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More than 20 million people in the United States have survived a completed or attempted rape in their lifetimes, and approximately 22.5 million people have problematic substance use. The interplay between these two issues is complex: a history of sexual assault predicts substance abuse and, conversely, substance abuse increases sexual assault risk. This secondary analysis of the Virginia Twin Study of Psychiatric and Substance Use Disorders data for White female-female twins (n=1,497) examines the role of multiple traumas in the sexual assault/substance abuse association. Structural models were used to examine pathways between child sexual abuse (CSA), other traumas, familial factors, social support, psychiatric disorders, and substance abuse. The models also integrate the ACE twin design to estimate genetic, shared environment, and individual-specific environment contributions to liability for psychiatric disorders and substance abuse. Study findings support an interplay between childhood trauma, development of substance abuse and psychiatric disorders, and risks for adult victimization. The findings also support assertions that multiple traumas may increase likelihood for substance abuse and psychiatric disorders, and that these disorders predict risk of adult sexual assault. Across all ACE models, both genetics and common environment produced consistently large estimates of influence on liability for substance abuse. Individual-specific environment played a smaller role but was also often significant, and the pathways from trauma variables to both psychiatric disorders and substance abuse tended to be strong. This supports an interaction between genes and environment/experience in which genetic predisposition, though present, may or may not be activated depending on life experiences. Study findings underscore the need for integrated services for clients with history of multiple traumas and for clients with trauma history and substance abuse or psychiatric disorders. / text

This study employed a survey design. 5,000 special education teachers were sampled across the nation to determine their perceptions of knowledge of substance abuse, and instructional and behavioral management skills to address students with disabilities who are abusing substances. The following research questions were addressed: (a) What are special education teachers’ perceptions of substance abuse intake among their students; (b) What are special education teachers’ perceptions of their knowledge of different substance abuse areas; (c) What are special education teachers’ perceptions of their classroom knowledge in addressing instructional and behavioral management issues of special education students abusing substances; (d) Are there differences in the teachers’ perceptions of their substance abuse knowledge and related classroom pedagogy skills across: (i) school levels kindergarten/elementary, middle, high school), (ii) school locations (rural, urban, suburban), and (iii) teacher disability assignment (as determined by their students’ primary disability). Descriptive statistics, one-way analysis of variance (ANOVA) repeated measures, and multivariate analysis of variance (MANOVA) was used to analyze the data. The results revealed that although special educators perceive their students abuse substances, they think it is only by a small percentage of students. Significant differences were noted in the teachers’ perception of knowledge in the six substance abuse areas assessed. Significant differences of the teachers’ perceptions of knowledge were also noted across school locations and teacher disability assignments. Future studies should focus on conducting more extensive research in this limited area of study. / text

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

A growing body of research suggests that patterns of personal pronoun use in couples - particularly we-talk (first person plural pronouns) and you-talk (second person pronouns) - are potentially meaningful markers of adaptive and maladaptive functioning, respectively. Despite this growing couple literature, very little is known about the relational implications of we-talk and you-talk in larger social units like families, where relevant interaction patterns are often triadic and involve members of different generations. The present study employed baseline observational and self-report data from a multi-site study of family therapy for adolescent substance drug abuse to (a) describe patterns of personal pronoun use in families consisting of two parent figures and at least one adolescent child, during conversations that had a collaborative (plan a menu) and a conflictual (discuss a recent argument) valence; and (b) explore associations between pronoun patterns and various indicators of adaptive adolescent and family functioning. As hypothesized, automated text analysis of transcripts from 74 English speaking families revealed more we-talk in the cooperative (menu) task, more you-talk and I-talk in the conflict (argument) task, and significant variations in pronoun frequency by family role (more I-talk by adolescents, more we-talk and you-talk by parents). Additional coding, guided by structural family systems theory, took into account the source and referent of each pronoun utterance (e.g., parent-parent we-talk, cross-generation you-talk), and these structural pronoun variables showed stronger associations with concurrently observed family interaction patterns than global (raw count) pronoun variables did. Contrary to expectation, you-talk was a stronger predictor of concurrent family behavior and adaptive youth/family functioning than we-talk, and associations between pronoun patterns and indicators of adaptive functioning were stronger for the conflict task than the cooperation task. The results suggest that relational meanings of pronouns are substantially more complex in triadic intergenerational family interactions than in dyadic romantic relationships. Discussion of these results includes study limitations and possible directions for further research.

Parents who abuse drugs and alcohol are at increased risk of child maltreatment, including the neglect of their children’s health. The present research investigates the effectiveness of the SafeCare® Health module in training mothers with a history of substance abuse living in a residential treatment facility to correctly identify and treat their children’s illnesses. Three mothers of children ages 5-years-old and younger participated in the study. Using a multiple-baseline, single-case experimental design, the research team examined the participants’ ability to select the most appropriate course of action for addressing their children’s illnesses. Results indicate that parents’ skills increased steadily during the intervention, with two of the three participating parents demonstrating mastery of the skills presented. The results suggest that this intervention has great potential to be feasible and effective with this population in this setting. Future research should further investigate the relevance of this intervention with vulnerable populations living in a residential setting to examine whether the changes in targeted parenting skills result in changes in behavior that impact child maltreatment incidence reductions.

There is little known about mothers who are recovering from addictions who lose custody of their children. This hermeneutic thesis, using Canadian phenomenologist Max van Manen’s method and a combination of both scholarly elements and rich storytelling, explores the lived experience of four women recovering from addictions who have lost custody of their children. Using a dual approach of manual and computer-assisted coding, three themes (each with three sub-themes) emerged from semi-structured interviews. The first theme, betrayal, examines three sources of betrayal for the women. The second theme, soul-ache, describes the spaces that a mother finds herself in upon losing custody of her children. The third and final theme, reclamation, follows the mothers as they learn to live again. The findings of this thesis, situated within disciplinary knowledge, extend current knowledge regarding these mothers. The implications arising from this thesis are discussed and recommendations for future research are provided. / 2011-03

This thesis examines the associations between substance use/ misuse and mental health outcomes among Canadians with a Traumatic Brain injury (TBI). Its primary aim is to explore whether or not individuals with a TBI have higher rates of substance use/misuse and poorer mental health than Canadians without a TBI, and to examine two competing hypothesis that help to explain these behaviours -- the impaired brain functioning and the general coping hypotheses. Drawing on data from the 2009-2010 Canadian Community Health Survey, a nationally representative cross-sectional survey, this research assessed substance use and mental health outcomes among those with a TBI, as well as two control groups: (1) individuals with a back or spinal injury; and (2) healthy non-injured controls. Analyses include descriptive statistics and multivariate regressions (logistic and multinomial) adjusting for a range of injury and socioeconomic variables. Those with a TBI demonstrated significantly elevated rates of binge drinking, illicit drug use, and having an anxiety disorder relative to non-injured Canadians, and provided partial support for both the impaired brain functioning and general coping hypotheses to substance use. These findings indicate that public health policy should increase awareness amongst healthcare and social workers on the necessity of continued follow-up of those who experience a TBI in order to reduce future health conditions and to reduce the likelihood of re-injury.

THIS STUDY EXAMINES SUBSTANCE ABUSE IN SOUTH AFRICA WHICH POSES MAJOR CHALLENGES IN THE AREAS OF ASSESSMENT, TREATMENT, REHABILITATION AND AFTER-CARE. THIS HAS A DIRECT IMPACT ON A NUMBER OF POLICIES DEALING DIRECTLY WITH RESOURCES, BUDGETS, NORMS AND STANDARDS OF / FOR SERVICE DELIVERY. THIS STUDY FOCUSSES ON THE AGENCIES AND THE INDIVIDUALS BECAUSE BOTH ARE CRUCIAL IN THE INTERVENTION, PLANNING OF TREATMENT AND REHABILITATION PROGRAMMES AS WELL AS IMPLEMENTING POLICY. THIS RESEARCH INVESTIGATED THE TYPES OF TREATMENT AVAILABLE, THE MULTI-DISCIPLINARY TEAM, ITS FUNCTIONS, AREAS OF NEED AND CONCERNS REGARDING THE CURRENT POLICIES. THE ASSESSMENT OF THE SERVICE DELIVERY ORGANISATIONS REVEALED, DEDICATION BUT ALSO A NUMBER OF ISSUES THAT NEEDED TO BE DEBATED UPON. FEW AGENCIES CHANGED OR USED MORE UP TO DATE INTERVENTION MODELS, WHICH GIVES THE CLIENT FREEDOM OF CHOICE AND ALLOWED HIM/HER TO BE THE MAJOR CHANGE AGENT IN HISIHER BEHAVIOUR CHANGES. A LACK OF KNOWLEDGE OF CHEMICAL SUBSTANCES AND SUBSTANCE ABUSE LEADS TO INAPPROPRIATE TREATMENT PLANS WHICH IN MANY INSTANCES LEADS TO THE RELAPSE RATES REMAINING HIGH. A STUDY OF THE MULTI DISCIPLINARY AND INDIVIDUAL TEAM MEMBERS OF GOVERNMENTAL, NON-GOVERNMENTAL AND PRIVATE REHABILITATION AND TREATMENT CENTRES WAS CONDUCTED TO ASSESS THEIR KNOWLEDGE BASE AND ISSUES THEY FACED. AN EXAMPLE WOULD BE THE DUAL DIAGNOSED CLIENTS, WHO HAVE FALLEN THROUGH THE NET BECAUSE OF LACK OF TRAINING THEORY AND PRACTICE 0N THE PART OF THE MULTI-DISCIPLINARY TEAM. THE STUDY REVEALED THAT THE GAP BETWEEN POLICY AND PRACTICE NEEDS TO BE MORE INTEGRATED TO ACHIEVE THE DESIRED DRUG FREE INDIVIDUALS. AGENCIES DO NOT HAVE THE TIME OR THE ENERGY TO DEAL WITH AND IMPLEMENT NEW AND OTHER POLICY CHANGES. THIS RESULTS BECAUSE OF OVERLOAD, LACK OF FUNDS AND LACK OF HUMAN RESOURCES. THROUGH THE LITERATURE STUDY A COMPREHENSIVE PROGRAMME FOR TREATMENT AND REHABILITATION IS RESEARCHED TO MEET THE UNIQUE INDIVIDUAL NEEDS OF THE SUBSTANCE ABUSER AND ALSO THE TEAM /INDIVIDUALS WHO PLAN THE TREATMENT. A LARGE NUMBER OF MODELS ARE DISCUSSED SO THAT THE PLANNING TEAM CAN CHOOSE APPROPRIATE ONES TO MEET THE NEEDS OF CLIENTS. ANOTHER AREA OF ASSESSMENT WAS THE INDIVIDUAL TEAM MEMBERS OPINIONS ON TREATMENT TIME FRAMES AND TREATMENT STRATEGIES. THIS THESIS RESEARCHED EVERY COMPONENT TREATMENT PROGRAMMES AND STRATEGIES AND SHOULD BE USED AS A REFERENCE AND TRAINING GUIDE BY ALL THOSE INVOLVED IN SERVICE DELIVERY IN THE FIELD OF SUBSTANCE ABUSE IN SOUTH AFRICA AND GLOBALLY. OF SPECIAL EMPHASIS WOULD BE THE UNDERSTANDING OF DUAL DIAGNOSIS AND THE PROVISION OF A SUITABLE TREATMENT PROGRAMME. THE INVESTIGATION INTO SOCIAL POLICIES PROVIDES FOR A MORE COMPREHENSIVE PARTNERSHIP BETWEEN AGENCIES AND GOVERNMENT TO MEET THE NEEDS FO SUBSTANCE ABUSERS IN SOUTH AFRICA AND WORLD WIDE. / Thesis (Ph.D)-University of KwaZulu-Natal, 2005.

Substance abuse is a major problem amongst the youth worldwide. The goal of this study was to explore the knowledge and perceptions on the dangers of substance abuse among the affected youth attending St John of God Community Services, in Mzuzu, Malawi. The participants in the study were selected on the basis that they had been diagnosed as having a substance induced psychotic disorder and are currently receiving treatment from the hospital either as hospitalised or as outpatients. The study used both quantitative and qualitative research designs. The purposive sampling method was used to identify the quantitative sample while the qualitative sample was selected by using the theoretical sampling method. Forty-five participants completed the questionnaire to provide the quantitative data and 7 participants were interviewed to provide the qualitative data. The quantitative data was analysed by using Statistical Package for Social Sciences (SPSS) and the results were presented in tables and graphs. The qualitative data was analysed manually and the results were presented by using the participants' direct quotes. The findings of the study revealed that lack of knowledge and perceptions of the dangers of substance abuse are not the only contributing fac tors to substance abuse amongst the youth. As the results showed, that the youth had vast knowledge on the dangers of substance abuse and they also perceived these dangers negatively. However, it was found that other factors such as the enjoyment aspect and unemployment influenced the youth to start abusing substances. / Thesis (M.N.)-University of KwaZulu-Natal, 2005.