Injurious Suicide Attempts Among Middle and High School Students: Association with Sexual Dating Violence and Substance Use Christian Nwabueze, Hilary Elom Introduction: Suicide is one of the leading causes of death among the teenage population. Substance use and sexual dating violence is also common among this group. Aim: To determine the association between sexual dating violence, substance use and the risk of injurious suicide attempts. Methods: The data consists of a nationally representative sample of 15, 624 Middle and High School students in the 2015, Youth Behavioral Risk Surveillance System Survey. Majority of the respondents were aged 13 to 17 years. Results: There were 7757 (50.03%) females and 7749 (49.97%) males. There were 8666 (66.3%) and Blacks and Asians were 14.87% and 5.63% respectively. A total of 1072 (9.87%) had attempted injurious suicide in the past year (females=68.1%, males =31.91%). About 10% had experienced sexual violence within the last year. The proportion attempted suicides who were illegal drugs users, current alcohol, tobacco and marijuana users were 9.14%, 8.87%, 9.08%, 9.36% respectively. Those who did not experience sexual dating violence had a higher odd (OR=1.81, CI = 1.497 – 2.188, P = <0.0001) of injurious suicide than those who did not date at all. Abstinence from smoking, alcohol, marijuana and illegal drug use (OR = 0.396, CI = 0.341 – 0.459, p = <0.0001) in the past month was significantly associated with reduced risk for injurious suicide attempts. Conclusion: Abstinence from substance use reduces the risk for injurious suicide attempts among middle and high school students. Sexual dating violence seems to be a significant risk factor for injurious suicide attempts in this group. Key words: suicide, sexual violence, substance use, abstinence

Adverse childhood experiences (ACEs) are linked to risky health behaviors (e.g., alcohol, substance use), chronic health conditions (e.g., diabetes, cancer), higher medical costs, and early death. Children exposed to trauma are seven times more likely to develop a substance use disorder in adolescence or adulthood compared to those who were not exposed. However, not all children who experience ACEs will grow up to have detrimental outcomes. One aspect of parenting that may be particularly relevant for promoting risk or resilience in the context of adversity is parental emotion socialization (ES). Despite the established link between ACEs and substance use, no research, to date, has examined whether ES serves as a risk or protective factor in the context of ACEs and subsequent substance use. As such, the present study aims to fill this gap by examining ES as a moderator of the relationship between ACEs and substance use. Participants (N=550, age M=20.4, SD=4.7) were recruited from SONA systems: a university operated online platform where students may choose to voluntarily participate in a variety of self-report research studies in exchange for course credit or extra credit. The present project comes from a larger study called the Religion, Emotions and Current Health (REACH) study. Retrospective measures regarding the participants' adverse childhood experiences and their parent’s emotion socialization behavior include The Adverse Childhood Experiences Survey (ACEs) and The Coping with Children’s Negative Emotions Scale (CCNES). Alcohol Use Disorders Identification Test (AUDIT) and the Drug Abuse Screening Test (DAST-10) was used to assess for current substance use. All analyses will be conducted using the R package for statistical computing. Bivariate correlations will be examined for all variables using Pearson’s correlation coefficient method. A hierarchical multiple regression analysis will be implemented to determine if parental emotion socialization moderates the relationship between childhood adversity and substance use. The estimated multiple regression formula, ( Y) ̂= i + b1X + b2M + b3XM + ey; where Y ̂ = outcome (i.e., current substance use), X = the predictor variable (i.e., ACEs), M = primary moderator variable (i.e., parental emotion socialization from childhood), and b3XM= interaction will be applied with R’s base lm(Y~X*Z) function. The proposed study will test two main hypotheses: 1) ACEs from childhood will act as a predictor for current substance use in adulthood (as reflected in the literature) 2) ES will act as a moderator on the relationship between ACEs and substance use; however, the nature of this interaction will vary depending on the type of ES behaviors. Specifically, the link between ACEs in childhood and substance use in early adulthood will be exacerbated by a childhood marked by high levels of non-supportive ES; whereas, the link between ACEs in childhood and substance use in early adulthood will be lessened (buffered) by a childhood marked by high levels of supportive ES.

Pain is the leading cause of Emergency Department (ED) visits making it one of the primary concerns of the emergency medical field. The experience of pain is subjective and unique to every individual making it difficult to effectively manage. As a result, the subjective nature of pain is also commonly associated with drug-seekers often claiming to have pain simply to receive narcotics to support their addiction. There have been numerous studies completed to determine how to effectively recognize drug-seeking. This integrative literature review will identify the common behaviors that have been seen as indicators of drug-seeking in the ED. The evidence collected from articles published between 2001 and 2011 examined the use of assessment tools, drug screening, and prescription monitoring programs for distinguishing drug-seekers. The evidence did not identify a specific evaluation tool used to recognize drug-seekers; however, the research did suggested that using these techniques can help to identify drug-seeking behavior allowing emergency medical staff to effectively manage pain in the ED.

Research indicates that young adults have relatively high rates of psychological distress and substance use. Research also suggests that psychological distress and substance use are correlated as individuals may turn to substance use as a coping mechanism for psychological distress. The goal of the current research is to examine the relationship between psychological distress and substance use among college students. A secondary question is to determine if the relationship between psychological distress and substance use is different for men and women. College students are a good sample for this research question for a number of reasons. First, more young adults are enrolled in college today than ever, with about 70% of high school graduates in 2011 enrolling in college the following fall. Second, research indicates that the prevalence of substance use is relatively high among college students and that young adults enrolled in college are at increased risk for certain types of substance use compared to their same age peers who do not attend college. Third, research indicates that college students are at greater risk for psychological distress compared to their same age peers who do not attend college. This may be due to the fact that college students are exposed to unique stressors that are likely to increase risk for psychological distress. The current research uses data from a sample of college students to examine the relationship between psychological distress and substance use. Several forms of substance use are included for the dependent variable. First, a measure of binge drinking is used based on the Harvard School of Public Health College Alcohol Study to measure binge drinking. Second, a measure of marijuana use is included. Third, a measure of prescription drug misuse is included based on the National Survey on Drug Use and Health. All substance use measures are coded 0 = No and 1 = Yes.; The independent variable of interest is psychological distress, measured with Kessler's Psychological Distress Scale (K10). We also measure respondent's sociodemographic characteristics (e.g., age, gender, race/ethnicity) and correlates of substance use (e.g., Greek affiliation, peer substance use, and grades) to include as controls in our analysis. A positive correlation is expected between psychological distress and substance use, as respondents with higher levels of psychological distress will be more likely to report binge drinking, marijuana use, and prescription drug misuse. In addition, it is expected that the relationship between psychological distress and all forms of substance use is moderated by gender. The relationship between psychological distress and substance use is expected to be stronger for females. To test research hypotheses several logistic regression models are estimated.

This thesis examines the possibilities of living an authentic life for an alcoholic, both in and out of Alcoholics Anonymous. Authenticity is explored using the existential models put forth by Jean-Paul Sartre and Soren Kierkegaard. Alcoholics Anonymous figures prominently in this analysis. It is suggested that A.A. acts inauthentically in its claims that it is not a religious organization. A.A. creates special problems for female alcoholics because of the sexist and masculinist nature of its primary literature. While A.A. claims that its message is the only way by which an alcoholic can recover, other treatment methods exist. Suggestions are made that A.A. revise its main texts, and two alternative organizations to A.A. are briefly discussed.

Twelve-Step programs of substance abuse recovery are the most popular and most used mutual-help model in the U.S. One of the pivotal aspects of Twelve-Step is the often controversial idea of powerlessness. While a few recent dissertations have been conducted to look at issues related to women in Twelve-Step, most of what has been published in the literature on powerlessness in Twelve-Step is hypothetical, anecdotal, and theoretical. There is debate about the usefulness of the concept of powerless, especially for women in recovery, though no research was found specifically exploring this issue. The current study examines the experiences of powerlessness among women who are using Twelve-Step substance abuse recovery. Because experiences of powerlessness are abstract and may be difficult to articulate, a data collection method called ZMET (Zaltman, 2004) was utilized. This method helped women discuss their thoughts and feelings about powerlessness through the use of images of representative metaphors and analogies. Participants were 13 women who were in various stages of recovery using Twelve-Step. In-depth interviews were used to understand women's experiences of powerlessness in their recovery while two surveys were used to determine women's levels of affiliation with Twelve Step programs and their level of agreement with the First Step of Twelve Step. Overall, women felt positively about powerlessness in their recovery and felt it provided a sense of relief. Eleven of the 13 women felt powerlessness was an important aspect of their recovery while two felt it was either not relevant or not something they fully embraced. In exploring the metaphors women had for their experiences of powerlessness, a number of themes emerged. Many of the metaphors indicated processes while some were static. Themes also included metaphors of current events, nature, and babies. Other themes were: Higher Power; a general sense of powerlessness over many things in life and; choosing not to share certain experiences in Twelve-Step meetings. Implications for women in recovery, clinicians, and future research are included as well as strengths and limitations of the study. / Ph. D.

This descriptive study explored whether women in substance abuse treatment who report a history of sexual and/or physical abuse have different drug use profiles than women who do not report such abuse. The data originated from a NIDA (National Institute on Drug Abuse) study designed to evaluate the effects of different treatment modalities in inpatient substance abuse treatment for women. The study compared the drug profiles of women in four areas: drug of choice, frequency of use, problem severity, and level of psychological problems. The following groups were compared: 1) women who did not report abuse, 2) women who reported physical abuse only, 3) women who reported sexual abuse only, and 4) women who reported physical and sexual abuse. The study did not find significant differences in either drug choice, problem severity, or frequency of drug use. In the area of psychological problems, the study did find a significant difference in interpersonal sensitivity between participants who reported a sexual abuse history vs. the other abuse groups. This finding suggests that women with a sexual abuse history are more mistrustful in their relationships with others, and this may suggest that group treatment will be more difficult for sexually abused women than individual treatment. Overall, the findings may also suggest abused women do not need different drug or alcohol treatment approaches than non-abused women although it does not preclude attention to the effects of their abuse. / Master of Science

This study examines how substance-abusing women and their partners perceive their relationship and how these perceptions are related to women's treatment completion. The participant pool came from a larger study comparing the effects of adding couples therapy to traditional substance abuse treatment. All couples were in a committed relationship of at least six months duration. The sample was 166 mostly white and lower income women and their partners. The primary drugs of choice were opiates, alcohol, and cocaine. Relationship perceptions were assessed prior to treatment by using the Kansas Marital Satisfaction Scale, the Dyadic Formation Inventory, and the Family Assessment Device. These scales all measure relationship quality as perceived by the subjects. Perceptions of the women with substance abuse problems who completed treatment did not differ significantly from those who dropped out. The partners' perceptions did differ significantly. Partners of women who dropped out reported more couple commitment and more couple interaction as measured by the DFI, and higher overall general functioning, as measured by the FAD, than the partners of those who completed. These findings suggest the importance of partners' involvement in, and support for, the woman's drug treatment. / Master of Science

Despite the fact that much information is available in the literature regarding adolescents with a substance abuse problem, little exists that focuses on the parents' personal experience dealing with this problem. Not many researchers actually interviewed parents--when they did, it was usually for parents' observations of their adolescent or their views of treatment success--and seemingly none did so for the purpose of allowing parents to tell their own story in their own words. Furthermore, most of the existing literature has tended to see such parents in terms of their deficits, even when advocating the importance of their being included in the treatment process. Through the lens of a Family Systems perspective and by allowing parents to speak for themselves, this preliminary study explores what it was like for three parents to have had their sons go through a residential substance abuse treatment program. Six categories emerged from the semi-structured interviews: initial departure, settling in, homecoming, resources, costs and losses, and advice to other parents and professionals. The findings expand the primarily negative view of such parents to include a richer and more complex understanding. / Master of Science

In my thesis, I will argue that while at first glance Spinoza's system seems to conflict with itself and provide an explanation of the mind that can be more confusing than helpful, its aspect of panpsychism provides a sort of lifeline for understanding. Not only does Spinoza's cosmopsychism make his system cohesive, but it can also be independently motivated by ideas that are compatible with the more contemporary intuitions in philosophy of mind. I will explore the specific nature of this universal mentality, how Spinoza's particular genre of panpsychism relates to other theories of panpsychism, and how his conception of omnipresent mind affects our understanding of consciousness and its place in the world.