnaire. The study found that adolescent girls utilizing community-based street clinics and alternative schools are diverse, varying in age, culture, sexual orientation, background, and living arrangement. Substance use and delinquency were found to have a strong, significant, positive relationship. Depression played a smaller role in the prevalence of delinquency with this sample. In addition, various risk factors were found to be related to substance abuse (as a predictor for delinquency), including rule behavior, self-esteem, somatic complaints, and externalized problems. The strong relationships among substance abuse, delinquency, and risk factors have implications for prevention and treatment programs, supporting the inclusion of evidenced-based drug and alcohol programs that focus on positive coping strategies for problem solving and emotional regulation for at-risk adolescent girls.

Committee:

Molly Reid, Ph. D. (Committee Chair); Patricia Linn, Ph.D. (Committee Member); Patricia O'Hagan, Ph.D. (Committee Member)

Subjects:

Behaviorial Sciences; Mental Health; Psychology

Keywords:

adolescent delinquency; adolescent depression; youth depression; youth substance abuse; teen; depression; substance abuse

Smith, Donna CarrollSubstance use attitudes and behaviors of students with learning disabilities
Doctor of Philosophy, The Ohio State University, 2004, Physical Activity and Educational Services
The focus of this study was to report and analyze the responses of students, grades 6 - 12, who had Specific Learning Disabilities (SLD) and attended schools in 17 public school districts and 12 parochial and private schools in and surrounding a major Midwestern city. The data were collected through the Primary Prevention, Attitude and Use Survey (PPAAUS, 2000) that was administered every 3 years to all students in Grades 6 - 12 in these schools. A random sample of 470 students with SLD, selected from a database of approximately 3,760 students, reported that they participate in classes for students with SLD. The independent variables established were Gender (Male and Female) and Grade Level (Middle School and High School), and the dependent variables were the responses to the items of Feelings; Perceptions of School Climate; Willingness to Use Alcohol, Tobacco, and Other Drugs; Frequency of Use; Age of First Use; and Location of Use. The results of the Feelings items indicated that Middle School students reported feeling more stressed and anxious about their school work than did High School students. Males reported being more sad and depressed, more angry, and more nervous and anxious than did females. Males also reported that they felt worse about their schoolwork. Middle School students with SLD had more positive perceptions of school climate than did High School students, and there was no difference between males and females and their reported perceptions of school climate. There was no difference between males and females and their reported use of alcohol, tobacco, and other drugs. High School students reported more actively using alcohol, tobacco, and other drugs than did Middle School students. No differences were found by Gender or Grade Level for locations of substance use. An examination of the age of first substance use indicated that students with SLD who used generally began using substances between the ages of 12 to 15 years. Recommendations for program development and future research were generated.

Committee:

Michael Klein (Advisor)

Keywords:

Adolecents; drugs; alcohol; tobacco; marijuana; high school students substance abuse; middle school students substance abuse; high school drug use; middle school drug use

Hammers, Dustin B.Cognitive Modeling Analysis of Performance on the Iowa Gambling Task in Undergraduates Reporting Substance Use
Master of Science (MS), Ohio University, 2005, Psychology (Arts and Sciences)

Substance abusers display decision-making and executive functioning impairments, as measured by the Iowa Gambling Task (IGT) and Wisconsin Card Sorting Test (WCST), respectively. Reward-driven personality appears to be related to these constructs, and has also been shown to be higher in substance abusers. The current study examines decision making, executive functioning, and reward-driven personality characteristics of undergraduate substance users and controls. Decision-making performance (IGT) is separated into cognitive, motivational, and consistency processes. The present study finds that substance users perform significantly worse on IGT relative to controls, although no differences in the underlying cognitive or motivation processes exist. Substance users also perform significantly worse on WCST and display a more reward-driven personality. Thus, impaired decision-making and executive functioning and reward-driven personality are evident even in non-clinical substance users, suggesting these findings might be premorbid characteristics of substance users, not reflective of brain damage consequent to years of substance abuse.

Committee:

Julie Suhr (Advisor)

Subjects:

Psychology, Behavioral

Keywords:

Decision Making; Substance Abuse; Executive Functioning; Gambling Task; Personality

Paugh, Charles R.Vocational Rehabilitation for Persons with Dual Diagnoses: Specific Service Patterns that Enhance Earnings at the Time of Case Closure
Doctor of Philosophy, The Ohio State University, 2003, Physical Activity and Educational Services
In spite of the growing interest in vocational rehabilitation (VR) services for those with psychiatric disabilities, there still remains a large group of individuals, those with a dual diagnosis (D2) of a psychiatric disability and comorbid substance abuse problem, whose needs are not being met within the VR community. VR professionals are not prepared to treat the special needs of this group. Consequently, unemployment figures are likely to be even higher for those diagnosed with a D2. D2 is a large problem that appears to be growing, as approximately 6 out of every 100 persons in the United States are believed to suffer with comorbid issues. As a result of inequities in treatment, individuals with a dual diagnosis are unable to maintain employment and continue to drain economic resources This study asserts that the large and growing population of persons with dual diagnoses will greatly benefit from increased awareness by the VR community. This is the first study of its kind to examine which of the existing 13 rehabilitation services best provide the opportunity for positive VR outcomes (i.e., increase in earnings) in the treatment of persons with dual diagnoses. In addition, this study examines whether change in income at the time of case closure of a VR case reflects a significant relationship between specific classifications of someone's dual diagnosis and the services that person has received. Similarly, the relationship between race and services provided is evaluated based on change in income. Five of the possible 13 VR services listed in the 1998 RSA-911 database were identified as significant predictors of enhance income at the time of case closure. They were College Training, Business Training, Job Finding, Counseling, and Transportation services. While a few isolated instances indicated that race or diagnosis classifications with services provided predict increased income, overall, their effects in this study were minimal. Our understanding of how to better meet the employment objectives of persons with a D2 can reduce the drain on public resources, as well as to enable individuals with a D2 to enjoy happy and productive lives.

Committee:

Bruce Growick (Advisor)

Subjects:

Education, Vocational

Keywords:

Vocational Rehabilitation; Mental Illness; Substance Abuse; Education

Dodd, Dan D.Is There a Relationship Between Alcohol/Drug Counselor's Strength of Belief in the Disease Concept of Addiction and Burnout?
Psy. D., Antioch University, 2015, Antioch Seattle: Clinical Psychology
This study examined the association between substance abuse counselors’ (a) level of burnout and strength of belief in the disease concept of addiction, (b) level of burnout and recovery status, and (c) recovery status and strength of belief in the disease concept. Participants were recruited via a purposive convenience survey sampling method of counselors who were certified Chemical Dependency Professionals (CDPs) or Chemical Dependency Professional Trainees (CDPTs) who were employed in substance use disorder outpatient treatment facilities. A total of 130 surveys were distributed of which 72 were returned giving a 55% response rate. Six surveys were removed due to not providing evidence of informed consent or high frequency of missed answers. Of the remaining 66 participants, 45 were female, 20 were male, and one declined to report gender status. The largest age cohort was 41 years of age and over. Participants completed a demographic questionnaire, the Maslach Burnout Inventory—HSS (Maslach, Jackson, & Leiter, 1966), and the Addiction Belief Scale (Schaler, 1995). Analysis of data included Spearman rank order correlation, Chi-square Test for Independence, and Fisher’s Exact Test. Results indicated that as strength in the belief in the disease concept increased, level of emotional exhaustion/burnout decreased. There was no association for the burnout subscales of depersonalization and personal accomplishment. In addition, there was no significant association between (a) level of burnout and recovery status, or (b) recovery status and strength of belief in the disease concept. Future research should determine if results of this study can be replicated and shift its focus from why professionals are leaving the addiction field to why individuals remain working in the field. The electronic version of this dissertation is at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu

Committee:

Alejandra Suarez, Ph.D. (Committee Chair); William Heusler, Psy.D. (Committee Member); Christopher Dunn, Ph.D. (Committee Member)

Subjects:

Clinical Psychology; Psychology

Keywords:

Substance Abuse Counselors; Burnout; Disease Concept; Recovery Status; addiction

Capece, Alexandra EParental Influences on Hispanic Adolescent Heroin Use
MS, University of Cincinnati, 2013, Education, Criminal Justice, and Human Services: Health Education
The purpose of this study was to examine the impact of parental factors on annual (past year) heroin use in Hispanic youth within the Greater Cincinnati area. The following research questions were examined for this study: 1) Do family structure, parental education, and parental job status impact Hispanic adolescents' annual heroin use? 2) Does the impact of these variables on Hispanic adolescents' annual heroin use differ based on sex and grade? Participants were Hispanic students in 7th through 12th grade (N = 946) in public and private schools within the Greater Cincinnati area. Logistic regression analyses revealed that annual heroin use differed based on family structure, parent education, and parent job status. Specifically, annual heroin use was significantly higher among students who did not live with their biological parents, students whose father had a high school diploma/GED or less, and students whose father was unemployed. Health professionals should consider these findings when developing drug prevention programs targeted toward Hispanic youth.

Committee:

Keith King, Ph.D. (Committee Chair); Rebecca Vidourek, Ph.D. (Committee Member)

Subjects:

Health Education

Keywords:

adolescent;Hispanic;heroin use;substance abuse

Phillips, Kristina T.Applying the Relapse Model to Harm Reduction: The Development and Evaluation of the Harm Reduction Self-Efficacy Questionnaire
Doctor of Philosophy (Ph.D.), Bowling Green State University, 2005, Psychology/Clinical
My study was designed to develop and evaluate a measure to assess harm reduction self- efficacy in intravenous (IV) opiate users. Using Marlatt and Gordon’s (1985) Cognitive Behavioral Model of Relapse, I developed the Harm Reduction Self-Efficacy Questionnaire (HRSEQ) to examine drug users’ perceived confidence in their ability to utilize specific harm reduction strategies in select high-risk situations. The study consisted of two major phases: 1) instrument development using focus groups of drug-takers and expert feedback and 2) experimental study of the influence of type of high-risk situation on self-efficacy to use harm reduction coping skills using a different sample of active or recently active drug users. In addition, I examined the reliability and construct/discriminant validity of the HRSEQ measure. After the HRSEQ was designed, I administered it along with other drug use measures, to 101 IV opiate users. Results indicated that harm reduction self-efficacy varied as predicted depending on type of high-risk situation. The HRSEQ demonstrated high internal consistency and was reliable across a one-week time period. The three HRSEQ scales were significantly associated (at a moderate to strong level) with the Harm Reduction Use Measure (HRUM), a scale that assessed use of harm reduction coping behaviors, thus providing support for construct validity. In addition, weak correlations and lack of associations between the HRSEQ scales and measures examining health self-efficacy, exercise self-efficacy, and self-efficacy to resist heavy drug use provided support for the discriminant validity of the HRSEQ. After further development, the HRSEQ could be a useful tool to gain a better understanding of clients’ confidence to utilize harm reduction interventions that will improve their health and well-being.

Committee:

Harold Rosenberg (Advisor)

Keywords:

harm reduction; addictions; substance abuse; self-efficacy; IVDU; relapse prevention

Steffener, Justin A.The Phenomenology of Court-Ordered Treatment: From the Perspective of Methamphetamine Dependent Adults
Psy. D., Antioch University, 2012, Antioch Seattle: Clinical Psychology
This phenomenological study was designed to explore with a sample of methamphetamine dependent adults their perceptions of the process involved in their experiences of court-ordered treatment. The motivation for this study derives from the researcher's wish to unearth ways to better understand and support the needs of adults suffering from addiction. A significant amount of research has already been conducted in regards to the treatment of methamphetamine addiction from the standpoint of quantitative measurements of treatment outcomes, but limited information is presently available from the perspective of the suffers. The stringent selection of the sample was composed of six individuals with prior histories of being court-ordered to drug treatment for methamphetamine use. The participants were drawn from Narcotics and Alcohol Anonymous groups in the Snohomish and King County regions of Washington State. The collection of data was primarily through the means of structured interviews that offered space for the individuals' perspectives to emerge. A brief survey was utilized as a supportive method to collect demographic information of the participants. This study gathered the statements of the participants and focused on the emergent themes that were collectively expressed among the participants' experiences. This research revealed the positive and negative impressions felt towards the court system and treatment processes. The findings showed that the court system experience was an incentive to enter and remain in treatment and was considered a positive once the participants accepted the obligations of the court system. The negative perceptions of the court system were due to issues related to practical concerns and perceptions of the court system as intimidating and punitive. Positive aspects of the treatment were experienced as learning skills to make positive life changes, acquiring new perceptions, learning from others and gaining a sense of community, and having positive life experiences. Negative aspects of treatment were experienced as challenges working with others (staff, counselors, and patients), lack of useful treatment interventions, and insufficient structure. Considering the various factors affect not only the treatment of individuals suffering from addiction, the recommendations address the specific needs reported by the individuals in the present study. The electronic version of this dissertation is at OhioLink ETD Center,www.ohiolink.edu.

Committee:

Mary Wieneke, Ph.D. (Committee Chair); Ned Farley, Ph.D. (Committee Member); Ruby Takushi, Ph.D. (Committee Member)

Subjects:

Clinical Psychology; Psychology

Keywords:

phenomenology; court ordered treatment; substance abuse; lived experience; crystal meth; methamphetamine; addictions

Song, Li-YuPsychopathology and substance abuse among adolescents with psychiatric disorders
Doctor of Philosophy, Case Western Reserve University, 1993, Social Welfare
The present study examined the association between psychopathology and substance abuse using the Youth Self-Report scale. To ensure the psychometric properties of the YSR scale, its factor structure derived by Achenbach was evaluated. The data obtained from a three year follow-up study of adolescents hospitalized for psychiatric treatment was used to test the hypotheses set forth in the study. The data was collected using a nonexperimental research design at three points in time. In the study, time 1 data was utilized for generating the initial findings, and time 2 for cross validation. Time 3 data was not used because the sample size was too small. The study confirmed part of Achenbach's findings in that four first order factors remained unidimensional; they are Somatic Complaints, Anxious/Depressed, Thought Problems, and Attention Problems. However, subdimensions were further derived for Social Problems, Delinquent Behaviors, and Aggressive Behaviors. Additionally, Social Problems, Thought Problems, and Attention Problems were found cross loaded on both Internalizing and Externalizing scales. The results of the tests for the structural models revealed that the measures of psychopathology explained significant amount of variance in substance abuse for the total sample and for the girls (29% and 36%, respectively), whereas explained variance was only 10% for the boys. Externalizing had significant effect on substance abuse; among the first order factors, Delinquent Behaviors, Aggressive Behaviors, Attention Problem were the three predominant predictors of substance abuseThe results of discriminant function analyses demonstrated the usefulness of the YSR in classifying substance abusers among adolescents with psychiatric disorders. For the girls, it enhanced the classification accuracy 34 percent greater than that achieved by chance; whereas, for the boys, for boys, 26 percent greater than chance. The study found that the gender differences were not on the types of psychopathology associated with substance abuse, but the extent of the differences between substance abusers and nonsubstance abusers. The differences were larger among the girls. Finally, the initial findings based on time 1 remained stable on time 2 for both the measurement model of the YSR and the structural model

Committee:

Mark Singer (Advisor)

Subjects:

Social Work

Keywords:

Psychopathology and substance abuse; Adolescents, psychiatric disorders

Beechey Riley, Tegan AnnePharmacist Utilization of Opioid Misuse and Abuse Interventions: Acceptability Among Pharmacists and Patients in Detox
PHD, Kent State University, 2017, College of Public Health
This study evaluates the acceptability of pharmacy based opioid misuse and abuse interventions by surveying practicing pharmacists and patients in treatment for substance use disorders. The survey instrument examines five specific pharmacy-based interventions using a Likert scale to measure acceptability: (1) Pharmacists counseling patients on the risks associated with opioid misuse and abuse, (2) pharmacists referring patients to drug treatment programs within the community, (3) pharmacists utilizing Prescription Drug Monitoring Programs (PDMPs) to validate prescriptions, (4) pharmacists providing emergency opioid overdose treatments such as naloxone with opioid prescriptions, and (5) pharmacists providing naloxone without a prescription. The goal of this study is to answer three research questions: which interventions are most acceptable to pharmacists, which interventions are most acceptable to patients, and which interventions produce statistically significant agreement on acceptability when both pharmacist and patient attitudes are compared. These data are used to identify a subset of interventions with high acceptability within and across the two groups. These findings are, in turn, used as an indication of professional and patient receptivity to specific interventions. The interventions with the greatest acceptability within each group and the strongest agreement across groups are identified, and changes to State regulations, organizational policy, and professional training that foster these interventions, as supported by the literature, are proposed.

Committee:

Sonia Alemagno, PhD (Committee Chair); VanGeest Jonathan, PhD (Committee Member); Phillips Lynette, PhD (Committee Member); Deric Kenne, PhD (Committee Member); Mark James, PhD (Other)

Subjects:

Pharmacy Sciences; Public Health Education; Public Policy

Keywords:

opioid; opiate; substance misuse; substance use disorder; substance abuse; pharmacist; patient; PDMP; PMP; patient counseling; treatment referral; OTC naloxone; dispensing naloxone; pharmacy-based interventions; misuse; addiction; overdose; prevention

Magrath, Steven MattMedication Assisted Treatment and the Three Legged Stool: Medical Providers, Chemical Dependency Professionals, and Clients
Ph.D., Antioch University, 2016, Leadership and Change
Opioid dependence has reached epidemic levels in the United States and around the world. With the increased prescribing of opioid pharmaceuticals and the influx of inexpensive heroin, the health care cost to society has topped $72.5 billion annually (Murphy et al., 2016). Opioid overdose deaths have now surpassed motor vehicle deaths and have tripled since 1990. In some age groups opioid overdose is the leading cause of death. This study seeks to analyze the only field that directly treats this primary brain disease: medication assisted treatment for opioid dependence. The three primary participants in this partnership include: (a) doctors and allied medical providers; (b) substance abuse counselors known in Washington State as Chemical Dependency Professionals (CDPs); and (c) clients affected by opioid dependence. Together they combine medical approaches and psychosocial counseling with clients to attain the goal of recovery. Attitudes and beliefs of these three groups of individuals vary, as do their views toward the medications currently being utilized in the treatment field. This study measures these differences and discusses the implications for clients, medical providers, and CDPs. It was hypothesized that differences in opinions across the three groups about medication assisted treatment, length of time clients should be on medications, and recovery limit positive outcomes. Data were collected via survey from more than 250 clients being treated for opioid dependency and from over 200 professionals (medical and counseling). Descriptive and comparative ANOVA and t-test statistics were used in the analysis. Results indicate that there remain large differences in beliefs and attitudes among the medical providers, CDPs, and clients on key issues related to medication assisted treatment. The gap appears to be especially evident when comparing the two professional groups who treat clients with opioid use disorder. CDPs and medical providers are working from a different set of paradigms and approaches especially as related to their beliefs about the use of medications. CDPs are generally less supportive of medication assisted treatment. Medical providers and CDPs disagree about the length of time clients should be on medications and the long term goals of opioid dependence treatments. In addition clients in opioid treatment programs that use methadone have significantly different views on many issues from those who use buprenorphine/naloxone (Suboxone®). Findings from this study can be used to improve the services provided to clients to increase provider awareness of the ways that attitudes and perceptions impact treatment outcomes. The electronic version of this dissertation is at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu

Committee:

Carol Baron, PhD (Committee Chair); Jon Wergin, PhD (Committee Member); Stacy Rasmus, PhD (Committee Member); Adam Kartman, MD (Committee Member); Monica Skewes, PhD (Other)

Subjects:

Counseling Psychology; Medicine; Pharmaceuticals

Keywords:

drug abuse; opioid; heroin; substance abuse; treatment; counseling; Chemical Dependency Professionals; clients; doctors; providers; attitudes; Suboxone; buprenophine; naloxone; methadone; recovery

Waterfield, Elizabeth AnnSocial Resiliency Factors and Abstinence from Substance Abuse in Lucas County, Ohio Adolescents
Doctor of Philosophy, University of Toledo, 2010, Counselor Education

Adolescent alcohol and other drug (AOD) use is a serious problem in the United States which often results in grave consequences to individuals and society. Research into adolescent AOD use has traditionally focused on identifying risk factors that may aid in identifying youth in need of intervention and/or treatment for AOD problems. The resiliency perspective has developed as an alternative to the risk-factor orientation to research and intervention in adolescent AOD use. Researchers using the resiliency approach aim to provide insight into why many adolescents, despite exposure to multiple risk-factors, do not use substances. Examples of social resiliency factors proposed to be protective of adolescent AOD include volunteering, sports, religious, arts, and civic activities. Advantages of the resiliency approach have included simultaneous consideration of both risk and protective factors, examination of how multiple systems interact to affect young people, and efficacy in proactively preventing AOD use in adolescent versus addressing problems after they have been initiated.

The purpose of this study was to identify social resiliency factors that may predict abstinence from the use of AOD in students attending Lucas County, Ohio, schools in grades 10 through 12 utilizing data from the 2006 Lucas County (Ohio) Alcohol and Drug Addiction Services (ADAS) Board Youth Alcohol & Other Drug Use Survey. The specific resiliency factors examined were participation in sports or athletic activities, arts or civic activities, religious activities, volunteering or community activities, and alcohol or drug prevention clubs. The drugs of abuse examined include tobacco, alcohol, and marijuana. A Chi square analysis was employed to examine if each resiliency activity (independent variables) was predictive of abstinence from the use of tobacco, alcohol, and marijuana use (dependent variables). Results supported previous research indicating that sports and athletic activities may be somewhat protective against use of cigarettes, but not for alcohol, especially in males. Significant results were found for females for arts and civic activities, religious activities, and volunteering and community activities. However, results for males for each of these resiliency factors were negative, with the exception of religious activity and marijuana. Significance for participation in drug and alcohol prevention clubs was not found for any group or substance. Differences in independent variable measurement issues may be factors in the lack of consistency in results. Non-participation in several of the resiliency activities was found to be associated with substance use, especially in females.

Committee:

Nick Piazza, Ph.D (Committee Chair); John Laux, Ph.D (Committee Member); Wendy Cochrane, Ph.D. (Committee Member); Morris Jenkins, Ph.D. (Committee Member)

Subjects:

Mental Health; Psychology

Keywords:

Substance Abuse; Adolescents; Resiliency

Natarajan, AravindhanMotivational Level and Factors Associated with Stages of Change: Mandated Treatment for Substance Abuse under the Criminal Justice System
Doctor of Philosophy, Case Western Reserve University, 2010, Social Welfare

This secondary analysis study examines factors associated with stages of change and motivation among offenders undergoing mandated substance abuse treatment under the criminal justice system. The sample is comprised, almost exclusively, of people of minority ethnic identity with the largest group being of Hispanic origin. The sample of 160 respondents was drawn from the prison system in New York. These respondents were classified as belonging to either pre-action (n=60) or action group (n=100) based on the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). The pre- action group included those who were in precontemplation, contemplation and preparation stages as defined by Prochaska and DiClemente’s Transtheoretical Model, and the action group included those who were in action and maintenance stages. The research examined whether pre-action and action groups differed in terms of internal motivational level (as measured by the motivation subscale of CMR Scale); level of depression (Beck Depression Inventory); consequences of addiction (items from the Addiction Severity Index); and Criminal History (number of convictions, arrests, seriousness of legal problems).

The study found a significant difference between the groups in terms of consequences of addiction variables: pre-action group members had a higher score on clinician’s ratings of respondents’ need for drug treatment and need for legal services; and reported a higher score on their perception of the seriousness of legal problems facing them. Respondents who belonged to pre-action reported a higher number of substances of abuse and were initiated into substance use at a younger age compared to those in the action group.

Discriminant Function Analysis and Logistic Regression were carried out to examine factors that predict stage membership. Consequences of addiction variables gained salience over internal motivation, depression and criminal history in the overall model. Age of initiation, clinician’s ratings of respondents’ need for legal services and need for drug treatment were the variables that best explained stage membership. Implications for developing and improving mandated treatment programs under the criminal justice system are discussed.

Committee:

Kathleen Farkas, PhD (Committee Chair); Judith Lipton, PhD (Committee Member); Mark Singer, PhD (Committee Member); Elizabeth Tracy, PhD (Committee Member)

Subjects:

Social Research; Social Work

Keywords:

Substance Abuse; Mandated Treatment; Criminal Justice System; Stages of Change; Transtheoretical Model; Motivation

Carpenter, TracyRecovering Women: Intersectional Approaches to African American Addiction
Doctor of Philosophy, The Ohio State University, 2009, Comparative Studies
This dissertation uses an interdisciplinary approach to examine the sociopolitical impact and ideological work of stereotypes that stigmatize people with intersecting identities. Focusing on the Crack Mother icon, I first examine how misrepresentations in films, media and literature influence legislation and policies that target poor women of color for punishment. I contextualize the Crack Mother as part of a continuum of cultural icons that represent African American women as deviant. I then incorporate data from ethnographic research among African American Narcotics Anonymous groups to offer an alternative version of African American women’s experience with drug addiction and use of twelve-step recovery approaches. Positing self-representation at the forefront prioritizes perspectives that challenge dominant narratives of addiction. The presentation of African American women as conscientious participants within a folk culture that values determined living turns on its head Western notions of expertise, organization, temporality, illness and so forth. The project is grounded in cultural studies, folklore, and African and African American studies. I incorporate critical race theory when conducting discourse analysis with films and literature from popular culture. I use alignment theory to flesh out participants’ footing in racial, social, gender, religious and other identities using data gathered from ethnographic interviews with 10 African American women members of twelve-step programs with two and more years of continuous abstinence. I also conduct analyses of addiction surveys distributed to 23 African American women, more than 10 taped speeches from Narcotics Anonymous events, and observations at over 500 Narcotics Anonymous meetings in two mid-sized, U.S. cities over five years. Alcoholics Anonymous and Narcotics Anonymous program literature was used to show connections between participants’ narratives and program ideology.

Committee:

Amy Shuman (Advisor); Nina Berman (Committee Member); Maurice Stevens (Committee Member); Valerie Lee (Committee Member)

Subjects:

African Americans; American History; American Studies; Black History; Criminology; Cultural Anthropology; Families and Family Life; Folklore; Gender; Linguistics; Literature; Mass Media; Minority and Ethnic Groups; Personal Relationships; Religion; Rhetoric; Social resea

Keywords:

African American women; addiction; substance abuse; recovery; twelve step programs; Narcotics Anonymous; representation; stereotype; film analysis; intersectionality

BESINGER, BRIDGETT A.MOTHERS IN ADDICTION TREATMENT: THE ROLE OF ONSITE CHILDCARE
PhD, University of Cincinnati, 2004, Arts and Sciences : Psychology
Women’s alcohol and drug use present serious health risks and significant economic consequences. Only a small percentage of the estimated 4 million American women needing addiction treatment receive services. Childcare issues have been identified as one of the most significant barriers to treatment for women. When childcare is provided, treatment access and outcome improve. However, the means by which childcare improves treatment efficacy remain unexamined. The objective of the present study was to examine the role of onsite childcare for chemically dependent mothers receiving residential treatment services. Invoking the Self-in-Relation model, it was hypothesized that including children in treatment enhances recovery by providing an opportunity for mothers to improve their relationships with their children. Fifty-one women entering a residential substance abuse treatment program with at least one child registered in the onsite child development program were enrolled in the study. Women were individually interviewed approximately 3 weeks after program entry. Discharge status and length of treatment stay were abstracted from participant files 90 days post treatment entry. Results were mixed. Women described childcare staff and services as important sources of support during treatment. However, perceived support for the mother-child relationship was not associated with treatment outcomes. The data were suggestive that the Self-in-Relation model may provide a viable framework for conceptualizing the inclusion of children in treatment. Qualitative data highlighted the need to evaluate co-residency issues when children are included in residential treatment settings. Both research and clinical implications are discussed.

Committee:

Dr. Robert Noll (Advisor)

Subjects:

Psychology, Clinical

Keywords:

substance abuse treatment; addicted mothers; children of substance abusers; parenting

Bonar, Erin EEffect of Injecting Drug Users' HIV Status on Treatment Providers' Acceptance of Harm Reduction Interventions
Master of Arts (MA), Bowling Green State University, 2007, Psychology/Clinical
The current study was designed to examine the degree to which injecting drug clients' HIV status influenced substance abuse treatment providers’ acceptance of educational harm reduction interventions and traditional treatment interventions. A nationwide sample consisting of 131 substance abuse treatment agency directors (or staff with similar responsibilities)completed an internet-based procedure in which they were presented with a fictitious vignette describing the educational, occupational, legal, and drug history of an injecting drug user (IDU) who was described as either HIV-positive, HIV-negative, HIV status unknown, or no information was presented on HIV status. I also varied vignette clients’ gender (male or female), age (25-years-old or 35-years-old), and ethnicity (Caucasian or African American). Participants rated the acceptability of five harm reduction interventions (i.e., non-injecting routes of administration, site rotation, reduced use as an outcome goal, muscling, and cleaning needles with bleach) and four traditional treatment interventions (i.e., group therapy, a self-help group, complete abstinence as an outcome goal, and learning about the disease model of addiction) for the fictitious vignette client. Participants’ acceptance ratings of both harm reduction and traditional treatments did not differ as a function of the vignette client’s gender, ethnicity, or age. Acceptance of harm reduction interventions varied as a function of HIV status, with significantly higher acceptance for clients who were HIV-negative compared to those whose HIV status was not known. There was no impact of HIV status on traditional treatment ratings, but traditional treatments were significantly more acceptable than harm reduction treatments combining across all HIV conditions. Future research should address whether education about the value of harm reduction interventions increases acceptance and use of such interventions with drug clients, and other client characteristics and counselor attitudes and values that might influence acceptance of harm reduction interventions.

Committee:

Harold Rosenberg (Advisor)

Subjects:

Psychology, Clinical

Keywords:

harm reduction; substance abuse treatment; HIV; community attitudes toward mental illness

Noe, Sean R.History of Parenting as Predictor of Delinquency, Moral Reasoning and Substance Abuse in Homeless Adolescents
Master of Science, The Ohio State University, 2008, Human Development and Family Science
Fifty-five homeless youth between the ages of 14 and 20 years were studied in examination of the unique relationships between years spent living with each biological parent, self-reported delinquency, and moral reasoning among a homeless youth population. Subjects were administered a set of demographic questions, the National Youth Survey questionnaire, the Form-90 substance abuse interview, and the Socio-Moral Reflection Measure-Short Form. Correlations among variables were examined, and a linear regression model was tested. Delinquency was found to be significantly correlated with age and gender, with females displaying more delinquency than males. A regression model showed that delinquency could be predicted using variables age, gender and moral reasoning. Proportion of years spent living with father had different effects for males and females in the study. Moral reasoning scores for the sample were lower than would be expected from a normative sample, but were as expected from a delinquent sample.

Committee:

Michael Glassman, PhD (Advisor); Natasha Slesnick, PhD (Committee Member)

Subjects:

Behaviorial Sciences; Ecology; Educational Sociology; Families and Family Life; Social Structure; Social Work; Sociology

Keywords:

morality; moral reasoning; delinquency; substance abuse; adolescence; adolescent; homeless; homeless youth; parenting; Youth Self Report; SRM-SF; SRMS; sociomoral; father presence; moral development

Bonar, Erin ElizabethUsing the Health Belief Model to Predict Injecting Drug Users' Use of Harm Reduction
Doctor of Philosophy (Ph.D.), Bowling Green State University, 2011, Psychology/Clinical
Based on the Health Belief Model (Rosenstock, 1966), the current study was designed to examine whether injecting drug users' (IDUs) beliefs about two injecting-related health conditions (i.e., non-fatal overdose and bacterial infections) and two harm reduction behaviors that prevent these conditions (i.e., injecting test shots and pre-injection skin cleaning) predicted their short-term intentions to engage in those two health behaviors. Ninety-one current IDUs recruited from needle exchange programs in Ohio and Michigan completed a series of questionnaires. Specifically, participants answered questions about their perceived susceptibility to and the perceived severity of the two health conditions, the perceived benefits and barriers of engaging in these two harm reduction behaviors, their self-efficacy to use these harm reduction behaviors, perceived social network norms regarding use of the harm reduction behaviors, and their recent use of and short-term intentions to use the behaviors in four drug-use situations (i.e., in withdrawal, not in withdrawal, alone, with others). Participants also completed a brief interview about their health promotion behaviors and perceived barriers to using the two harm reduction behaviors. Results indicated that recent past use of these two harm reduction behaviors consistently and positively predicted short-term intentions across all four situations. Only two constructs of the Health Belief Model also predicted intentions to engage in harm reduction, depending on the drug-use situation. Specifically, perceived susceptibility to non-fatal overdose and perceived benefits of test shots were significant positive predictors of intentions to engage in test shots, but only if injecting when not in withdrawal; perceived susceptibility was a significant positive predictor of intentions to do test shots, but only when injecting if alone. Participants' rating of how often other injectors in their network use test shots was also a significant and positive predictor of doing test shots, but only if injecting with others or injecting alone. Analysis of open-ended interview responses also revealed that participants engage in behaviors to preserve their health in general and specific to injecting, and that they identify a variety of barriers to engaging in harm reduction behaviors. Based on these results, future research could evaluate whether discussing susceptibility to non-fatal overdose, listing the benefits of test shots, and encouraging IDUs to inject with others who engage in harm reduction behaviors may be valuable additions to interventions designed to increase these two harm reduction behaviors. Future research should explore whether the HBM predicts actual use of harm reduction interventions in addition to behavioral intentions and what other non-cognitive factors predict the use of harm reduction.

Committee:

Harold Rosenberg (Committee Chair); William O'Brien (Committee Member); Anne Gordon (Committee Member); Molly Laflin (Committee Member)

Subjects:

Psychology

Keywords:

health beliefs; harm reduction; injecting drug use; substance abuse

Anderson, BrentTask Persistence as a Predictor of Substance Abuse Treatment Outcomes
Doctor of Psychology (Psy.D.), Xavier University, 2016, Psychology
Substance abuse is associated with poor treatment retention and high relapse. However, positive substance abuse treatment outcomes are associated with time spent in treatment and treatment completion. As such, it is important to identify person variables associated with entering and completing treatment so those at risk for failure can be identified early and provided with additional supports. The current study examined the utility of a behavioral measure of task persistence—the Mirror-Tracing Persistence Task (MTPT)—to predict entering 28-day residential substance abuse treatment, completing treatment, and the number of completed days in treatment. The sample (N = 101) was comprised of individuals completing medically supervised detoxification; the majority (78%) were opioid dependent. The predictive power of the MTPT was tested in isolation and in the context of affective functioning. Furthermore, the relations between the theoretical construct of learned industriousness, task persistence and treatment outcomes were empirically tested. Results indicated that task persistence was significantly related to entering treatment but this relation was modest. Task persistence was not related to completing treatment or number of days of treatment completed. Counter to expectations, affective functioning and learned industriousness were not related to task persistence or to the primary treatment outcomes.

Committee:

Susan Kenford, Ph.D. (Committee Chair)

Subjects:

Psychology

Keywords:

Distress Tolerance; Mirror Tracing Persistence Task; Substance Abuse Treatment; Opiate Abuse; Learned Industriousness

Ahuama-Jonas, Chizara UStrength in the Midst of Pain: Relationship Power, Victimization, and HIV Risk Behaviors among Substance Abusing African American Women
MA, University of Cincinnati, 2014, Arts and Sciences: Psychology
This study assessed the associations between victimization (physical, adult sexual, and child sexual abuse), relationship power, and unprotected sex occasions in substance abusing African American women. The current study was a secondary analysis of baseline data collected from 124 African American women from the National Institute on Drug Abuse Center for Clinical Trials Network 0019 (CTN 0019) (Tross, Campbell, Cohen, Calsyn, Pavlicova, Miele, et al., 2008). The CTN 0019 protocol was a multi-site randomized clinical trial that assessed the intervention of Safer Sex Skills Building (SSSB) in women substance abusers to reduce HIV risk. In the current sample, 70.2% (N=87) endorsed lifetime physical abuse from a male sexual partner. There were no associations between victimization and unprotected sexual occasions in the current sample at baseline (p>.05). Moreover, there were no associations between negotiation skills and unprotected sexual occasions in the current sample. The moderation model of SRP decreasing the relationship between victimization and risky sexual behavior was nonsignificant (p>.05). The current study is among the first to examine moderating factors of SRP in substance-abusing African American women.

Committee:

Ann Kathleen Hoard Burlew, Ph.D. (Committee Chair); Bridgette Peteet, Ph.D. (Committee Member); Matia Solomon, Ph.D. (Committee Member)

Subjects:

Psychology

Keywords:

HIV risk; African American; substance abuse; victimization; women

Kennedy, Kerry S.Motivation in substance abuse treatment: Assessing the relationship between the transtheoretical model of change, self-determination theory, and their impact upon treatment outcomes
Doctor of Philosophy, The Ohio State University, 2005, Social Work
As the field of chemical dependency treatment has changed and evolved over the past decade, so has the perception of the importance of the motivation of persons entering into treatment. Two theories focus on motivation in substance abuse: Self-determination theory and the Transtheoretical Model of Change. Self-determination theory provides a theoretical basis for the source of motivation, and outlines a continuum of motivation from amotivation to external motivation to internal motivation. The Transtheoretical Model of Change describes stages, processes, and levels of change. The purpose of this research was to explore the relationship between Self-determination theory and the Transtheoretical model of change. Specifically, Self-determination theory was operationalized as internal or external source of motivation, and the Transtheoretical model was operationalized as the stages of change: precontemplation, contemplation, and action. The second purpose of this research was to examine the relationship between source of motivation and chemical dependency treatment outcome, measured both as use after intake and treatment completion. Data used for this study were from the Drug Abuse Treatment Outcome Study (DATOS). A multinomial logistic regression analysis indicated that there was a significant relationship between source of motivation and the stage of change at intake (n = 8719). People entering treatment with high levels of internal motivation were more likely to be in the action stage than people with high levels of external motivation. A logistic regression analysis from the 12-month follow-up (n = 731) indicated no significant relationship between source of motivation and treatment completion or use after admission to substance abuse treatment. No difference existed between people with high levels of internal or high levels of external motivation and people with low levels of internal or low levels of external motivation. This study supports a definition of motivation that is dynamic and changing.

Committee:

Thomas Gregoire (Advisor)

Subjects:

Social Work

Keywords:

substance abuse; treatment outcomes; Transtheoretical model of change; self-determination theory

Bozzelli, Elizabeth KatherineSubjective Definitions of Substance Abuse Problems: Does Age Matter?
Master of Gerontological Studies, Miami University, 2008, Gerontology
The language associated with substance use behavior is not clearly defined, making effective communication on the topic difficult. This study employs focus groups and surveys to explore how substance abuse problems are defined among two different age groups. Age-specific vignettes describing substance use behavior of hypothetical individuals allowed for an examination of stereotyping and in-group/out-group thinking. Respondents were asked to rate the degree to which the individual has a substance abuse problem on a continuous scale. The analysis focused on respondent perceptions of substance abuse in relation to age and gender of both the individual in question and the respondent. Significant findings suggest that the initial framework of in- and out-group thinking is not the dominant influence on respondent judgments of target person behavior. Instead, the concepts of age norms and the "growing-up" effect are more helpful in making connections among the outcomes of the study. These outcomes overwhelmingly indicate that "age matters" in perceiving the severity of substance use behavior.

Committee:

Suzanne Kunkel, PhD (Advisor); Jane Straker, PhD (Committee Member); Jennifer Kinney, PhD (Committee Member)

Subjects:

Gerontology; Health; Psychology; Sociology

Keywords:

definition of; substance use; defining; drinking; college student; Baby Boomer; vignettes; Age Norms; Theory; substance abuse; rite of passage

Weekes, Jerren C.The Relation of Race/Ethnic-Matching to the Engagement, Retention, and Treatment Outcomes of Adolescent Substance Users
MA, University of Cincinnati, 2011, Arts and Sciences: Psychology
This study examined the relation of race/ethnic-matching (i.e., matching therapist and client based on self-reported race/ethnicity [REM]) to the treatment outcomes of 471 Hispanic, African American, and White adolescents in substance abuse treatment. Additionally, exploratory analyses were conducted to examine family functioning as a moderator variable between racial/ethnic match and treatment outcomes. Logistic and multiple regression analyses revealed that REM, alone, did not significantly predict the treatment outcomes of the African American and White adolescents. However, REM predicted an increase in the externalizing behaviors (e.g., non-compliance, aggression, hyperactivity) and substance use of Hispanic adolescents 12 months post baseline assessment. Family functioning moderated the relationship between REM and treatment engagement for African American adolescents. As family functioning worsened, African American adolescents who were matched had a higher likelihood of treatment engagement. Implications for substance abuse treatment with ethnic minority adolescents and future race/ethnic-matching research are provided.

Committee:

Ann Kathleen Hoard Burlew, PhD (Committee Chair); Farrah Jacquez, PhD (Committee Member); Bridgette Peteet, PhD (Committee Member)

Subjects:

Psychology

Keywords:

substance abuse;adolescent;ethnicity;treatment engagement;race matching;ethnic matching

Russo, JessicaAn Exploratory Study of Within Group Differences of Substance Abusing Mothers Using Bowen Family Systems Concepts on the Personal Authority in Family Systems Questionnaire
Doctor of Philosophy, University of Akron, 2009, Counselor Education and Supervision

In order to better serve clients, mental health professionals need to gain more insight into factors that predict substance abuse among women. By identifying the perception that women addicts’ have of their families of origin, it was hoped that this study would identify areas that could be focused on to enhance treatment outcomes.

This exploratory study was guided by Bowen’s Family Systems Model and attempted to examine its constructs using the Personal Authority in Family Systems Questionnaire of within group differences of substance abusing mothers in a treatment program. Data used in this investigation was collected at a Northeast Ohio substance abuse treatment facility with a sample of 80 substance abusing mothers.

Results related to General Hypothesis 2 found that the overall subscales approached significance in predicting drug of choice for marijuana users only. The hypothesis was tested using a multiple linear regression. This hypothesis was found to be significant (p= 0.015) predicting marijuana use. The overall subscales of the PAFSQ all predicted marijuana use with spousal intimacy (p=0.02) and personal authority ( p=0.04) adding unique significance above and beyond the influence of ethnicity, custody, alcohol, opiates and cocaine use.

Committee:

Patricia Parr, PhD (Committee Chair)

Subjects:

Mental Health; Psychology; Social Work; Welfare; Womens Studies

Keywords:

family of origin; substance abuse; personal authority; within group differences; mothers; Bowen

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