This dissertation examines key areas in ontology through the intersection of metaphysics and physics. I argue that modern physics gives us good cause to look for new metaphysical models in place of the classical conceptions of ‘object' and ‘space'. Part I addresses the object in itself, wherein I argue that physics, along with various philosophical concerns, encourages us to re-evaluate the intrinsic/ extrinsic distinction in favour of new classifications. In particular, I use conclusions of relativity theory and the acquisition of mass via the Higgs field as indications of the inadequacy of intrinsicality, concluding that the distinction is more trouble than it is worth. Part II examines the intersection of objects and space, wherein I criticise substantivalism and promote singular fundamental ontologies like relationalism and supersubstantivalism. I examine phenomena like spatial expansion and field theory as well as separability issues more generally to emphasise the lack of rationale for a substance dualism of ‘object material' and ‘space material'. I also challenge the coherence of substantivalism's ‘occupation relation' and the ease of interpreting mathematical models into physical terms. I conclude that, again, the classical notion of ‘object' and its substantival framework are misplaced and should be put aside in favour of developing monistic ontologies. Part III looks at space in itself and the properties commonly attributed to it. I explore issues of separability using key experiments, and what makes spaces ‘physically real', before an extended examination of dimensions and dimensionality, highlighting the confusion physicists express toward such a ubiquitous concept in modern physical theories. I also explore how we use dimensions and reasons for adopting realist or instrumentalist approaches toward them, arguing that much more work should be focused on this area. I conclude with ways in which physics motivates new metaphysical models and suggest improvements for future methodological partnerships.

Stress is associated with poor mental health, specifically anxiety and depression, and stress and mental health problems are predictors of substance dependence and relapse. Social characteristics, such as racial/ethnic minority status, female gender, and low socioeconomic status, are often associated with increased psychological distress and substance use disorders. Pearlin’s social stress theory postulates that this association is due to increased exposure to stress and subsequent experiences of distress related to social disadvantage and decreased access to resources for coping with stress. This project uses a social stress theoretical perspective to examine predictors of substance use after treatment entry and follow-up addiction severity in a large sample of Kentucky substance abuse treatment participants (N = 1123). A conceptual model is tested to determine if social characteristics along with psychological distress, perceived stress, and economic hardship are predictors of substance use and follow-up addiction severity. In addition, since recovery support, efficacy, and self-control have been previously identified as mediators in the stress and relapse processes these factors were included as mediators in the model tested. The conceptual model was tested with three outcome variables, substance use between baseline and 12-month follow-up, follow-up alcohol addiction severity, and follow-up drug addiction severity. Bivariate and multivariate analyses, including logistic regression and ordinary least squares regression, were used to test conceptual models with the full sample and also with a subsample with baseline substance use indicative of potential substance dependence. Findings indicated that significance of predictors varied depending on outcome variable, although recovery support, efficacy, and self-control were significant predictors of all three dependent variables. Findings for each outcome variable are discussed, as well as limitations of the present study, implications for social work practice, and implications for future research.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Bakgrund: I Sverige uppskattas att 29500 personer utvecklat ett problematiskt narkotikabruk. Droger påverkar hjärnans delar som är kopplade till känslor av lust och välbehag. Narkotika är beroendeframkallande, hälsofarligt och påverkar hela människan. I samhället förekommer fördomar mot personer som har substansmissbruk vilket kan leda till utanförskap, mindervärdeskänslor och minskad benägenhet att uppsöka sjukhusvård. Syfte: Syftet var att beskriva sjuksköterskors attityder och erfarenheter av att möta personer som har ett substansmissbruk samt att beskriva de valda artiklarnas datainsamlingsmetod. Metod: Litteraturstudie med deskriptiv design. Elva artiklar inkluderades i studien, 4 med enkäter, 1 enkät med öppen fråga och 6 intervjuer. Artikelsökning genomfördes i databaserna Cinahl och Pubmed. Huvudresultat: Sjuksköterskor hade olika uppfattningar om orsaken till missbruk, där det ansågs bero på antingen brist på eget ansvar eller livsomständigheter. Sjuksköterskor beskrev personer som har ett substansmissbruk som manipulativa, våldsamma och krävande vilket byggde på tidigare erfarenheter. Andra sjuksköterskor hade ett holistiskt synsätt och såg människan bakom missbruket. Viktiga faktorer för en god relation var att vara ärlig och rak. Vidare beskrevs också att utbildning och erfarenhet hade betydelse för sjuksköterskans attityder och erfarenhet av personer som har ett substansmissbruk. Slutsats: I mötet spelar erfarenhet av missbruk, människosyn och utbildning stor roll för interaktionen mellan sjuksköterskan och personen som har ett missbruk. Där det råder brist på utbildning och erfarenhet finns känslor av misstro och frustration som leder till avståndstagande. Positiva attityder sammankopplas med sjuksköterskans förmåga att ha en helhetssyn och öppenhet mot personer som har ett missbruk. / Background: In Sweden it´s estimated that 29,500 people have developed a problematic drug abuse. Drugs affect the parts of the brain that affect feelings of desire and pleasure. Drugs are addictive, harmful to health and affects the whole person. The society’s stigma against people who have substance abuse can lead to alienation, inferiority and reduced tendency to seek hospital treatment. Aim: The aim of this literature review were to describe nurses' attitudes and their experience of meeting people who have a substance use disorder and to describe the selected articles method of data collection. Method: A literature study with descriptive design. Eleven articles was included in the study, 4 questionnaire, 1 questionnaire with an open question and 6 interviews. The search of the articles were carried out in the databases Cinahl and Pubmed. Findings: Nurses have different attitudes about the cause of substance use, some considered it to be because of lack of responsibility and others because of life circumstances. Nurses described people who have a substance use disorder as manipulative, violent and demanding, which was based on previous experiences. Other nurses had a more holistic approach and saw the person behind the substance use. Honesty and straightforwardness were important factors in meeting people with substance use disorder. Education and previous experience were important to the nurse's attitudes and experience. Conclusion: Experience, humanity and education played a major part in the interaction between the nurse and the person who has a substance use disorder. Where there is lack of education and experience feelings of distrust and frustration lead to rejection. Positive attitudes were linked to the nurse's ability to have a holistic approach and openness toward people who have a substance use disorder.

The purpose of this study was to explore the developmental characteristics of young children (ages 11-60 months) with prenatal substance-exposure. A developmental rating scale, the Developmental Checklist (DC) of the Developmental Observation Checklists (DOCs) was utilized. The DC measures the domains of language, motor, social/behavioral, and cognition, as well as overall developmental status.

Substance use disorders (SUDs) are often comorbid with other psychopathology such as mood disorders, anxiety disorders, and personality disorders. While some research suggests individuals with comorbid psychopathology are more likely to seek substance use treatment than those with independent disorders, other studies have also shown many individuals with dual diagnoses still never seek treatment. Moreover, few studies have tried to elucidate the underlying structure of SUD treatment rejection, and instead examined it in more simplistic terms. In addition, studies have tended to examine the impact of individual disorders on treatment rejection, but have not incorporated an empirically supported approach to conceptualizing psychopathology in terms of comorbidity between broad latent dimensions referred to as internalizing (e.g., depression, anxiety) and externalizing (e.g., antisocial personality disorder, polysubstance use) psychopathology. Modeling psychopathology in terms of internalizing and externalizing psychopathology is becoming a prominent approach to understanding mental disorders, yet little research to date has investigated the effects these broad dimensions have on SUD treatment rejection. The current study utilized latent variable modeling techniques to (1) determine the latent structure of SUD treatment rejection in a large U.S. sample, and investigate whether treatment rejection is a multidimensional construct; and (2), to explore the ability of internalizing psychopathology, externalizing psychopathology, and personality pathology to predict the SUD treatment rejection factor(s). The current study relied on use of a general population sample of 43,093 individuals from the first wave of National Institute on Alcohol Abuse and Alcoholism's National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study. Support was found for the hypothesis that SUD treatment rejection would be a multidimensional construct.  Exploratory structural equation modeling indicated a three-factor model best fit the data. Operational definitions and clinical implications of these three treatment rejection factors ("Objective barriers," "Psychological barriers," and "Self-focused barriers") are discussed. Among internalizing psychopathology, externalizing psychopathology, and personality pathology, structural equation modeling identified internalizing psychopathology as the most robust predictor of these three factors for alcohol treatment rejection (n = 1063), indicating endorsement of treatment barriers increased as levels of internalizing psychopathology increased. This pattern also held true for externalizing psychopathology, while personality pathology only negatively predicted objective treatment barriers.  For drug treatment rejection (n = 562), only internalizing psychopathology significantly predicted the treatment rejection factors, indicating treatment endorsement of drug treatment barriers increased as levels of internalizing psychopathology increased. Implications of these findings and directions for future research are discussed.

Researchers have previously identified substance use and borderline personality disorder as factors that increase risk for suicidal thoughts and behaviors. This study explored the relationship between these factors in samples of students and individuals seeking outpatient treatment. Supplemental data collected via the internet (MTurk) also looked at experiential avoidance (EA) with the Avoidance and Fusion Questionnaire for Youth. The Structured Clinical Interview for the DSM-IV, Alcohol Use Disorders Identification Test, Scale for Suicide Ideation, and Personality Assessment Inventory- Borderline Features Scale elicited information regarding severity and/or frequency of substance use, suicidal thoughts, and borderline features respectively. Additionally, the Psychiatric Diagnostic Screening Questionnaire was administered to the UNT sample. The UNT sample analyses indicate substance use moderates, strengthening, the relationship between borderline features and current suicidal thoughts. However, severity of suicidal thoughts was lower for individuals high in both borderline features and substance use disorder symptoms compared to those low in borderline features and high in substance use symptoms. The MTurk sample analyses suggest substance use functions as a mediator. A robust relationship existed between substance use severity and EA, showing substance use as a behavioral marker for EA. In conclusion, concurrent treatment of substance use and borderline personality features would be beneficial in reducing risk for suicidal thoughts. Further investigation into the role and utility of addressing EA is warranted.

The effects of family functioning and tangible support from family members are examined in an opiate addicted population. The study specifically assessed drug use, self-efficacy, and quality of life as treatment outcomes of interest. There have been mixed findings in the literature in regards to how families influence rehabilitation from substance use. Specially, previous research has shown that families can further patients’ recovery, while other findings have shown that families can impede patients’ recovery from substance use. The aim of this study was to analyze potentially contributing factors related to the family system, to gain a stronger understanding of how families influence recovery for patients receiving treatment for their opiate addiction. The study included 110 participants who were patients from a medically assisted recovery facility. The participants took survey measures regarding beliefs about their self-efficacy, quality of life, family functioning, and tangible support received from family members. The participant’s drug use information was verified through facility databases of current urine screens and prescription use. Survey results did not substantiate the hypotheses that tangible support influences treatment outcomes. However, hypotheses that family functioning would positively influence self-efficacy and quality of life were supported. The belief that family functioning would have a negative relationship with the participant’s drug usage was not corroborated by the data, as there was no relationship found between these variables. Finally, there was no moderating relationship observed between family functioning, tangible support, and treatment outcomes. This was contrary to expectations that a moderating relationship would be present. Implications of how the study’s findings can inform research and clinical interventions in an opiate addicted population are discussed.

A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Arts in Clinical Psychology. Johannesburg, 2016 / Substance dependence is a global issue that is becoming significantly more problematic. This is due to the fact that it does not just have a devastating effect on the individual but results in profound spin-off effects, which impact society as a whole. Much research has been conducted within this area and contemporary research has seemed to focus on the link between attachment styles and substance abuse. Since its conception by John Bowlby, attachment theory has achieved an empirical authority that has contributed to its popularity in modern times. However, despite this renewed interest there still exists a gap in the literature around the role that relationships, throughout the lifespan, play in areas such as pathology and recovery. Consequently, this research embarked on an interpretive phenomenological exploration of the way relationships impact the lives of individuals suffering from substance dependence. Adults in recovery from substance dependence were individually interviewed about their experiences of their relationships during and after their years of abusing substances. Hermeneutical phenomenological analysis was used to analyse this data and it revealed a typical model of pathology where a negative childhood experience had cascading effects that culminated in the later dependence on substances. Participants all highlighted relationships with themselves or others as pivotal to either seeking substances or to going into recovery. These themes were then located within Bowlby’s (1976, 1980) developmental pathways framework in order to make sense of the progression of substance dependence along the lifespan as it manifested in these participants. / MT2017

This exploratory, quantitative study investigated the prevalence rate of people with cooccurring substance-related and psychiatric disorders (CODs). A treatment-seeking sample from Houghton House Addiction Recovery Centre in Johannesburg, South Africa was used. Details of the case histories of the clients were collected, coded and analysed using Statistical Analysis System (SAS). The results indicated that 57.1% of 419 clients had one or more co-occurring psychiatric disorder, along with a substance-related disorder. Of the 239 with a COD, 155 had a mood disorder, 40 had an anxiety disorder, 39 had ADHD, 35 had an eating disorder, 8 had a conduct disorder and 5 had schizophrenia. Statistically significant relationships were found for ADHD with cannabis-related disorders and polysubstance dependence; anxiety-related disorders with alcohol-related disorders; and mood disorders with cocaine-related disorders, possibly substance-induced disorders and substance-induced disorders. These results showed that there was large group of people who presented for substance abuse treatment who have one or more COD. Having a COD made the nature of their problems particularly complex. There is a need for greater awareness of this vulnerable group. This would serve to improve the treatment that people with CODs receive.