Texte remanié de Diss.: Philosophie--Basel, 1974. / Bibliogr. p. I-IV. Index.

abstract: Specific cultural variables have been found to protect against the onset of alcohol, tobacco and drug use among Latino adolescents. It has been suggested that targeting similar cultural components during the treatment of drug dependence and abuse for Latino adults may also enhance the effectiveness of the intervention, although few studies have explored this hypothesis. The current study attempted to remedy this disparity by exploring the potentially protective influence of two cultural variables, ethnic pride and family traditionalism, on self-efficacy to avoid drug use following residential substance abuse treatment among 99 Hispanic and 85 non-Hispanic White males. Results of the study indicate that higher levels of ethnic pride predict greater confidence to remain abstinent from drugs following substance abuse treatment, and that this relationship is stronger among Hispanic participants than non-Hispanic White participants. Family traditionalism was not a significant predictor of drug avoidance self-efficacy for either group, suggesting that some specific cultural variables may be better targets for substance abuse treatment than others. Study limitations and future directions for research and clinical practice are discussed. / Dissertation/Thesis / M.A. Psychology 2011

There is a vast amount of information that the bones can offer and this can be on a macroscopic level, a microscopic level, or both. Understanding the changes in bone morphology can provide an understanding the broader picture of an individual’s life. The natural progression of changes in bone follows the natural progression of life. On the macroscopic level, morphological changes occur to skeletal elements such as the pubic symphysis and the sternal rib ends. These characteristics are used when determining the age of an individual. On the microscopic level, histological methods have been developed to determine the age of an individual based on changes in the microstructure of an element. While age at death estimations are based on a known sequence of change over time, time is not the only variable that effects bone morphology. Different pathologies and trauma can also alter skeletal elements. Just as disease processes and trauma act of signaling pathways in the body that cause changes in bone to occur, drug use also acts on the brain and can affect the same signaling pathways that are involved in bone regulation. It is hypothesized here that chronic cocaine use will have a detectable effect on bone morphology. The study sample used consisted of rats, some exposed to cocaine and others not. The experimental groups consisted of eleven Male Wistar Rats (Rattus norvegicus) from the Laboratory of Behavioral Neuroscience at Boston University in Boston, Massachusetts. The rat’s self-administered cocaine at a 0.3 mg/kg dosage and the concentration of the IV solution was 1.6 mg/ml of cocaine. The control group includes five female Sprague Dawley rats (Rattus norvegicus) from the Boston University Animal Science Center in Boston, Massachusetts. These rats were exposed to a training protocol but were not given any drugs prior. All samples went through a dissection and maceration process to obtain the femora and humeri. Mass, volume, and length measurements were taken for each element to be used for later analysis. One femur was chosen at random from each rodent to be used for histological analysis. Femora were embedded in a 2-part epoxy resin and then cut in half using a diamond band saw. A Buehler IsoMet Low Speed Saw was used to obtain thinner sections and a Buehler MetaServ 250 grinder was used to achieve a thickness of 100-120 μm. India ink was used for staining and all stained sections were put onto slides, covered with Permount and a cover slip, and labeled. Upon microscopic examination, it was determined that the outer circumferential lamellar bone thickness would be measured and compared between the experimental and control groups. Photographs were taken of each cross-section at 1x and 4x magnification through the NIS-element software. The ImageJ image-processing program was used for analysis. The thickness of the outer circumferential lamellar bone and the thickness of the total cross-section was taken at four random locations of each 4x magnification photograph. The ratio of the thicknesses and the outer circumferential lamellar bone thickness alone were compared. When comparing density values calculated from the original mass and volume measurements, a significant difference was found between the control and experimental groups. Samples that had been exposed to cocaine had lower density values than those not exposed to any drugs. The control group mean density equaled 1.492 g/mL and the experimental group mean density equaled 1.082 g/mL. A significant difference was found between the ratio of the thicknesses and between the outer circumferential lamellar bone thickness alone. The experimental group had ratio values significantly higher than the control group. The control groups mean ratio equaled 0.2686 while the experimental groups mean ratio equaled 0.4427. This indicates that in the control group, the outer circumferential lamellar bone thickness, on average, covered about 25% of the total cross-section, and the experimental groups outer circumferential lamellar bone thickness, on average, covered almost 50% of the total cross-section. These results were similar when comparing the outer circumferential lamellar bone thickness alone. The control groups thickness was significantly lower than the experimental groups thickness. The control group’s thickness measurements had a mean of 189.7674 μm and he experimental group’s thickness measurements had a mean of 343.2753 μm. These results are just the preliminary data that shows that chronic cocaine use does have an effect on bone morphology on a microscopic level. Only on histological characteristic was analyzed but there are many more traits that can be analyzed.

BACKGROUND: Substance use disorders are highly prevalent and highly stigmatized. They are defined as conditions in which the use of one or more substances, in spite of negative consequences, leads to a clinically significant impairment or distress. Stigma is a characteristic deemed undesirable by society. Stigma is dependent on the relationship between the specific discrediting or undesirable characteristic and the social context. LITERATURE REVIEW FINDINGS: The various manifestations of stigma include public or external stigma, provider stigma, and internal stigma. External stigma is the negative beliefs that society holds about people in stigmatized groups, for example patients with substance use disorders or HIV. Another type of stigma is provider stigma, referring to the negative beliefs that providers hold about patients belonging to these stigmatized groups. Internal stigma is defined as the devaluation that people in stigmatized groups hold about themselves in relation to society. Stigma is continued when there is a lack of familiarity and education with a stigmatized condition or group. PROPOSED PROJECT: The proposed project aims to address and decrease provider stigma in physician assistant trainees before they begin their clinical training through an educational intervention. This thesis will propose the development and evaluation of a new curriculum to educate physician assistant students on substance use disorders and their treatments, frame substance use disorders as chronic diseases, and aid physician assistant student trainees on recognizing their attitudes and biases, or prejudices, toward working with patients with substance use disorders. The project will assess attitudes before and after the education intervention to analyze if attitudes toward patients with substance use disorders have changed as a result of the educational intervention. The goal of the educational curriculum is to improve physician assistant student attitudes toward working with patients with substance use disorders before they encounter this population in clinical practice. SIGNIFICANCE: Physician assistants are clinicians who diagnose illness, develop treatment plans, manage their own patients, and often serve as the primary clinician for patients. Physician assistants will encounter a number of patients with substance use disorders throughout the course of their careers. Addressing provider stigma in this group will help improve treatment outcomes in this patient population and give the students the confidence and knowledge to manage patients with substance use disorders. As a result of completing this curriculum, physician assistant students will have decreased stigma and better attitudes toward working with patients with substance use disorders.

Magister Artium (Child and Family Studies) - MA(CFS) / Substance use amongst youth in Grabouw has been recognised as a concern by the community. Essentially parenting styles and family functioning are important contributors to adolescents‘ engagement in substance use. Adolescence is a sensitive time for youths as they are faced with many developmental changes; consequently it is vital for positive parenting styles and healthy family functioning to be present to ensure healthy development. However, previous research shows that families of substance users do not function in a healthy manner and tend to have negative parenting styles. The aim of this study is to compare family functioning and parenting styles within the families of substance users and non-users in Grabouw. The study used a quantitative approach with a cross-sectional, correlational comparative design. The sample consisted of 300 adolescents between the ages of 15-17 years in schools in Grabouw. The participants completed the McMaster Family Assessment Device (FAD) and the Parenting Styles Dimension Questionnaire (PSDQ). Descriptive statistics and the Pearson correlation were used to analyse the data. A t-test was used to determine the differences between groups. The findings of the study show that there is no difference in family functioning between the user and non-user groups. Notably, findings reveal that authoritative and permissive parenting styles are the prevalent parenting styles in both user and non-user groups. Furthermore the results indicate that the authoritarian parenting style was higher in the substance using group. The findings also show that there is no correlation between family functioning and the authoritative parenting style.

This convergent parallel mixed methods study based on Social Ecological Model investigated substance abuse among undergraduate university students at one of the universities in Ethiopia. For quantitative strand of study, data was collected from 422 randomly selected undergraduate students. Data were analysed using Statistical Package for Social Sciences version 17. For qualitative strand, face-to-face interviews were conducted with 17 purposefully selected participants directly involved with students abusing substances. The findings revealed that factors at individual, interpersonal, institutional, community and societal levels affect substance abuse among university students. The study also uncovered loopholes in the policies, guidelines, and programme implementations in the prevention, control, and management of substance abuse at the university. Based on the findings, the researcher developed guidelines based on the findings of the study, the critical literature review, and the inputs from the experts who reviewed the guidelines. The researcher assumes that implementation of the guidelines will reduce substance use and substance abuse among university students. / Health Studies / D. Litt. et Phil. (Health Studies)

The primary purpose of this study was to utilize an ecological-transactional theoretical framework and an existing longitudinal data set to examine the relationships among neighborhood context, family supervision, association with deviant peers, and patterns of substance use during adolescence. Participants included 821 youth from the Longitudinal Cohort Study of the Project on Human Development in Chicago Neighborhoods (PHDCN) data set. Data include primary caregiver and youth self-report measures of adult supervision, peer associations, and substance use. Data also include community survey and systematic social observation measures of neighborhood social processes such as collective efficacy, social disorder and social capital, neighborhood disadvantage, policing, and perceived danger collected from 1994-2001 in the city of Chicago. Latent growth curve modeling analyses were used to answer the research questions. Study results were significant associations between neighborhood social processes and substance use. Contrary to previous findings, more positive neighborhood social processes were related to higher levels of substance use for females. For both the African American/Black and Hispanic/Latino groups, deviant peer associations were related to higher levels of substance use at age 12. For the Hispanic/Latino group, higher neighborhood socioeconomic status was related to greater increases in substance use over time. Study results suggest the continued importance of research to discover sex and ethnic variation in associations among contextual influences and adolescent substance use. The current study makes a significant contribution to extant literature by examining the influence of neighborhood social processes, deviant peer associations, and supervision on substance use trajectories. Including peers, parental, and neighborhood factors&mdashin one model&mdashprovided a more comprehensive examination of how contextual influences impact the development of adolescent substance use. In addition, using a multilevel analysis with a diverse, longitudinal data set provided further insights into understanding ethnic and gender variation in the development of adolescents' substance use. Supplemental files include description of PHDCN scale items, HOME measure, Deviance of Peers measure, and items from the Substance Use Interview.

This thesis portfolio includes two studies, a qualitative grounded theory of treatment adherence in people who inject drugs (PWID) and a systematic review of staff turnover in substance misuse services. The empirical paper is presented first, the findings of which led to the systematic review. The qualitative interview study arose from observations made within a clinical trial for the treatment of chronic Hepatitis C (HCV). The Chief Investigator of the ERADICATE trial team initially approached the Adult Psychological Therapies Service to investigate what seemed to be an anomaly – patient engagement with HCV treatment had far exceeded expectations. Indeed, positive treatment adherence is not common among PWID. What is more remarkable is participants continued the trial while experiencing the highly aversive side-effects of interferon, a medication known to mimic opioid withdrawal. It is important, if not crucial, to acknowledge the wider socio-cultural context in which this thesis portfolio was produced; the political landscape changed significantly over the course of writing. Divisive judgements about what characteristics make a person worthy and deserving of resources, became more dominant in public discourse and heightened the author’s awareness to these aspects in the data. PWID are among the most marginalised, and stigmatised groups in society. Several of the participants interviewed were homeless and all were at various points on a relapsing trajectory of injecting drug use. Perhaps positive treatment adherence in this population is counter-intuitive because intuition is often based on assumptions derived from implicit biases. Indeed, until 2008, Scottish policy systematically denied HCV treatment to PWID. Due to the assumption that re-infection was inevitable, treatment was seen to be wasteful. Epidemiological studies now show is that public health is significantly improved when PWID are treated, as population prevalence goes down. Completing this thesis led to an examination of fundamental assumptions, not just relating to the participants or the data, but also relating to the question of what Clinical Psychology is. What can we contribute to the science of human behaviour? How does a self-aware mind arise and become autonomous? What leads adults to mentalize and enact their intentionality through particular behaviours, like taking medication? In grappling with these questions, the reader will detect the influence of developmental theorists, Vygotsky, Erikson and Bowlby. Seminal experiments, such as Tronick’s still face (Tronick, 1989)1 and Harlow’s monkeys (Harlow and Zimmerman, 1958)2, alongside newer fields of interpersonal neurobiology and developmental trauma have supplied the soil in which to ground the data gathered in this study. From our earliest days we are designed to absorb stimuli and integrate our perception into a gestalt. When PWID are characterised as “chaotic”, there is a failure to appreciate what this may really reflect: difficulty making sense of internal experience resulting in the absence of order, coherence and meaning. Therefore, the ontological presupposition underlying both the empirical paper and systematic review, is that humans are resilient, relational beings. When the correct conditions and contingencies are in place, our innate propensity to learn and grow can manifest in positive, adaptive behaviour. Narratives are not only ways of seeing the world, but ways of constructing it; we live through and are created by the stories told by others and ourselves (Murray, 2003)3. The public narrative of scepticism that has emerged around scientific endeavour, makes it all the more incumbent upon researchers to carry out their work with personal conviction, integrity and transparency (Rea, 2017, February 22)4. This qualitative analysis was completed with a high level of scientific rigour. Indicators of quality were employed throughout, for example, particular attention was paid to preserving the colloquial expression of participants in transcription and substantiates the authentic representation of their voice. The resultant grounded theory shows that the interpersonal context is a key part of adherence behaviour among PWID. This finding precipitated another question, if good quality relationships are important for patient engagement, how do staff stay engaged in the task of providing consistent, sensitive care on a sustained basis? The current evidence base on supporting and preserving compassion did not substantiate a systematic review, however, the opposite phenomenon, people leaving their jobs has been explored. As Clinical Psychologists we are able to connect with and influence different audiences by skilfully adapting our language. In order to appeal to managers and team leaders, the most pragmatic way of framing staff disengagement, was to examine actual staff turnover as a ‘hard’, concrete outcome. The methodological quality of studies included for review was reasonable in the context of methodological limitations. Findings point to the importance of collective support, good quality relationships and job satisfaction in mitigating against turnover in substance misuse services. This thesis portfolio is a sensitive and pragmatic understanding of engagement in both PWID and staff with the respective systems within which they are embedded. The results are contextualised and oriented toward medical colleagues working in HCV treatment, service leaders and fellow applied psychologists.

abstract: Juvenile delinquency is a complex issue that effects youth, families, and society. Studies have found that parenting styles are a significant contributor to numerous behaviors that influence juvenile delinquency, specifically substance use and poor academic achievement. This literature has been used by to the juvenile justice system to develop family based interventions for delinquent youth in efforts to reduce recidivism. However, previous studies have primarily sampled from the general population, which has limited their usefulness in creating selective interventions for the delinquent population. This thesis offers Baumrind (1966) and Maccoby & Martin's (1983) theory of parenting style typologies as a framework for understanding the effects of parenting style on substance use and academic achievement among delinquent youth. Using juvenile court case files from Maricopa County collected from 2005-2010, (N = 181), logistic regression was performed to test the hypotheses that (1) delinquent youth with Authoritarian, Uninvolved, and Permissive parenting will be more likely to use substances than youth with Authoritative parenting and that (2) delinquent youth with Authoritarian, Uninvolved, and Permissive parenting will be more likely to have poor academic achievement than youth with Authoritative parenting. Using Authoritative parenting as the reference group, it was found that delinquent youth with Permissive and Uninvolved parenting had a higher likelihood of substance use than delinquent youth with Authoritative parenting, and that delinquent youth with Permissive parenting had a higher likelihood of poor academic achievement than youth with Authoritative parenting. These findings have important theoretical implications as well as practical implications for intervention strategies for delinquent youth, which are additionally discussed. / Dissertation/Thesis / Masters Thesis Criminology and Criminal Justice 2014

abstract: The primary goal of this study was to investigate whether youth from an affluent community showed elevated rates of substance use and associated problems in young adulthood relative to national norms. The secondary goal was to determine if parents’ “containment,” or stringent disciplinary action, of adolescent substance use as measured in Grade 12 could help predict substance use in senior year of college, over and above other parenting factors. The final goal was to assess trends of substance use over time for stability based on categories of participants’ overall levels of use in Grade 12, (low, medium, high). Results indicated that substance use remained elevated into young adulthood, relative to national norms, consistent with extant research involving upper middle class youth. In regression analyses, high parents’ containment was associated with low substance use in senior year of college; however, the inclusion of Grade12 use as a covariate reduced this association with containment such that it was no longer statistically significant. Such results suggest a mediated effect, with Grade 12 substance use mediating the effects of Grade 12 Containment on college senior year substance use. Finally, upper middle class youth were found to remain in their relative substance use group (low, medium, high) as determined at Grade 12 through all four years of college. Taken together, these results emphasized the importance of high school substance use behaviors as a notable risk factor for problematic substance use over time. / Dissertation/Thesis / Masters Thesis Psychology 2015