Depression affects over 17 million American adults yearly and has been identified as the leading cause of disability in people between the ages of 15 and 44 years. There is evidence that feeling neglect or a lack of parental attachment during childhood is associated with depression. One construct that has been overlooked is love from a parent. The purpose of this study was to analyze the association between individuals who felt not wanted/loved during adolescence and lifetime depression and to examine this association by gender. We examined 5114 participants aged 24–32 years at Wave IV of the National Longitudinal Study of Adolescent Health (Add Health) public use dataset. We used logistic regression analysis to determine the association between an individual feeling not wanted/loved by their parent/caregiver prior to age 18, covariates, and lifetime depression. We then stratified by gender and ran logistic models for both men and women separately. Overall, 16.2% (n = 827) reported lifetime depression diagnosis, while 16.5% of the participants reported feeling not wanted/loved “often,” while 29.8% reported it as “sometimes.” Feeling not wanted/loved “often” was associated with higher odds of depression (AOR = 3.00; 95% CI, 2.45–3.66; p < .001) versus “sometimes” (AOR = 1.59; 95% CI, 1.31–1.90; p < .001). When stratified by gender, feeling not loved/wanted was associated with depression among both men (AOR = 3.70; 95% CI, 2.60–5.25; p < .001) and women (AOR = 2.73; 95% CI, 2.13–3.48; p < .001). Feeling not loved or wanted by a parent/caregiver during adolescence has serious implications, for both men and women. Future studies should further examine this construct and identify family-based interventions that focus on parent/caregiver and child relationships.

Background: The current study examines the association of perceived racial and social class discrimination with cannabis involvement among Black youth and young adults. Methods: This secondary analysis used data from the Missouri Family Study (MOFAM), a high-risk longitudinal family study of alcohol use disorder, oversampled for Black families. Offspring (n = 806) and their mothers were interviewed by telephone. Cox proportional hazards regression analyzes were used to examine associations of racial and social class discrimination (experienced by offspring and their mothers) with offspring cannabis involvement. Two stages of cannabis involvement were analyzed: timing of 1) initiation and 2) transition from initiation to first cannabis use disorder (CUD) symptom. Results: The study found that offspring report of experiencing racial (HR: 1.28, CI: 1.01–1.62) and social class discrimination (HR: 1.45, CI: 1.14–1.84) were associated with cannabis initiation in our fully adjusted model. Mothers’ report of discrimination predicted a lower hazard of cannabis initiation among offspring (HR: 0.79, CI: 0.64–0.98). Offspring social class discrimination (HR: 2.45, CI: 1.71–3.51) predicted an increased hazard of transition from initiation to first CUD symptom, while offspring racial discrimination (HR: 0.57, CI: 0.39–0.85) was associated with lower hazard of transition in our fully adjusted model. Conclusions: As rates for cannabis use among Black youth are disproportionately rising, there is a critical need to identify pathways to its use among Black youth. These findings suggest racial and social class discrimination may be important targets in efforts to prevent cannabis involvement among Black youth and emerging adults.

Background: The mood stabilizer lithium has long been reported to be associated with reduced suicide risks, but many studies reporting associations between lithium and reduced suicide risks also have been nonrandomized and lacked adjustment for many potential confounders, active controls, uniform follow-up, or intent-to-treat samples. Concerns also have been raised that medications being considered as potential suicide preventative might increase risks of nonsuicide mortality while reducing risks of suicide. Methods: Three studies of Veterans Health Administration (VHA) patients were conducted combining high-dimensional propensity score matching with intent-to-treat analyses to examine the associations between lithium and valproate and one-year suicide and nonsuicide mortality outcomes. Results: In intention-to-treat analyses, initiation of lithium, compared to valproate, was associated with increased suicide mortality over 0-365 days among patients with bipolar disorder (Hazard Ratio (HR) 1.50 [95% Confidence Interval 1.05, 2.15]) Nonsuicide mortality among VHA patients with or without bipolar disorder was not significantly associated with the initiation of lithium compared to valproate ( HR 0.92 [0.82-1.04]). Rates of treatment discontinuation, however, were very high (≈ 92%). Longitudinal analyses revealed that the increased suicide risks associated with initiating lithium among patients with bipolar disorder occurred exclusively after discontinuation of lithium vii treatment. In secondary analyses restricted to patients still receiving their initial treatment, there was no difference in suicide risk between the initiation of lithium or valproate. Conclusions: Significantly increased risks of suicide were observed at one year among VHA patients with bipolar disorder initiating lithium compared to valproate, related to risks observed after the discontinuation of lithium treatment Since these studies are nonrandomized, confounding may account for some or all of our findings, including the risks observed after lithium discontinuation. Nevertheless, these results suggest that health systems and providers consider steps to minimize any potential lithium discontinuation-associated risk. Approaches might include educating patients about possible risks associated with discontinuation and closely monitoring patients after discontinuation if feasible. Given the obvious importance of any substantive difference between lithium and valproate in suicide or nonsuicide mortality risk, our studies also suggest that further research is needed, especially research that can further minimize the potential for confounding.

Nicotine dependence is hypothesized to be due to neuroadaptations that ultimately drive compulsive nicotine use. The studies in this thesis aim to understand how the “upregulation” of nicotinic acetylcholine receptors (nAChRs) caused by chronic exposure to nicotine contributes to nicotine reward and nicotine withdrawal. Previous studies have shown that chronic nicotine induces upregulation of nAChRs containing the α4 subunit (α4* nAChR) within the Ventral Tegmental Area (VTA), a brain region critical for the rewarding properties of all illicit drugs. Curiously, α4* nAChR upregulation occurs specifically in the inhibitory GABAergic neuronal subpopulation of the VTA. To determine if increased expression and activation of α4* nAChRs in VTA GABAergic neurons contributes to nicotine dependence behaviors, I devised a viral-mediated, Creregulated gene expression system that selectively expressed α4 nAChR subunits containing a “gain-of-function” point mutation (a leucine mutated to a serine residue at the TM2 9´ position: Leu9´Ser) in VTA GABAergic neurons of adult mice. Sub-reward doses of nicotine were sufficient to activate VTA GABAergic neurons in mice expressing Leu9´Ser α4 nAChR subunits in VTA GABAergic neurons (Gad2VTA: Leu9´Ser mice) and exhibited acute hypolocomotion upon initial injection of low doses of nicotine that developed tolerance with subsequent nicotine exposures compared to control animals. In the conditioned place preference procedure, nicotine was sufficient to condition a significant place preference in Gad2VTA: Leu9´Ser mice at low nicotine doses that failed to condition control animals. I conclude from these data that upregulating α4* nAChRs on VTA GABAergic neurons increases sensitivity to nicotine reward. In a separate study testing the hypothesis that overexpression of Leu9´Ser α4* nAChRs in VTA GABAergic neurons disrupts baseline behavior and promotes anxiety-like behaviors, I found that overexpressing Leu9´Ser α4* nAChRs in VTA GABAergic neurons had a minimal effect on unconditioned anxiety-like behaviors. Drug naïve Gad2VTA: Leu9´Ser and control mice failed to exhibit any behavioral differences in the open-field, marble burying test and elevated plus maze compared to control. Together, these data indicate that overexpression of the “gain-of-function” α4* nAChRs in VTA GABAergic neurons contributes to reward sensitivity without increasing susceptibility to nicotine withdrawal symptoms. My data indicates that nAChRs expressed in VTA GABAergic neurons may be a suitable target for the development of better smoking cessation aids.

Objective: To examine the relationship between hope, core self-evaluations, physical function, emotional well-being, health risk behaviors, and academic performance in freshman enrolled in their first year of college. Participants: Freshman (N = 495) attending a large public university in the Northeast completed an online survey between February 1 to February 13, 2017. Methods: Cross sectional descriptive survey. Linear regression, path analysis, and structural equation modeling procedures were performed. Results: Core self-evaluations mediated the relationship between hope and emotional well-being and academic performance. Contrary to the hypotheses, higher hope predicted more sexual risk taking behaviors and alcohol use. Conclusions: Core self-evaluations is an important component of hope theory. Hope Theory is useful for predicting emotional well-being, and academic performance, but not as useful for predicting drug use, alcohol use, and sexual risk taking. Hope and core self evaluations interventions are needed to improve academic performance and emotional well-being in university freshman.

Objective: To determine the feasibility of an online cognitive behavioral therapy for insomnia (CBT-I) in bereaved older adults. Participants: The study participants include adults aged 55 and older (N = 30) that lost a loved one within the past five years and are currently experiencing symptoms of insomnia. Methods: This study used an experimental design and was guided by the Transitions Theory developed by Meleis. Descriptive statistics and t-tests were used to measure changes within and between groups. Experimental arm had the CBT-I online treatment and the control arm had attention controlled online tasks. Intervention fidelity was measured. Results: The online CBT-I intervention is a feasible intervention for bereaved older adults with insomnia. High retention rates were shown in both groups, and both groups’ insomnia and mood symptoms improved at post- study measurement. There were no statistically significant differences seen in any measure between groups. Conclusions: Transitions in older adult life includes loss of friends and family as well as development of sleep issues. The Transitions Theory is useful for informing the design of behavioral interventions in this older population. Further research is needed to understand how sleep can be improved by cost effective online interventions that might not include solely CBT-I.

Colleges across the nation are increasingly interested in improving retention of students. Many universities have begun offering workshops and courses targeted at improving study skills in academically underprepared students with the goal of helping students succeed in higher education and continue enrollment. The impact of such courses on study skills themselves has been supported, but prior research has not examined the courses impact on students' beliefs about their ability to succeed in college - that is, their levels of academic self-efficacy. This study examined pre- and post-test levels of academic self-efficacy in college students enrolled in a study skills course in comparison to students not enrolled in such a course. Results indicated that students identified as academically underprepared did indeed have lower levels of skill and academic-self efficacy than students not enrolled in study skills courses, and students enrolled in study skills courses had greater increases in academic self-efficacy than comparison students.

Self-report methods are often used as the main or only measure of college students' alcohol consumption (e.g., Alfonso, Hall, & Dunn, 2013; White et al., 2003). However, these data are limited because students are rarely able to accurately state or pour the standard serving size for various types of alcohol, rendering the validity of self-report questionable (Midanik, 1982; White et al., 2003). Moreover, students are often required to participate in university alcohol training programs; these programs are generally information-based and rarely contain a skills training component, in which students practice identifying and pouring standard servings of alcohol. Researchers have evaluated the effectiveness of nutrition and alcoholic beverage portion training procedures that make use of practice, measurement aids, and verbal feedback; however, to our knowledge, the effect of stimulus fading on a free pour procedure has not been assessed even though research suggests stimulus fading is an effective training procedure. In the current study we assessed the effects of individualized 1) verbal feedback, 2) superimposition training (i.e., measurement aids), and 3) stimulus fading training on college students' ability to accurately free pour a standard serving of beer into 18 oz training and generalization cups using an ABA and in some cases, an ABACA design. Results suggest that all three types of training are effective in teaching college students to free-pour the standard serving size of beer. Further research is required to evaluate effective individual and group trainings, use of different alcohol types and various sized containers, and maintenance and generalization of the skill over time and across settings.

Research on operant learning principles suggests that discriminative stimuli, and negative and positive reinforcement play a role in the maintenance of smoking behavior. Smoking research from a respondent learning paradigm focuses on the role of environmental stimuli that function as elicitors of physiological responses related to smoking. Basic research suggests that compensatory responses may play a role in drug tolerance and relapse. In one preliminary study assessing the role of compensatory responses to smoking stimuli (Machado, 2011), drops in carbon monoxide (CO) were observed only when smokers viewed smoking related stimuli. However, it is possible that these patterns were influenced by CO monitor sensitivity to differing exhalation durations in which exhalation duration may have been under stimulus control of the smoking stimuli. The purpose of the current study was twofold: Study 1 controlled for exhalation duration by holding exhalation duration constant using a within subject design and Study 2 precisely measured but did not control total exhalation duration in an attempt to replicate the results from Machado (2011). Results from Study 1 did not support the presence of compensatory responses in smokers; results from Study 2 did not support the presence of operantly maintained exhalation durations. Study limitations, implications and future directions are discussed.

Recent research suggests that infants as young as 5 months old demonstrate an innate or unlearned ability to make judgments about others' prosocial and antisocial behavior. Data used to support this assertion suggest that, when given a single opportunity to choose a puppet after watching a puppet show, more infants (72-100% of infants) choose a helper puppet (the puppet that "helps" another puppet attain its goal) over a hinderer puppet (the puppet that "hinders" another puppet from attaining its goal). However, to date, no independent research teams have published a replication of these methods and results. The purpose of the current investigation was to replicate Hamlin and Wynn (2011) and extend their work by including within-subject repeated measures of choice. Twenty infants were shown a puppet show nearly identical to that used by Hamlin and Wynn (2011) and asked to make a choice between the two puppets afterwards (i.e., the helper or hinderer); infants were then asked to choose a puppet four more times, resulting in five choices per infant. Results of the current investigation failed to replicate those of Hamlin and Wynn (2011), as infants in the current investigation did not consistently choose the helper more often during subsequent choice trials. Implications and limitations of this study, as well as suggestions for future research are discussed.