MPH / Department of Public Health / See the attached abstract below

Thesis (MPH.) -- University of Limpopo, 2021 / The purpose of this study was to determine and describe the lived experiences of youth residing in Elias Motsoaledi Municipality at Sekhukhune District about Nyaope. A qualitative research was applied using the Phenomenolgical research design to explore the lived experiences. The purposive sampling technique was used to select the participants at Rite Substance organization between the age of 18 and 35, and also the convenient sampling applied to select key informants. The study revealed that the youth Nyaope users experienced; the lived physical effects such as ;bodily weakness and strenght, bodily pains, drowsiness, loss of appetite and poor hygiene, the psychological effects such as mental relaxation, regret and worry, drug dependency and addiction, and the social effects such as family rejection, community stigmatization, relationship failure, engagement in crime, and economic and educational failure. As such, more funds, staff and resources are needed to assist in dealing with the Nyaope crisis.

Bakgrund: Antalet dödsfall relaterat till narkotikarelaterat substansbruk ökar. Personer med narkotikarelaterat substansbrukssyndrom utgör en marginaliserad och stigmatiserad grupp i samhället. Dessa personer löper förhöjd risk för ohälsa, inte minst till följd av deras substansbruk. Stigmatisering inom hälso- och sjukvården är särskilt allvarligt, då det drabbar människor i ett särdeles sårbart tillstånd. Mot bakgrund av detta föreligger ett behov av att sammanställa tidigare forskning som studerat erfarenheter hos personer med narkotikarelaterat substansbrukssyndrom av att vårdas på sjukhus.   Syfte: Syftet var att undersöka de erfarenheter personer med narkotikarelaterat substansbrukssyndrom har av att vårdas på sjukhus. Metod: En icke-systematisk litteraturöversikt med integrerad dataanalys genomfördes baserat på 16 vetenskapliga originalartiklar. Litteratursökningarna utfördes i databaserna PubMed och CINAHL utifrån MeSH-termer och CINAHL Subject Headings, samt ytterligare relevanta sökord. Samtliga artiklar som inkluderades i studien har genomgått en kvalitetsgranskning enligt Sophiahemmet Högskolas bedömningsmall.   Resultat: Tre huvudkategorier identifierades, vilka var Erfarenheter av ojämlik vård, Erfarenheter av bemötande och Erfarenheter av utebliven vård. Resultatet visade att personer med narkotikarelaterat substansbrukssyndrom hade erfarit bristande bemötande av vårdpersonal till följd av stigmatisering och diskriminering, vilket ledde till konsekvenser som fördröjd eller nekad vård. Det framkom att vårdpersonal saknade kunskap om substansbrukssyndrom och hur substansbruksrelaterade tillstånd behandlas. Vidare visade resultatet att substansbruk utgjorde ett hinder för att erhålla adekvat smärtlindring, då vårdpersonalen antog att denna patientgrupp enbart sökte vård för att få tillgång till narkotikaklassade substanser. Personer med substansbrukssyndrom avbröt inte sällan sin sjukhusvistelse mot medicinsk inrådan, främst till följd av abstinensbesvär och inadekvat smärtlindring. Slutsats: Denna litteraturöversikt kan bidra till att hos vårdpersonal medvetandegöra patientgruppens erfarenheter och användas till grund för vidareutbildning inom området. Då flera stigmatiserade grupper kan tänkas uppleva liknande bemötande när de söker vård, kan föreliggande litteraturöversikt också användas för att förstå de erfarenheter stigmatiserade grupper generellt kan antas ha av att söka vård. / Background: The number of deaths related to narcotics related substance use is increasing. People with narcotics related substance use syndrome constitute a marginalized and stigmatized group in society. These people run an increased risk of ill health, especially as a result of their substance use. Stigmatization in health care is particularly serious, as it affects people in a particularly vulnerable state. In light of this, there is a need to compile previous research that has studied experiences of people with narcotics related substance use disorder being cared for in hospital settings.   Aim: The aim of this study was to examine experiences of people with narcotics related substance use disorder who have received hospital care.   Method: A non-systematic literature review with integrated data analysis was conducted based on 16 original scientific articles. The literature searches were carried out in the databases PubMed and CINAHL based on MeSH terms and CINAHL Subject Headings as well as additional relevant keywords. All articles that were included in the study have undergone a quality review according to Sophiahemmet University's assessment template.  Results: Three main categories were identified, as follows: Experiences of unequal care, Experiences of encounters and Experiences of missed care. The results showed that people with narcotics related substance use disorder had experienced a lack of treatment by healthcare professionals as a result of stigmatization and discrimination, which led to consequences such as delayed or denied care. It emerged that healthcare staff lacked knowledge about substance use disorder and how substance use related conditions are treated. Furthermore, the results showed that substance use constituted an obstacle to obtaining adequate pain relief as the healthcare staff assumed that this patient group only sought care to gain access to narcotic-classified substances. People with substance use syndrome often terminated their hospital stay against medical advice, mainly as a result of withdrawal symptoms and inadequate pain relief.  Conclusions: This literature review can contribute to raising awareness of the patient group's experiences among health care professionals and be used as a basis for further education in the field. As several stigmatized groups can conceivably experience similar treatment when they seek care, the present literature review can also be used to understand the experiences stigmatized groups can generally be assumed to have from seeking care.

Both employers and out-patient treatment centres are key role players in addressing workplace related substance abuse. On the one hand, employers are directly and indirectly affected by the huge problem of substance abuse. On the other hand, out-patient treatment centres provide, as their core goal, for the treatment of substance abuse and dependency. Due to the extent of the problem of substance abuse, collaborative intervention measures between employers and out-patient treatment centres are essential – especially the involvement of specialists in the treatment of substance abuse. Such a collaboration process requires specific, resolute measures, as well as a structured process in order to ensure sustainability and results. A networking programme that provides the opportunity to implement this collaborative process is proposed. Sound collaborations indeed provide the foundation to establish the networking programme for combating the problem of substance abuse in the workplace. A collaborative effort to address the problem of substance abuse in the workplace requires not only rallying the strengths and resources of both employers and out-patient treatment centres, but also developing a programme with well-defined processes beneficial to both. A qualitative research study by means of a grounded theory approach was conducted to explore how networking between employers and out-patient treatment centres might aid in addressing the problem of substance abuse in the workplace. Article 1 is a literature overview of substance abuse within the workplace and concerns the national directives, legislation requirements and measures of intervention aimed at dealing with the problem. The literature findings reveal clear national directives, legislation requirements and workplace policies, all aimed at providing a well-defined context for employers to manage substance abuse in the workplace. In addition, specialist treatment services are available to assist employers in addressing the problem in the workplace. Internal support structures in the workplace, however, often independently address the problem of substance abuse without involving the specialists. Literature findings indicate, though, that the personnel involved in the internal support structures are often not equipped to deal effectively with the problem. Research findings indicate positive treatment outcomes for employees with substance abuse problems. Statistics, however, indicate that the identification of employees with substance abuse problems is limited and that referrals of employees for treatment are infrequent. Underutilisation of out-patient treatment centres is therefore commonplace. Literature specifically indicates that the majority of employees are moderate drinkers and substance abusers, with only a small number being dependant. It is further indicated that the moderate drinkers and substance abusers account for almost half of the workforce. The critical factor, however, is that these categories of drinkers cause the majority of industrial accidents and are also responsible for the highest absenteeism rate. Prevention measures, sensitising the entire workforce to the early signs and dangers of substance abuse, facilitate the achievement of the best results in combating the problem. With an eye towards this, national directives advocate the following: intensified campaigns to educate people regarding the early signs and dangers of substance abuse, comprehensive prevention measures and increased rehabilitation efforts. Literature identified a limitation to effectively address substance abuse in the workplace, a problem catered for by specialist treatment centres. Article 2 reports the findings of a situation analysis regarding both the concerns and problems of employers and out-patient treatment centres, as well as resources needed to combat substance abuse in the workplace. Representatives from the employment sector, and out-patient treatment centres, participated in the situation analysis. Employees involved in substance abuse treatment programmes also participated in the study. A specific limitation, identified during the situation analysis, was the limited knowledge regarding the negative consequences of substance abuse in general. An unsupportive workplace environment, with regards especially to substance use and abuse, was also identified. Though empirical findings reported the existence of support structures in the workplace, these structures were found to be incapable of dealing with the problem. In the event of substance misconduct, employers are legally obligated to provide treatment and rehabilitation before considering dismissal; however, employers perceived these obligations as additional demands. Employers did not realise the possible benefits of treatment over dismissal. Misinformation and misinterpretation of the legal obligations were also identified during the research study. The stand against the problem of substance abuse in the workplace revealed a limited collaboration between employers and out-patient treatment centres. Employers were often not aware of specialist treatment centres and the available services. A lack of marketing and visibility – on the part of out-patient treatment centres – and an indifference and lack of support in the workplace were regarded as some of the causes for the limited collaboration between employers and out-patient treatment centres. Both ignorance in the workplace about the scope of substance abuse and a general lack of knowledge regarding the problem were identified as further limiting factors. A need for collaboration between employers and out-patient treatment centres was identified, especially if the problems of substance abuse in the workplace were to be successfully addressed. The development of a networking programme for employers and treatment centres was recommended and the core components to establish such a programme were identified. Article 3 discusses the components which were identified during the situation analysis and presents guidelines to develop a networking programme for employers and out-patient treatment centres. The components identified by the participants served as framework for the proposed networking programme. The programme comprises a specific purpose namely collaboration between employers and out-patient treatment centres, specific characteristics to sustain the programme, and the implementation of distinguishable procedures to establish and ensure sustainability of the programme. The purpose of the networking programme is to promote, between employers and out-patient treatment centres, a collaboration that will address the problem of substance abuse in the workplace. Involvement in the programme holds significant potential benefits for all relevant role players; the programme, in other words, advocates benefits for employers, employees and out-patient treatment centres. The proposed networking programme includes specific procedures for establishing and sustaining the programme: Firstly, assessing the limitations, needs and strengths of both the employment sector and out-patient treatment centres; secondly, establishing a network agreement that defines the roles and responsibilities of the role players; thirdly, collectively planning the networking activities and implementation of these plans; and, finally, collaboratively evaluating the impact and effectiveness of the programme. The aforementioned procedures also apply to both the evaluation of the limitations and progress of the treatment programmes, as well as to the evaluation of service delivery of the treatment centres. As it enables the revision of plans that provide individualised services, the continuous reassessment of the limitations and strengths of the networking programme is important. Out-patient treatment centres are considered responsible for initiating the networking programme. Effective collaboration between employers and out-patient treatment centres, as well as quality service delivery by the treatment centres, is regarded as critically important. Ultimately, the networking programme – regarded as a collaborative process between employers, employees and out-patient treatment centres – promotes a partnership geared towards combating the problem of substance abuse in the workplace. The researcher concluded the study with the formulation of a theory regarding the development of a networking programme as its end goal. Also, it is hoped that both out-patient treatment centres and the employment sector (employers and employees) may benefit from it in practice. Eventually, the proposed networking programme was based on the data collected from the situation analysis in this study, the researcher’s experience as a counsellor in substance abuse treatment and her exposure to different networking programmes, as well as supportive theoretical knowledge. A guideline for application of the networking programme in practice is included in the study alongside examples of projects to apply the programme. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

The influx of youth abusing substances is a major problem. The effect of substance abuse may have far-reaching consequences for defining the vulnerability of the offending group as well as for contributing to the disaster risk faced by the community as a whole. The effects of substance abuse on young people have the potential to contribute to an increased vulnerability of this group. It becomes the responsibility of the family and community to bear the burden of its drug-afflicted members and the implications of their addiction. The study was conducted in Bekkersdal, which is a community that has a significant problem with youth abusing substances. The degree to which their abuse affects families and the broader community in terms of increasing risk has not been examined. The dissertation aims to evaluate the effect of substance abuse among the youth on the risk profile of the Bekkersdal community. According to Disaster Risk Reduction, one of the important activities of the state is to increase capacity of communities and households to minimize the risk that may occur and also most importantly, monitoring the likelihood of and the state of alertness to disasters that may occur. A qualitative, explorative research design was employed and data gathered using structured interviews involving 30 adults namely School Principals, Teachers, Community Social workers, Community Leaders, Religious Leaders, Disaster managers and a Nurse from the area. The interviews were analysed by means of themes. The research indicated that substance-abusing youth create conditions which undermine human, physical and social capital and hence contribute to instability in the livelihood-based system. It was also evident to this research that it encourages the importance of engaging community members in discussions about aspects that concern them which is an empowerment process in itself. As they become more involved, they also have hope that things will work better for them by actively rebuilding their own lives and communities. All the information gathered revealed the link between the negative impacts of substance abuse and its risk profile in the Bekkersdal community. / M Development and Management, North-West University, Potchefstroom Campus, 2015

Both employers and out-patient treatment centres are key role players in addressing workplace related substance abuse. On the one hand, employers are directly and indirectly affected by the huge problem of substance abuse. On the other hand, out-patient treatment centres provide, as their core goal, for the treatment of substance abuse and dependency. Due to the extent of the problem of substance abuse, collaborative intervention measures between employers and out-patient treatment centres are essential – especially the involvement of specialists in the treatment of substance abuse. Such a collaboration process requires specific, resolute measures, as well as a structured process in order to ensure sustainability and results. A networking programme that provides the opportunity to implement this collaborative process is proposed. Sound collaborations indeed provide the foundation to establish the networking programme for combating the problem of substance abuse in the workplace. A collaborative effort to address the problem of substance abuse in the workplace requires not only rallying the strengths and resources of both employers and out-patient treatment centres, but also developing a programme with well-defined processes beneficial to both. A qualitative research study by means of a grounded theory approach was conducted to explore how networking between employers and out-patient treatment centres might aid in addressing the problem of substance abuse in the workplace. Article 1 is a literature overview of substance abuse within the workplace and concerns the national directives, legislation requirements and measures of intervention aimed at dealing with the problem. The literature findings reveal clear national directives, legislation requirements and workplace policies, all aimed at providing a well-defined context for employers to manage substance abuse in the workplace. In addition, specialist treatment services are available to assist employers in addressing the problem in the workplace. Internal support structures in the workplace, however, often independently address the problem of substance abuse without involving the specialists. Literature findings indicate, though, that the personnel involved in the internal support structures are often not equipped to deal effectively with the problem. Research findings indicate positive treatment outcomes for employees with substance abuse problems. Statistics, however, indicate that the identification of employees with substance abuse problems is limited and that referrals of employees for treatment are infrequent. Underutilisation of out-patient treatment centres is therefore commonplace. Literature specifically indicates that the majority of employees are moderate drinkers and substance abusers, with only a small number being dependant. It is further indicated that the moderate drinkers and substance abusers account for almost half of the workforce. The critical factor, however, is that these categories of drinkers cause the majority of industrial accidents and are also responsible for the highest absenteeism rate. Prevention measures, sensitising the entire workforce to the early signs and dangers of substance abuse, facilitate the achievement of the best results in combating the problem. With an eye towards this, national directives advocate the following: intensified campaigns to educate people regarding the early signs and dangers of substance abuse, comprehensive prevention measures and increased rehabilitation efforts. Literature identified a limitation to effectively address substance abuse in the workplace, a problem catered for by specialist treatment centres. Article 2 reports the findings of a situation analysis regarding both the concerns and problems of employers and out-patient treatment centres, as well as resources needed to combat substance abuse in the workplace. Representatives from the employment sector, and out-patient treatment centres, participated in the situation analysis. Employees involved in substance abuse treatment programmes also participated in the study. A specific limitation, identified during the situation analysis, was the limited knowledge regarding the negative consequences of substance abuse in general. An unsupportive workplace environment, with regards especially to substance use and abuse, was also identified. Though empirical findings reported the existence of support structures in the workplace, these structures were found to be incapable of dealing with the problem. In the event of substance misconduct, employers are legally obligated to provide treatment and rehabilitation before considering dismissal; however, employers perceived these obligations as additional demands. Employers did not realise the possible benefits of treatment over dismissal. Misinformation and misinterpretation of the legal obligations were also identified during the research study. The stand against the problem of substance abuse in the workplace revealed a limited collaboration between employers and out-patient treatment centres. Employers were often not aware of specialist treatment centres and the available services. A lack of marketing and visibility – on the part of out-patient treatment centres – and an indifference and lack of support in the workplace were regarded as some of the causes for the limited collaboration between employers and out-patient treatment centres. Both ignorance in the workplace about the scope of substance abuse and a general lack of knowledge regarding the problem were identified as further limiting factors. A need for collaboration between employers and out-patient treatment centres was identified, especially if the problems of substance abuse in the workplace were to be successfully addressed. The development of a networking programme for employers and treatment centres was recommended and the core components to establish such a programme were identified. Article 3 discusses the components which were identified during the situation analysis and presents guidelines to develop a networking programme for employers and out-patient treatment centres. The components identified by the participants served as framework for the proposed networking programme. The programme comprises a specific purpose namely collaboration between employers and out-patient treatment centres, specific characteristics to sustain the programme, and the implementation of distinguishable procedures to establish and ensure sustainability of the programme. The purpose of the networking programme is to promote, between employers and out-patient treatment centres, a collaboration that will address the problem of substance abuse in the workplace. Involvement in the programme holds significant potential benefits for all relevant role players; the programme, in other words, advocates benefits for employers, employees and out-patient treatment centres. The proposed networking programme includes specific procedures for establishing and sustaining the programme: Firstly, assessing the limitations, needs and strengths of both the employment sector and out-patient treatment centres; secondly, establishing a network agreement that defines the roles and responsibilities of the role players; thirdly, collectively planning the networking activities and implementation of these plans; and, finally, collaboratively evaluating the impact and effectiveness of the programme. The aforementioned procedures also apply to both the evaluation of the limitations and progress of the treatment programmes, as well as to the evaluation of service delivery of the treatment centres. As it enables the revision of plans that provide individualised services, the continuous reassessment of the limitations and strengths of the networking programme is important. Out-patient treatment centres are considered responsible for initiating the networking programme. Effective collaboration between employers and out-patient treatment centres, as well as quality service delivery by the treatment centres, is regarded as critically important. Ultimately, the networking programme – regarded as a collaborative process between employers, employees and out-patient treatment centres – promotes a partnership geared towards combating the problem of substance abuse in the workplace. The researcher concluded the study with the formulation of a theory regarding the development of a networking programme as its end goal. Also, it is hoped that both out-patient treatment centres and the employment sector (employers and employees) may benefit from it in practice. Eventually, the proposed networking programme was based on the data collected from the situation analysis in this study, the researcher’s experience as a counsellor in substance abuse treatment and her exposure to different networking programmes, as well as supportive theoretical knowledge. A guideline for application of the networking programme in practice is included in the study alongside examples of projects to apply the programme. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

The influx of youth abusing substances is a major problem. The effect of substance abuse may have far-reaching consequences for defining the vulnerability of the offending group as well as for contributing to the disaster risk faced by the community as a whole. The effects of substance abuse on young people have the potential to contribute to an increased vulnerability of this group. It becomes the responsibility of the family and community to bear the burden of its drug-afflicted members and the implications of their addiction. The study was conducted in Bekkersdal, which is a community that has a significant problem with youth abusing substances. The degree to which their abuse affects families and the broader community in terms of increasing risk has not been examined. The dissertation aims to evaluate the effect of substance abuse among the youth on the risk profile of the Bekkersdal community. According to Disaster Risk Reduction, one of the important activities of the state is to increase capacity of communities and households to minimize the risk that may occur and also most importantly, monitoring the likelihood of and the state of alertness to disasters that may occur. A qualitative, explorative research design was employed and data gathered using structured interviews involving 30 adults namely School Principals, Teachers, Community Social workers, Community Leaders, Religious Leaders, Disaster managers and a Nurse from the area. The interviews were analysed by means of themes. The research indicated that substance-abusing youth create conditions which undermine human, physical and social capital and hence contribute to instability in the livelihood-based system. It was also evident to this research that it encourages the importance of engaging community members in discussions about aspects that concern them which is an empowerment process in itself. As they become more involved, they also have hope that things will work better for them by actively rebuilding their own lives and communities. All the information gathered revealed the link between the negative impacts of substance abuse and its risk profile in the Bekkersdal community. / M Development and Management, North-West University, Potchefstroom Campus, 2015

National prevalence surveys indicate that lifetime and recreational drug use among all social classes have increased steadily over the last decade in Ireland (Moran et al., 2001a, Mayock, 2002, National Advisory Committee on Drugs, 2008a). Drugs research has been traditionally based on the identification, weighting and interrelatedness of risk and protective factors within a "risk prevention paradigm". This paradigm has been criticised for its lack of inclusion of individual, group and wider structural aspects, and occurs within a greater awareness of greater social discourse and societal shifts. The research papers in this portfolio of work are thematically analysed and conceptualised within the theoretical framework of cognitive and structural social capital. The descriptive research and later, more conceptual papers investigating drug use among rural youth, Travellers and cocaine use, are thereby explored in terms of the potential ‘normalisation of rural youth drug use’ within contemporary risk discourse, the assimilatory threat of increasing drug use among the ‘Traveller community’., and the emergence of the ‘recreational cocaine user’ in Irish society. The social processes of individualisation, reciprocity and trust which constitute social capital are deemed to provide potent collective frameworks for the navigation of risk in day to day ‘localised’ settings. The ‘interrelated normative frameworks’ and ‘processes of risk neutralisation’ are underpinned within a wider social capital understanding of the meaning of drug activity in associational life based on ‘interpersonal and institutional trust’ and ‘mutual resource acquisition’. Contemporary drug policies must consider the contextual constraints of the ‘risk society’, which impact on inherent individual ‘power resources’, whereby individual agency and drug taking is better understood within situational agency of ‘localised’ social, gender, ethnic and cultural capital.

Purpose: Substance use and weapon carrying among adolescents is a growing concern. The objective of this study is to investigate the association between adolescent substance use and weapon carrying using the 2013 Youth Risk Behavior Survey (YRBS). Methods: Analyses were conducted using the 2013 YRBS, a nationally representative dataset sampling public and private high school students throughout the United States (US). Data from a total of 148,282 US adolescents were used in the present study. Results: Two outcomes were assessed: weapon carrying within the past 30 days and weapon carrying on school property within the past 30 days. Among adolescents who carried a weapon, 77.3% were male, 62.7% were white, 28.5%% were in 9th grade, 33.8% used a tobacco product and 57.4% drank alcohol within the past 30 days, while 22.8% used a Schedule 1 drug and 14.0% used a Schedule 2 drug during their lifetime. Among adolescents who carried a weapon on school property, 74.4% were male, 55.1% were white, 26.5% were in 11th grade, 40.1% used a tobacco product and 61.9% drank alcohol within the past 30 days, while 32.1% used a Schedule 1 drug and 26.9% used a Schedule 2 drug during their lifetime. For the multivariable model predicting adolescent weapon carrying, tobacco use (adjusted odds ratio (AOR) = 2.31, 95% CI: 2.06, 2.59), alcohol use (AOR = 2.04, 95% CI: 1.81, 2.29), and Schedule 2 drug use (AOR = 2.27, 95% CI: 1.83, 2.80) were significantly associated with increased risk of carrying a weapon, adjusting for all covariates in the model simultaneously. For the multivariable model predicting adolescent weapon carrying on school property, tobacco use (AOR = 2.33, 95% CI: 1.89, 2.86), alcohol use (AOR = 2.53, 95% CI: 2.02, 3.18), and Schedule 2 drug use (AOR = 2.58, 95% CI: 1.94, 3.43) were significantly associated with increased risk of carrying a weapon on school property, adjusting for all covariates in the model. Raw counts and weighted frequencies are reported. Conclusions: Statistically significant associations between adolescent substance use and weapon carrying were found, suggesting that adolescent substance use is associated with increased weapon carrying behavior, both off and on school property. Future weapon carrying prevention efforts should target not only adolescents who are high risk for weapon carrying, but also those who are at risk for misusing substances.

The three studies presented in this dissertation generated new insight about the attitudinal ableism experienced by people with mental illness, substance use, and physical disabilities. First, the purpose of study one was to synthesize existing evidence about the implicit (unconscious) biases toward people with mental illness. Extensive academic database searches were performed and 19 articles were selected for review. Main findings from the review indicated that 63% of the participant samples showed an implicit bias against people with mental illness. Further, the implicit biases were positively correlated with explicit desires for social distance in two studies and were not improved by interventions or prior contact in six studies. Second, the purpose of study two was to investigate potential mediators in the pathway between perceived stigma and internalized stigma among people with substance use disorders. A total of 125 individuals completed the survey packet. Results indicated that overall social support (particularly affectionate social support) and maladaptive coping behaviors were significant mediators of the pathway. Personality characteristics, overall coping behaviors, adaptive coping behaviors, emotional/informational social support, and tangible social support were not significant mediators. Third, the purpose of study three was to validate and expand upon existing research on the microaggressions perceived by people with physical disabilities. The third study was also an initial exploration into the applicability of Glick and Fiske's (1996) theory of ambivalent sexism in conceptualizing ableist microaggressions. Specifically, Glick and Fiske's (1996) theory was used as a framework for conceptualizing ableist microaggressions as examples of ambivalent ableism, characterized by hostility and benevolence toward people with disabilities. Twelve individuals with visible, physical disabilities were interviewed about their microaggressive experiences and the personal impacts of being targets of ableism. Participants' experiences were coded and categorized as representing hostile ableism, benevolent ableism, or impact on the target. Hostile microaggressive experiences included othering, victimizing, and desexualizing; benevolent microaggressive experiences included helping and infantilizing; and impacts on the target included passing/covering and internalizing. Finally, implications related to research, education, and practice for each of the three studies were discussed in the concluding chapter of this dissertation.