Studies on forgiveness and its relationship to substance abuse have consistently found salutary associations between the two, yet empirical investigation of variables that may serve as mediating factors in this relationship is in need of more attention. With recent models positing psychological distress as a key component of the forgiveness-substance abuse association, constructs such as psychache, depression, and hopelessness may be likely candidates as mediators of this relationship. As such, cross-sectional, self-report data from 577 undergraduate students was used to perform multiple mediation analyses on the relationship of three dimensions of forgiveness (i.e., of self, of others, of uncontrollable situations) with two substance use outcomes (i.e., problematic alcohol use and problematic drug use), as mediated by psychache, depressive symptoms, and hopelessness. Results indicated that forgiveness of self and forgiveness of uncontrollable situations were associated with lower levels of psychological distress and fewer substance use problems, whereas forgiveness of others was associated with greater levels of psychological distress and more substance use problems. Psychache and depressive symptoms, but not hopelessness, played a role in the forgiveness–substance use problems association. Implications of these findings are discussed, particularly in the context of the self-medication hypothesis.

Decades of research on parenting and emotion socialization have yielded consistent results that more supportive, warm, emotion-focused, and balanced parenting results in better long-term outcomes for children, particularly outcomes related to internalizing and externalizing symptoms. Further, in the context of childhood adversity, supportive and sensitive relationships and environment appear to protect against the development of internalizing symptomology. However, limited knowledge exists regarding these processes and their outcomes for children in rural Appalachia. The current project aimed to explore parenting, emotion socialization, adverse childhood experiences (ACEs), and internalizing and externalizing symptoms in college students raised in rural Appalachia. The sample consists of 591 students attending college in the Appalachian Highlands who completed self-report measures of retrospective parenting styles (i.e., how their parents parented them as a child), emotion socialization (i.e., emotion expression and environment in their home as a child), adverse childhood experiences (i.e., adverse experiences occurring for them prior to the age of 18), and religious support (i.e., experiences of being supported or unsupported by religious group as a child). Participants also completed self-report measures of current internalizing (i.e., depressive symptoms, anxiety symptoms) and externalizing (i.e., alcohol use, drug use) symptoms. To explore possible avenues of risk and resilience, simple moderation analyses were conducted in SPSS using Hayes’ PROCESS 4.0 Macro to explore if supportive or unsupportive environments moderate the relationship between ACEs and internalizing or externalizing symptoms. In both supportive and unsupportive emotional environment models for internalizing symptoms, the interactions were not significant, indicating no presence of moderation. However, in both supportive and unsupportive emotional environment models for externalizing symptoms, the interactions were significant, suggesting moderation. Further, authoritarian parenting also significantly moderated the relationship between ACEs and externalizing symptoms. Specifically, in a sample of students attending college in the Appalachian Highlands, in the context of high childhood adversity, growing up in a family marked by discouraging the displays of negative emotions and punitive parenting in childhood appear to be protective factors against substance use in adulthood, but not against depression or anxiety. Further, religious social support from childhood was not a protective factor in the context of ACEs and mental health outcomes. These results are inconsistent with much of the parenting and emotion socialization literature and suggest that Appalachian families may have different adaptive processes of parenting and emotion socialization. These results offer one piece of a much larger puzzle to understanding avenues for risk and resilience for children and families in Appalachia. As such, the results will be discussed in the context of Appalachian culture with a focus on further exploration of these processes and their implications.

This study examined the links among child maltreatment (i.e., child sexual abuse, child physical abuse, child emotional abuse, and child neglect), eating disorder symptoms, problematic use of drugs and alcohol, coping strategies, and emotion regulation in women. This study also examined coping strategies and emotion regulation as potential moderators of the links among child maltreatment, eating disorder symptoms, and problematic substance use. Maltreatment in childhood is linked with numerous adverse outcomes across the lifespan. For instance, the development of maladaptive coping styles, poor emotion regulation, substance use problems, and eating disorders all are linked to a history of child maltreatment, but how these factors interact has yet to be investigated. These constructs were examined through hierarchical multiple regressions in a sample of 383 women age 19 or older, recruited online. Results indicated that women who experienced greater overall child maltreatment engaged in more problematic drug use and more problematic alcohol use and women with child sexual abuse (CSA) engaged in greater levels of problematic drug use. Avoidance coping was associated with greater levels of problematic drug use, dieting, bulimia and food preoccupation, and overall eating disorder symptoms. Women with more severe eating disorder symptoms and who used greater expressive suppression, also engaged in more problematic alcohol use. When considered together, all forms of child maltreatment were associated with greater avoidance and problematic drug and alcohol use, CSA survivors used less avoidance and expressive suppression, and child neglect (CN) survivors used more avoidance and expressive suppression. These findings suggest that health care professionals working with women survivors of child maltreatment should be aware of increased risk of developing substance use problems as well as less effective coping and emotion regulation strategies that may be stemming from victimization experiences. In addition, it may be helpful for clinicians working with women with eating disorders or problematic substance use to focus on improving coping and emotion regulation skills. / Graduate

Indiana University-Purdue University Indianapolis (IUPUI) / The problem behavior theory suggests that the engagement in one problematic behavior increases the likelihood of engagement in another problematic behavior. Previous research has found among youth an increasing probability of co-occurring dieting and substance use behavior, particularly among girls. However, to date findings are inconclusive on the temporal ordering of these behaviors. Further, limited research has been conducted to explore whether the temporal ordering of the two behaviors exist similarly between White and Black youth. The present study will use a cross-lagged panel design across one year to examine the temporal ordering between dieting behavior and substance use among a sample of 2,016 adolescent females (grade mean=7; 77.2% White; 22.8% Black). We hypothesized that a bidirectional relationship would be observed between the two behaviors. However, given no published studies on this relationship by race, no a priori hypotheses were made for this second aim. Result showed that within the full sample dieting behavior significantly predicted substance use one year later, but the inverse relationship was not found. Additionally, this effect was replicated in the White sample but null effects in both directions was found among Black youth. These findings provide support for a temporal relationship between dieting behavior and substance use, such that the former predicts risk for the latter. Moreover, although there is evidence of race differences in the risk pathway, further research is needed to confirm this effect. Future studies are also needed to determine whether this observed temporal relationship is present among adolescent females of other racial/ethnic groups, as well as if the relationship varies as a function of other demographic variables, such as age (e.g., early, mid, or late-adolescence).

Indiana University-Purdue University Indianapolis (IUPUI) / African American adolescents have historically been considered at low risk for substance use relative to the White adolescent majority based on national prevalence estimates. However, during the last decade, African American adolescents’ rates of marijuana use—alone and in combination with other substances—have increased disproportionately relative to those of their White peers. Given the strong relationship between marijuana use and other substance use and the functional consequences associated with concurrent substance use during adolescence, the increase in marijuana use among African American youth may contribute to increased substance-related health disparities across the lifespan. Thus, the current study examined daily associations between marijuana use and other substance use among African American adolescents relative to their White peers. It also examined whether those associations differentially predicted behavioral health consequences among African American adolescents. Participants (N = 35; 42.9% African American) were adolescents age 14-18 who reported past 30-day use of marijuana, alcohol, and/or tobacco products. Respondents completed daily diaries reporting their substance use for 14 consecutive days, followed by self-report measures of internalizing symptoms, externalizing symptoms, and substance use problems. Multilevel regression and structural equation models were used to account for the nesting of days within individuals. Participants completed 458 diaries for a completion rate of 93.5%. African American respondents reported greater daily- and individual-level rates of marijuana use and concurrent substance use than White respondents. However, in multilevel models controlling for demographics, marijuana use was not related to concurrent use of alcohol and/or tobacco use and this relationship did not vary by race. Racial differences in the relationship between concurrent substance use and behavioral health consequences were observed such that the relationship was positive among White youth but not African American youth. Findings suggest that African American youth are at high risk for engagement in problematic patterns of substance use but that daily diary methods may not be most appropriate for illuminating these patterns. Despite these unexpected results, disparities in substance-related consequences among African Americans adults persist. Future research should examine long-term rather than proximal consequences of concurrent substance use among African American adolescents.

Indiana University-Purdue University Indianapolis (IUPUI) / Despite data suggesting that current substance use disorder treatments are largely effective in reducing substance use, most adolescents in SUD treatment experience relapse after finishing treatment. Understanding the factors proximal to relapse is crucial to understanding the course of substance use disorder and how best to improve recovery among adolescents. The current study represents part of a novel line of research using qualitative data analysis to examine these factors. Data for the present study were 200 de-identified node-maps, completed by high school students at Hope Academy, a recovery high school in Indianapolis, Indiana. The reported age in this sample ranged from 14-20 years (64.1% male, 89.1% White), with a mean age of 16.8 years (SD = 1.9 years). After a four-phase process of qualitative data sorting, primary people, places, and things most frequently described included using with others (n=153, 76.5%), away from home (n=156, 78.0%), and in response to negative affect (n=93, 48.4%). Eleven relapse pathways emerged: escaping (n=16), self-medicating (n=3), coping with tragedy (n=5), critical mass (n=6), unexpected activation (n=8), unexpected offer (n=22), planned use (n=19), resistant to recovery (n=5), not in recovery (n=22), passive agency (n=30), and acting out (n=15). Recovery is a system made up of many interrelated parts, including those related to the individual person in recovery, their thoughts, beliefs, feelings, and emotions; and those related to external factors, their environment, adverse life events, and the actions of other people. By considering the pathways together for their common features, they can each be said to represent one of three critical failures related to those three overarching facets of the system: failure to cope, failure to guard against temptation, and failure of belief. Identifying these overarching failures in the system is helpful because the failures contain in themselves the seeds of their solution, so by examining them as critical components to a relapse event, it may be possible to gain insight into how to prevent the same type of relapses from occurring in the future.

No description available.

A growing body of research is targeted towards characterizing and explaining nicotine’s complex interactions with the ApoE E4 allele on brain responses underlying cognitive processes. However, when and how the ε4 allele modulates neuroelectric brain responses in the presence of nicotine versus nicotine abstinence in nicotine-dependent smokers is not well characterized. Being able to understand this modulation is potentially quite important given that recent research implies that, relative to non-ε4 carriers, young adult carriers of the ε4 allele exhibit greater cognitive benefits from the use of nicotine. In the present study, electroencephalography (EEG) and the oddball-related P3b event-related potential (ERP) were used to better characterize the potential moderating effects of ApoE on P3b ERP amplitude changes associated with overnight nicotine deprivation in dependent smokers. Results showed a significant interaction between ApoE genotype and nicotine use, as ε4 carriers, relative to noncarriers, demonstrated significantly greater decreases following overnight deprivation, relative to prequit baseline levels. Additionally, there was a main of effect of P3b ERP amplitude to target stimuli being greater in ε4 allele carriers than in noncarriers during nicotine use, but no main effect of APOE genotype during overnight nicotine deprivation. These results are consistent with findings that the ApoE genotype moderates the effects of nicotine and alters neuroelectric brain responses associated with selective attention to infrequent target stimuli.

Substance use and substance use disorders (SUDs) pose a significant health and economic concern in the United States. Conditions and comorbidities exist that are associated with substance use onset, continuation, and outcomes. In the theory of Reinforcer Pathology, we can categorize these conditions into vulnerabilities, or factors that may be associated with susceptibility to substance use onset and poorer outcomes in substance use recovery. The theory of vulnerabilities and reinforcer pathology is tested through three investigations. The first investigation sought to establish the relationship between cumulative vulnerabilities and adolescent substance use in a cross-sectional analysis. The second investigation evaluates the temporal relationship of cumulative vulnerabilities and substance use among adolescents. The final investigation establishes the relationship of cumulative vulnerabilities and substance use among individuals in recovery from Opioid Use Disorder. Collectively, these reports suggest that the intersection and cumulation of vulnerabilities to substance use and substance use disorders are directly related to substance use outcomes. Future research and reports in the substance use domain should consider these constructs, their accumulation, and their co-occurrence patterns. / Doctor of Philosophy / Substance use and substance use disorders are a great health and economic concern in the United States. Conditions that are related to trying substances, using substances, and outcomes of this substance use. In the theory of Reinforcer Pathology, we can call these conditions vulnerabilities, or conditions that may be associated with the likelihood of starting to use substances and having poorer substance use outcomes in the long-term. Three studies investigate the theory of vulnerabilities and Reinforcer Pathology. First, the relationship between cumulative vulnerabilities and substance use among adolescents is assessed cross-sectionally or simultaneously. The second study examines the relationship between cumulative vulnerabilities and adolescent substance use over time. The third study examines the relationship between cumulative vulnerabilities and substance use among individuals in recovery from Opioid Use Disorder. Collectively, the studies in this report suggest that the overlap and cumulation of vulnerabilities to substance use and substance use disorders is related to substance use outcomes. Future research and other reports in the substance use domain should consider these constructs, their accumulation, and their co-occurrence patterns.

No description available.