Objectives: We investigated the prevalence of substance use disorders among emerging adults and quantified the extent to which emerging adults, compared to young adults, are at increased odds for substance use disorders. Methods: Data come from the 2012 Canadian Community Health Survey – Mental Health (CCHS-MH). Respondents were 15–39 years of age (n=9228) and were categorized as: early emerging adults (15-22 years); late emerging adults (23-29 years); and, young adults (30-39 years). Substance use disorders (alcohol or drug abuse/dependence) were measured using the Composite International Diagnostic Interview 3.0. The prevalence of substance use disorders was compared across age groups using design-based χ2 analyses. Odds ratios (OR) and 95% confidence intervals (CI) were computed from logistic regression models adjusting for sociodemographic and health covariates. All analyses were weighted to maintain representativeness of the study sample to the Canadian population. Results: The prevalence of alcohol use disorder was 8.0%, 6.6%, and 2.7% for early emerging adults, late emerging adults, and young adults respectively. For drug use disorder, the prevalence was 6.4%, 3.6%, and 1.3%. Compared to young adults, early and late emerging adults were more likely to report substance use disorders (p<0.01). The prevalence of drug use disorder was higher among early versus late emerging adults (χ2=119.8, p=0.01). Among all age groups, males were more likely to report alcohol or drug use disorders (p≤0.01 for all). After covariate adjustment, early and late emerging adults had greater odds of reporting alcohol (OR=3.2, 95% CI=2.2-4.9 and OR=2.4, 95% CI=1.6-3.4, respectively) or drug (OR=4.2, 95% CI=2.5-7.0 and OR=2.5, 95% CI=1.6-4.1, respectively) use disorders compared to young adults. Conclusion: Emerging adulthood represents an important developmental period in which individuals are at increased odds of reporting substance use disorders. This finding has implications for the provision of screening and treatment of substance use disorders as these individuals transition from the pediatric to adult healthcare system. / Thesis / Master of Health Sciences (MSc)

Background: Current national prevalence estimates of DSM-5 diagnosed substance use disorders (SUDs) among adults with justice system involvement are lacking. Methods: This study drew from NESARC-III data (n = 36,309; 2012–2013), a nationally representative U.S. sample, to examine current and lifetime alcohol use disorder (AUD) and drug use disorder (DUD) diagnoses among adults reporting current or prior drug-related, alcohol-related, and general legal problems. Results: Adults reporting current alcohol-related legal problems were 22 times more likely to have a current AUD diagnosis (AOR = 22.0, 95% CI = 12.1; 40.1) and 15 times more likely to have had a lifetime AUD diagnosis (AOR = 15.2, 95% CI = 7.5; 30.9) than adults without alcohol-related legal problems. Adults with lifetime drug-related legal problems were 3–5 times more likely to have a current (AOR = 2.6, 95% CI = 2.1; 3.2) and lifetime (AOR = 5.1, 95% CI = 4.3; 6.1) DUD diagnosis, with stimulant use disorder being the most prevalent (AOR = 5.4, 95% CI = 4.5; 6.5). Adults with general legal problems were around 3 times more likely to have a current AUD (AOR = 3.2, 95% CI = 2.6; 4.0) or DUD (AOR = 3.5, 95% CI = 2.8; 4.4). Women with any type of legal problem were more likely to have SUD diagnoses than men. Conclusions: SUD diagnoses are prevalent among adults reporting legal problems, particularly those involving alcohol. There is a continued need for community-based addiction prevention and intervention efforts, especially for women with justice system involvement.

Substance Use Disorder (SUD) is associated with high mortality rates and remains a public health concern in the United States. Although, numerous interventions are offered for adolescents struggling with substance misuse, minimal research is available on the effectiveness of treatments to reduce recidivism. Researching the most effective treatment offered to adolescents is crucial to treatment adherence and recovery. The purpose of this study is to determine the most effective SUD treatment for adolescent patients by exploring the perceptions and experiences of treatment therapists providing treatment. The trans-theoretical model was used with elements of the social cognitive theory as a guide to, adolescent placement in treatment programs and behavior changes. Twenty-three treatment therapists at Community Mental Health Centers from 23 counties in the State of Indiana were interviewed using the Colaizzi phenomenological methodological approach to obtain verification, validation, and validity for this study. Results suggested that assertive post-discharge plans after SUD treatment, motivational interviewing, cognitive-behavioral therapy, higher power faith for strength, and family involvement was evidence of effectiveness. Seven themes emerged from 225 significant statements. Among the dominant themes were understanding of SUD as a disease and the importance of family involvement in the treatment process. The study findings have the potential for positive social change to address the stigma of stereotyping of SUD through educational campaigns.

Eltern mit suchterkrankten Jugendlichen leiden an einem erhöhten Elternstress (ES). Die Gründe für dieses erhöhte Stresserleben sind aktuell noch wenig erforscht. Das Hauptaugenmerk dieser Arbeit war es, potenzielle sozioökonomische Stressoren, welche einen erhöhten ES erklären, zu identifizieren. Zu diesem Zweck füllten PatientInnen und ProbandInnen im Rahmen der großangelegten DELTA-Studie neben vielen weiteren Fragebögen den Elternstressfragebogen (ESF) aus. In einem anderen Fragebogen wurden Daten zur sozioökonomischen Situation der Familien erfasst, außerdem kam der Drug Use Disorder Identification Test (DUDIT) zum Einsatz, um die Suchtstärke der ProbandInnen zu ermitteln. Insgesamt 81 PatientInnen, welche im Zeitraum von Dezember 2017 bis Oktober 2020 in der Suchtambulanz des Universitätsklinikum Dresden behandelt wurden, erfüllten die Einschlusskriterien und wurden der abschließenden Studienkohorte dieser retrospektiven Arbeit hinzugefügt. Eine parallel dazu erstellte Kontrollgruppe beinhaltete 28 ProbandInnen. Es erfolgten deskriptive und inferenzstatistische Analysen der erhobenen Daten. Mittels Varianzanalyse mit Kovariaten (ANCOVA) sollte herausgefunden werden, welche Faktoren den ES beeinflussen. Der elterliche Erwerbsstatus, Schulabschluss und das objektiv messbare Einkommen waren nicht entscheidend für den ES. Auch die Suchtstärke des betroffenen Jugendlichen scheint keinen bedeutenden Einfluss zu haben. Die Varianzanalyse mit Kovariaten (ANCOVA) zeigte einen signifikanten Zusammenhang zwischen der Höhe des ES und der subjektiv wahrgenommenen finanziellen Situation (F(3,81) = 2,9, p = ,04, η2 par = 0,123). Je schlechter die Familien ihre finanzielle Lage einschätzten, desto höher war der ES. Die Ergebnisse legen die Vermutung nahe, dass die Substanzkonsumstörung (SKS) der Kinder selbst der Auslöser für einen erhöhten ES sein könnte. Eine finanzielle Unterstützung der betroffenen Familien sowie eine Beratung zum Ressourcenmanagement scheinen zur Unterstützung der SKS-Therapie sinnvoll.:1 EINLEITUNG 7 1.1 SUBSTANZKONSUMSTÖRUNGEN BEI JUGENDLICHEN 7 1.1.1 EPIDEMIOLOGIE 8 1.1.2 DIAGNOSEKRITERIEN UND SYMPTOME EINER SUBSTANZKONSUMSTÖRUNG 9 1.1.3 PSYCHOSOZIALE UND SOMATISCHE KONSEQUENZEN BEI SUBSTANZKONSUM IM JUGENDALTER 11 1.1.4 KONSEQUENZEN FÜR DAS UMFELD 12 1.2 ELTERNSTRESS ALS MÖGLICHE KONSEQUENZ EINER SUBSTANZKONSUMSTÖRUNG IM JUGENDALTER 14 1.2.1 NEUROBIOLOGIE DES STRESSES 14 1.2.2 ELTERNSTRESS – THEORETISCHER HINTERGRUND 15 1.3 PROBLEMSTELLUNG UND ZIELE DER ARBEIT 18 2 PATIENTEN UND METHODEN 20 2.1 STICHPROBE 20 2.1.1 BILDUNG DER ANALYSESTICHPROBE 20 2.2 STUDIENDESIGN 21 2.3 INSTRUMENTE 22 2.3.1 ELTERNSTRESSFRAGEBOGEN 22 2.3.2 SOZIODEMOGRAFIE-FRAGEBOGEN 23 2.3.3 DRUG USE DISORDER IDENTIFICATION TEST (DUDIT) 24 2.4 STATISTISCHE METHODEN 25 3 ERGEBNISSE 26 3.1 PATIENTENCHARAKTERISTIKA 26 3.2 SKALENVERGLEICH MIT NORMALBEVÖLKERUNG 28 3.3 PRÄDIKTOREN FÜR ELTERNSTRESS 29 4 DISKUSSION 32 4.1 EINORDNUNG UND INTERPRETATION DER ERGEBNISSE 32 4.2 IMPLIKATIONEN FÜR THERAPIE UND FORSCHUNG 36 4.3 LIMITATIONEN 37 5 ZUSAMMENFASSUNG 39 6 SUMMARY 40

Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse and Mental Health Services Administration. Multiple logistic regression analyses were performed to test the hypotheses regarding a predictive relationship between independent living arrangement, the principal source of treatment referral, and admissions to treatment for abuse of opioid, heroin, and cocaine. The results showed a significant association between the source of treatment referrals and independent living arrangement, and the increased odds of admissions for prescription opioids use disorder, heroin use disorder, and cocaine use disorder among adults aged 18-34 living in the United States. The implication for positive social change included a need for a targeted treatment and other intervention programs for young adults' users with associated higher-risk treatment referral categories and exposed to neighborhoods factors and health-risk behaviors in reducing the crisis of drug abuse in the United States.

Magister Psychologiae - MPsych / The outcome of child abuse, i.e. physical, emotional and/or sexual, and child neglect is multifactorial. The severity, duration and nature of abuse and the child’s vulnerabilities are all contributory factors with regards the outcome of abuse. Children who are traumatized are likely to be profoundly affected. Studies have shown and nearly every researcher agrees that early childhood traumas lie at the root of many emotional and psychological illnesses. It has been noted that drug abuse is a major problem in the Western Cape. This thesis explored the relationship between subjectively perceived childhood trauma and drug dependence in an in-patient treatment-seeking sample of adults in the Cape Town Metropolitan Area in the Western Cape. This thesis presents the results of a measure of childhood trauma, namely the Childhood Trauma Questionnaire [CTQ] and a measure of drug dependence, the Drug Use Disorder Identification Test [DUDIT]. The sample consisted of 52 participants and included both males and females. Only participants who were identified as drug dependent were included in the study. Patients who were actively psychotic and/or alcohol dependent were not included in the study. Ethical clearance was obtained from the University of the Western Cape’s higher degree ethical committee. The anonymity of the participants, the importance of responding openly and honestly and the sensitive nature of the questions were highlighted during the test administration. Questionnaires were administered in accordance with the guidelines stipulated in the respective manuals. The data was analysed through correlation. The study found a positive correlation between childhood emotional abuse and drug dependence, and childhood physical abuse and drug dependence.