Thesis advisor: Natalia Sarkisian / A multiplicity of scholarly publications has found salutary associations between various aspects of religion and mental health, particularly depression. However, Hispanic older adults are seldom the focus of empirical studies analyzing these relationships. I fill that gap. Theories on the effects of church attendance, private prayer, religious coping, and religiosity on depression are developed and investigated. These analyses are based on a sample of older Mexican-origin individuals (N = 1,495). Data were obtained from the Hispanic Established Population for Epidemiological Studies of the Elderly (H-EPESE), a longitudinal survey. Results reveal an inverse association between moderate church attendance and depression that persists despite controls for social support, financial strain, and physical and mental impairment. An inverse association between higher levels of religiosity and depression and a direct association between higher levels of religious coping and depression also persisted beyond all controls. Findings suggest that the effects of religion on depression vary and are not always salutary. Methodological and theoretical implications, limitations, and future research directions are discussed.

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MPH, Faculty of Health Sciences, University of the Witwatersrand / Introduction: The study analysed the admission trends at six adult medical wards in a regional hospital in Gauteng over 2005 and 2007. Methods: This was a retrospective analysis of data from admission ward registers and patient case notes. Information obtained included age, gender, duration of stay, clinical outcomes and disease profile. The study population comprised of all patients admitted to the adult medical wards at Tambo Memorial Hospital for the period 1 January 2005 to 31 December 2005 and 1 January 2007 to 31 December 2007. Results: The number of medical admissions increased by 2.07% during the years of study. The male admissions were slightly higher than the female admissions. The mean age of male patients decreased from 42.30 years to 40.41 years. In contrast the mean age for female patients increased from 38.00 years to 40.50 years. The average length of stay decreased from 6.16 days to 5.33 days. The younger age groups (15-34 years of age) accounted for the majority of admissions. Based on the ICD 10 coding, infectious and parasitic diseases accounted for the majority of the admissions followed by respiratory disorders. Tuberculosis became the most frequent diagnosis and was prevalent in the younger age groups followed by pneumonia. Hypertension was a common diagnosis in the older age groups (55 years and older). As was expected the majority of patients (86-95% in 2005 and 80.24% in 2007) were discharged home but a considerable number of patients were transferred to other institutions. Importantly, a decrease in the mortality rate from 4.02% to 0.03% was also demonstrated. Conclusions: An increase in the number of patient’s admissions, a decrease in the average length of stay and a decrease in mortality rate were noted during the study period. Changing trends with regards to gender, age and disease profile were also observed. The challenges and recommendations identified by the study will provide valid information that would be meaningful to hospital management as well as potential users such as budget planners, resource allocators and efficient referral pathways designers.

This study sought to identify any smartphone usage with significant positive or negative relationships with the religiosity of LDS young adults, with the hypothesis that smartphone usage would indeed have significant relationships with religiosity, both positively and negatively. Over 1,000 BYU students were surveyed for their usage of 36 popular and religious apps and of 33 different categories of content consumption, their content sharing, and compulsive use. That data was compared with their private religiosity (prayer, scripture study, and thinking seriously about religion) and religious experience (strength of beliefs, feeling the Spirit, finding strength through their faith, etc.) BYU students' smartphone usage is outlined, with Facebook dominating social media use and most students studying their scriptures on their phones. BYU students' religiosity is outlined, revealing a very believing and actively religious student body. Different forms of smartphone usage do have very significant associations with private religiosity, both positive and negative. Smartphone usage behaviors shown to have the greatest negative relationship with religiosity, are, in descending order: consuming "erotic/pornographic" content, "LGBT news or personalities" content consumption, consuming content about "Video gaming", using the Netflix app, and using the Snapchat app. Smartphone usage behaviors shown to have the greatest positive relationship with religiosity, are, in descending order: "LDS teachings and doctrine" content consumption, using the Bible Videos app, using the Gospel Library app, using the LDS Tools app, and using the Mormon Tabernacle Choir app.

Objective. To examine associations among attention-deficit/hyperactivity disorder (ADHD) symptom dimensions (hyperactivity, impulsivity, inattention, and sluggish cognitive tempo [SCT]) and functional impairment among adults. The potential influence of co-occurring internalizing and externalizing difficulties, as well as self-reported executive functioning deficits, on these associations was also evaluated. Methods. One thousand eight hundred and ninety-four adults (58.8% female; 75.9% Caucasian; age: M = 36.24 [SD = 11.65] years) recruited from Amazon’s Mechanical Turk (MTurk) completed extensive questionnaire batteries assessing ADHD symptoms, co-occurring internalizing and externalizing difficulties, executive functioning deficits, and functional impairment across a range of domains. First, factor analyses were completed to identify empirically-derived functional impairment factors for use in subsequent analyses. Second, associations between ADHD symptom dimensions and functional impairment factors were examined via a path model. Third, multiple mediation analyses were conducted to evaluate the impact of ADHD symptom dimensions on functional impairment domains via internalizing and externalizing difficulties. Finally, additional multiple mediation analyses were completed to examine to influence of ADHD symptom dimensions on functional impairment via self-reported executive functioning deficits. Results. Factor analyses identified four overlapping but distinct functional impairment factors indexing general impairment, quality of life, romantic relationship functioning, and social support. Path analyses revealed significant associations between increased ADHD symptoms and higher general impairment, lower quality of life, reduced romantic relationship functioning, and decrements in perceived social support. Multiple mediation analyses indicated that ADHD symptom dimensions influence functional impairment domains via specific internalizing, externalizing, and executive functioning difficulties. Conclusions. The pattern of findings provides further support for associations between ADHD symptom dimensions and a range of functional impairments, as well as highlighting potential exacerbation of these effects in the presence of co-occurring mental health and executive functioning difficulties. Current findings may help to clarify the complex phenomenology of ADHD in adults, and carry implications for improving extant treatment approaches.

This study used an explorative quantitative survey method for the purpose of examining bullying among older adults in retirement homes and the consequences of bullying among this population. The study also explored the type of bullying that occurs in the community. Senior community centers were the significant domains in which to research bullying among older adults because it involved immersion of the researcher into an environment of older adults who knew one another and have witnessed or have been victims of bullying in their retirement home communities. The primary purpose of this investigation was to enhance research on bullying among older adults in retirement homes. Another purpose of this research was to address the consequences of bullying in older adults and to address mental and physical consequences of bullying addressed in previous research. Currently there is not much research done on bullying among older adults. This study found that many older adults living in retirement homes are being bullied and many of them are not speaking up and isolating themselves for the purpose of avoiding their bullies. Moreover, this study shows that staff members of the retirement communities are lacking the knowledge of the bullying problem in their community. The study suggests that future studies on bullying among older adults include qualitative research to determine if older adults understand the difference of bullying and “just being grumpy” and also explore a qualitative research regarding the perpetrator of bullying and not the victims of bullying.

Coping plays an important role in human adaptation and well-being. However, surprisingly little is currently known about the normative development of coping. The ‘coping families’ framework, outlined by Skinner and colleagues (2003), provides a promising approach to the study of coping in developmental samples. The current examination tested the coping families approach in emerging adults. A total of 425 individuals (63.5% female), aged 18-31 years (M age 25.04 years), were recruited online through Amazon’s Mechanical Turk (MTurk) to complete questionnaires on demographic information, personality, childhood adversity, stress, coping behaviors in response to an interpersonal problem, mental health, emerging adult identity, substance use behaviors, and competence. Exploratory factor analysis (EFA) examined the structure of coping behaviors. Bivariate correlations were used to examine associations between age and coping behaviors, and regression analyses examined associations between coping behaviors and various adaptive and maladaptive outcomes. EFA results yielded partial support for the coping families approach. Correlations between age and coping were not significant, suggesting that there were no meaningful age shifts in coping in the present sample. Lastly, regression analyses suggested that coping behaviors significantly predicted some adaptive and maladaptive outcomes, after statistically accounting for potential confounding variables, such as personality and childhood adversity. Findings are integrated within existing research and implications for applied work are discussed.

The purpose of this online cross-sectional study was to identify cannabis user profiles by administration method and examine how differential cannabis policies influence intentions among young adults. Participants were assigned randomly to one of three hypothetical cannabis policy conditions (recreationally legal; medically legal; illegal). Within conditions, participants completed measures regarding cannabis use, including administration methods, cannabis attitudes, norms, perceived behavioral control, self-efficacy, and intentions. Latent class analysis (LCA) was used to determine sub-groups of past 30-day cannabis users by administration method followed by sub-group comparisons. Condition effects on intentions and associated variables were examined using ANCOVA. Four classes (Low-Blunt, Low-Bong, Mod-Poly, High-Poly) differing in demographics and tobacco use were identified. Recreationally and medically legal policy conditions resulted in more favorable cannabis attitudes, higher selfefficacy, and higher intentions to use compared to the illegal policy condition. Results inform cannabis intervention efforts and longitudinal research on the effects of cannabis policy changes.

Today's methadone patients differ from those of the past due to increases in polydrug use, mental health issues, and medical needs. Patients requiring methadone treatment for their opiate addiction are now older than those who initially presented for treatment when methadone treatment first started. The number of older opiate users will continue to grow as the population continues to age. Although previous studies on opiate addiction focused on using methadone in treatment of younger adults, this study used phenomenological methodology to explore the lived experiences of opiate addicted methadone users between the ages of 50 to 55, an understudied population. A sample of 8 older addicts from the Midwest, using methadone in their treatment, provided data collected in face-to-face interviews for this study. Content analysis of the data was conducted with the assistance of NVivo 11 to code and identify categories and themes. Emergent themes included: the impact of methadone use on participants' relationship with others, participants' attitude of being an older methadone user, mental health stressors related to being an older methadone user, struggles in attending the methadone clinic daily, and needing other treatment besides treatment for methadone use. The study impacts social change by informing addiction professionals who may want to develop appropriate treatment interventions for this population.

India has reported higher alcohol per capita consumption and problem use in the past. Per the 2005-06 NFHS-3, problem use has been disproportionately high among men, less educated people, those living in rural areas and lower socioeconomic groups. Despite the growing problem, the data available on the effectiveness alcohol treatment services is very limited. The proposed study intends to address this gap by analyzing the treatment outcome (i.e., complete abstinence) among adult users participating in de-addiction camps and the impact of various individual and environmental factors on alcohol use and treatment outcome. Data (N=176) was collected on adult alcohol users participating in treatment camps conducted in Manjakkudi village of Tamil Nadu between 2004 and 2009 by the T.T. Ranganathan Clinical Research Foundation (TTK center), a renowned non-profit organization. Treatment outcome and impact of various factors (AOI, ACEs, religiosity, family h/o addiction, other drug use, and relationship with family members) on the baseline alcohol use and outcome was analyzed using the advanced statistical methods of Structural Equation Modeling. As expected, heavy alcohol use was common among the sample. Almost 44% of the sample reported consuming 12 standard drinks per day. In addition, 83% of the patients scored high on the SADD scale indicating high alcohol dependence. Nearly, half (49%) of the population had a positive history of family addiction and more than half of the sample (66%) reported one or more ACEs. Nearly, 68% of the patients reported being sober at the end of 12 months’ post treatment. A total number of ACEs and supportive relationships with family members were found to influence the treatment outcome. Consistent with the literature, AOI was found to be associated with baseline alcohol use. By contrast, alcohol use was found to be higher among those who reported no tobacco use. Findings of this study indicate that trends of substance abuse are shifting in India and it is important to tailor the education and preventive efforts towards a younger population. In addition to patients, treatment providers should consider educating friends and family members to increase the support during the treatment process and guarantee long-lasting treatment effects