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Mortality reports show that most overdose deaths include more than one substance. In addition, there is a gap in the literature that discusses risk factors for polysubstance use. The objective of this study was to explore what factors relate to the likelihood of engaging in polysubstance use, defined as using more than one substance. Specifically, the goal was to evaluate predictors of simultaneous (i.e., the use of alcohol and another substance at the same time in the past six months) polysubstance use and concurrent (i.e., the use of any two substances in the past six months) polysubstance use, vs. no substance use and single substance use combined. Data were obtained from the 2021 CARA Orange County Residents Survey conducted by the Orange County Drug Free Office. Seven hundred thirty-five participants aged 18 years and older were asked about their drug use, risk perceptions of polysubstance use, sensation seeking, ACE scoring, and protective measures used while using drugs and alcohol. SPSS was used to conduct bivariate and logistic regression analysis to predict simultaneous and concurrent polysubstance use from demographic factors, sensation seeking, ACE scores, number of sexual partners, and incapacitated sexual assault. Bivariate and logistic regression analysis demonstrate that neither simultaneous nor concurrent polysubstance use were associated with most demographic factors. Number of sexual partners was positively associated with both simultaneous and concurrent polysubstance use; however, incapacitated sexual assault was not related to either type of polysubstance use. High sensation-seeking and high ACE scores were significantly associated with simultaneous and concurrent use. This research supported the hypothesis that higher sensation seeking and ACE scores were associated with a greater likelihood of engaging in both concurrent and simultaneous polysubstance use. Future research is needed to further explore the frequency and problems associated with polysubstance use. This study sets the groundwork to analyze psychosocial risk factors for polysubstance use.

Focusing on policy consultation, my dissertation consults on the current US addiction epidemic and aims to answer, "What is our disposition to addiction?" Borrowing and clarifying Ulmer's MEmorial method, as established in his text Electronic Monuments, the dissertation combines the ancient Greek practice of theoria, Deleuzian theory, and psychogeographic counter-mapping methods to trace ways in which ideological apparatuses construct addiction. The aim of the dissertation is to reveal an abject value by constructing MEmorials which provide space for individuals to mourn loss and see their relation to that loss. Through mourning, individuals strengthen their ties to other community members and new policy can be made possible. Currently there is not an AIDS-like quilt for the victims of the addiction epidemic; therefore, the dissertation proposes the construction of a physical and electronic MEmorial to addiction. By conducting a psychogeography, a method directly tied to logic and reasoning appropriate to electracy, I traced the abject value of desire as it is constructed through the assemblages that construct the values of the Bradenton, FL community. The psychogeography revealed a categorical image "DE" which I traced through the ideological state apparatuses working their effects on Bradenton, FL. The image also connects to Bradenton, FL to the larger National War on Drugs through the star emblem of John Wayne. Concluding from the method, I argue to create a MEmorial to addiction at the John Wayne Birthplace Museum to reveal the horror of our communal desires and call for national drug policy reform.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

TITLE: Gender differences in substance use and depression among caregivers AUTHOR INFO Memunat Ogunmefun Manik Ahuja Author Affiliations: College of Public Health, East Tennessee State University, Johnson City, TN 37614, United States Background: Around 20% of adults in the United States provide care for a loved one, with approximately 61% of these caregivers identifying as women. Typically, a caregiver is defined as someone who provides help and support to a family member or friend who is facing illness or disability as a result of a medical condition. Caregiving may be rewarding, but it can also cause significant psychological strain, leading to adverse consequences, such as turning to substance use to cope with stress. Increased levels of stress in caregivers can make them more susceptible to various health problems, such as depression and anxiety disorders, sleep disturbances, compromised physical health, cardiovascular disease, and substance use disorders. The aim of this study is to examine the gender differences in substance use and depression among caregivers using a nationally representative sample. Methods: We used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System a nationally representative U.S. telephone-based survey of adults aged 18 years and extracted data for non-metropolitan/rural counties. Logistic regression analyses were conducted separately to test the association between self-identified caregiver status and three outcomes, including depression and current alcohol use. We controlled for past month’s income, race, educational status, and age. Caregiver status was identified based on providing care or assistance to a friend or family member over the last 30 days. Results: Overall, 21.7% (n=13,653) of our participants self-identified as a caregiver, while 19.5% reported depression, past month alcohol use (48.2%), past month smoking (13.5%), and past month marijuana use (4.2%). Significant interactions were found between caregiver status and gender (p=.0001). We then stratified by gender. Among males, self-identified caregiver status was associated with higher odds of depression (OR=1.48, 95% CI, 1.41,1.55). Among females, caregiver status was associated with higher odds of depression (OR=1.48, 95% CI, 1.29, 1.39). Caregiver status did not predict alcohol use. Conclusion: Caregiving has been known to cause psychological strain which may be associated with alcohol use and depression. According to this study, being a caregiver may contribute to depression regardless of gender, but it does not necessarily affect alcohol consumption. The gender differences observed in this study highlight the need for interventions and support programs that are tailored to meet the unique needs and challenges faced by male and female caregivers. It is important for healthcare professionals to consider caregiver status and gender when assessing mental health risk factors.

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Rae Langton's interpretation of the distinction between things in themselves and phenomena solves many traditional problems at the expense of Kant's discussion of the categories and time, which she thinks are irrelevant to explaining the problem of affection. Langton applies the concept "substance" in a transcendentally real manner to things in themselves, in order to argue that we are ignorant of the latter because they are causally inert intrinsic properties. In doing so, she misdiagnoses the source of Humility, which can be properly understood by the fact that things in themselves are not objects of experience. Langton misapplies the concept of substance to things in themselves, and says that substance of the First Analogy is phaenomenon substantiatum. I argue that substance is a concept which should only be applied to matter in order to unite perceptions in an objective time order. / Master of Arts

L'obésité est de plus en plus décrite comme une maladie chronique, complexe et progressive caractérisée par une accumulation anormale ou excessive de graisses corporelles nuisibles à la santé. En plus d'entraîner des altérations métaboliques, physiques et psychologiques importantes, cette condition est associée à une fonction cognitive altérée et une augmentation du risque de maladies neurodégénératives. Afin d'améliorer la prise en charge de l'obésité et de développer des interventions individualisées, il s'avère essentiel de mieux comprendre les facteurs impliqués dans sa physiopathologie, dont l'implication du cerveau. Cet organe joue un rôle central dans la régulation de l'appétit, la prise alimentaire et la prise de poids. Des études d'imagerie par résonnance magnétique (IRM) ont montré des altérations au niveau de la matière grise et de la matière blanche cérébrales avec l'obésité. Ces altérations pourraient être induites par les nombreux désordres métaboliques associés à l'obésité. À l'inverse, ces altérations pourraient rendre un individu vulnérable à l'environnement actuel, ce qui favoriserait le gain de poids. Pour mieux comprendre les mécanismes impliqués dans les altérations cérébrales observées avec l'obésité, il est important de mieux caractériser les différences cérébrales et d'examiner leurs implications dans le développement et la progression de l'obésité. Le Chapitre 1 de ce mémoire présente les résultats d'une méta-analyse visant à examiner les altérations de l'intégrité de la matière blanche dans un contexte d'obésité. Nous avons montré que les individus avec obésité sont caractérisés par une réduction de l'intégrité de la matière blanche dans la partie antérieure droite du corps calleux, un faisceau qui relie les régions frontales impliquées dans les processus cognitifs. Des études futures sont nécessaires pour valider les mécanismes et vérifier si les altérations cérébrales associées à l'obésité sont permanentes ou si elles peuvent être renversées à la suite d'une intervention visant à améliorer la santé cardiométabolique. / Obesity is a chronic, complex and progressive disease characterized by an abnormal or excessive body fat accumulation that induces health issues. In addition to the well-known metabolic, physical and psychological alterations related to this disease, this condition is associated with impaired cognitive function and is a risk factor for neurodegenerative diseases. In order to improve the management of obesity and to develop individualized interventions, it is essential to better understand the factors involved in its physiopathology, including the involvement of the brain. This organ plays a central role in the regulation of appetite, food intake and weight gain. Magnetic resonance imaging (MRI) studies have shown alterations in the brain's grey matter and white matter with obesity. These brain abnormalities could be a consequence of the cardiometabolic alterations associated with obesity. Conversely, these brain differences might constitute risk factors for overeating and weight gain when individuals are exposed to favorable environmental or endogenous conditions. To better understand the mechanisms underlying brain alterations observed with obesity, it remains important to better characterize the brain differences and examine their implications in the development and progression of obesity. The Chapter 1 presents the results of a meta-analysis aiming to examine the most robust and reliable white matter integrity alterations with obesity. Our findings provide evidence that obesity is consistently associated with reduced white matter integrity in the genu of the corpus callosum, a region linking frontal areas involved in cognitive function. Future studies are needed to identify the mechanisms linking obesity with loss of white matter integrity and to verify if these brain alterations are permanent or whether they can be reversed after interventions targeting cardiometabolic health.

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Families are often confronted with some type of crisis during their family life cycle, and the presence of an adolescent substance abuser in the family could result in a family crisis. Most studies focus on the negative implications of substance abuse (Flisher, Parry, Evans, Muller, & Lombard, 2003; Parry et al., 2004). More recently, however, researchers have begun to move away from the pathogenic approach to a more strengths-based approach. Therefore the aim of this study was to investigate which factors are associated with family resilience in families with an adolescent substance abuser. Given the complexity of resilience, the Resiliency Model of Family Stress, Adjustment and Adaptation (McCubbin & McCubbin, 1988) was operationalised in this study to identify which variables could be associated with family resilience. A combination of quantitative and qualitative methods were used to gather data from a convenience sample of 50 families drawn from the Western Cape, South Africa. In order to control for gender effects, mothers who had in their families an adolescent substance abuser were encouraged to represent their respective families. A biographical questionnaire and seven quantitative self-report questionnaires were completed by each participant. Pearson product-moment correlations were calculated for the quantitative data in order to determine which independent variables (family factors) were associated with the dependent variable (family adaptation). A best-subsets multiple regression analysis was done to determine the linear combination of family characteristics (indicators) that correlates maximally with family adaptation (outcome variable). Thematic analysis was used to identify patterns or themes within the qualitative data during the qualitative data analysis. The results indicate that the level of family adaptation is better the higher the supportive patterns of communication in the family unit; and that the level of family adaptation is lower the more negative communication patterns are present. The results also indicate that family hardiness, the degree to which families use problem-solving and behaviour strategies during crises, and the use and maintenance of different routines and activities facilitate family adaptation. The qualitative results indicate that spirituality or religion, support from extended family, friends or neighbours, clear positive family communication, maintaining hope and a positive outlook, and the acceptance of the adolescent as part of the family contribute the most to family adaptation. The findings of this study could be used to improve the understanding of qualities that help families to adapt, and interventions and services based on these results may provide a meaningful contribution in the adaptation of families who find themselves in similar situations. This study not only is important to broaden the current literature on family resilience in this development phase, but also to help fill the void in current research. / AFRIKAANSE OPSOMMING: Dit gebeur gereeld dat gesinne gedurende een of ander ontwikkelingstadium met ʼn krisis gekonfronteer word. So sal die teenwoordigheid van ’n adolessente middelmisbruiker in ’n gesin op moontlike gesinskrisisse dui. Die meerderheid studies fokus op die negatiewe implikasies van middelmisbruik (Flisher, Parry, Evans, Muller, & Lombard, 2003; Parry et al., 2004). Navorsers het egter onlangs begin weg beweeg vanaf die patogeniese benadering na ’n meer sterkte-gebaseerde benadering. Die doel van hierdie studie was dus om ondersoek in te stel na faktore wat geassosieer kan word met gesinsaanpassing in gesinne met ʼn adolessente middelmisbruiker. Gegee die kompleksiteit van veerkragtigheid is die Veerkragtigheidsmodel van Gesinstres, Verstelling en Aanpassing (McCubbin & McCubbin, 1988) in hierdie studie geoperasionaliseer om veranderlikes te identifiseer wat met gesinsveerkragtigheid geassosieer kan word. ʼn Kombinasie van kwantitatiewe en kwalitatiewe metodes is gebruik om data vanuit ’n doelgerigte steekproef van 50 gesinne woonagtig in die Wes-Kaap, Suid-Afrika in te samel. Om vir die effek van geslag te kontroleer, is ma’s aangemoedig om namens die gesinne as verteenwoordigers aan die studie deel te neem. ʼn Biografiese vraelys en ook sewe selfbeskrywingsvraelyste is deur elke deelnemer voltooi. Vir die kwantitatiewe data is Pearson produkmoment-korrelasies bereken om te bepaal watter onafhanklike veranderlikes (gesinsfaktore) met die afhanklike veranderlike (gesinsaanpassing) verband hou. ʼn Beste substel regressieontleding is gedoen om die liniêre kombinasie van gesinskenmerke (voorspellers) wat maksimaal met gesinsaanpassing (uitkomsveranderlike) korreleer, te bepaal. Tematiese ontleding is in die kwalitatiewe data-ontleding gebruik om patrone of temas binne die kwalitatiewe data te identifiseer. Die resultate dui daarop dat die vlak van gesinsaanpassing beter is hoe hoër die ondersteunende patrone van kommunikasie in die gesinseenheid is; en dat die vlak van gesinsaanpassing laer is hoe meer opruiende patrone van kommunikasie in die gesin teenwoordig is. Verder dui die resultate ook aan dat gesinsgehardheid, die mate van probleemoplossings- en gedragstrategieë wat die gesin gedurende krisisse gebruik, en die gebruik en handhawing van verskillende roetines en aktiwiteite ook gesinsaanpassing fasiliteer. Die kwalitatiewe resultate dui daarop dat spiritualiteit of geloof, ondersteuning van die uitgebreide familie, vriende of bure, duidelike positiewe gesinskommunikasie, die behoud van hoop en ’n positiewe uitkyk, en aanvaarding van die adolessent as deel van die gesin die meeste tot gesinsaanpassing bygedra het. Die bevindinge kan nuttig gebruik word om begrip te verbeter van kwaliteite wat gesinne help om aan te pas. Intervensies en dienste wat op hierdie bevindinge gebaseer is, behoort ʼn betekenisvolle bydra te lewer in die aanpassing van gesinne wat hulle in soortgelyke omstandighede bevind. Die studie is nie net belangrik om die kennisbasis oor gesinslewe in hierdie ontwikkelingsfase te verbreed nie, maar ook om ʼn leemte in bestaande navorsing aan te vul.