The purpose of this study was to design and pilot an instrument, the WHIMM, that uses the Williams Hierarchical Integrated Model as a foundation for measuring needs met within and outside of substance use for individuals age 18 and older who report previously considering cutting down on alcohol or drug use. Instrument construction and validation were completed using a first pilot (n=200), a pilot one-re-contact (n=50), and a final administration (n=420). The scale development process allowed for initial validation of the WHIMM, including measurement of inter-item reliability, test-retest reliability, correlation between subscales, and construct validity. In addition, a scoring metric was developed to allow an individual’s WHIMM results to be interpreted based upon the national normative sample used for the present study. The overall WHIMM and each of the subscales for the Global and Substance Use forms yielded Cronbach’s alpha inter-item reliability coefficients equal to or greater than .90. Test-retest reliability for the WHIMM Global and Substance Use forms was generally adequate with the majority of subscales producing a minimum test-retest reliability coefficient of .70. The construct validity tests of the WHIMM demonstrated that the constructs measured by the WHIMM differ substantially from the constructs that are measured by the Alcohol Use Disorders Identification Test (AUDIT; Babor, Higgins-Biddle, Saunders, & Monteiro, 2001) and Drug Abuse Screening Test (DAST; Skinner, 1982). Exploratory factor analysis loosely supported the Williams Hierarchical Integrated Model’s discrete but interrelated elements. There were statistically-significant differences between scores on the WHIMM Global and WHIMM Substance Use forms. Implications, limitations, and suggestions for future research are also presented.

An inverse relationship exists between self-reported religiousness and substance use. However, we question whether religious culture impacts the veracity of self-reported substance use. The primary aim of this study of low-income pregnant women in South Central Appalachia was to determine the accuracy of self-reported substance use in pregnant women as well as to determine whether there were differences in use rates and/or differences in the degree to which women would accurately report substance use depending on their religiousness. Self-reported use and toxicology screening results taken from a larger prospective, longitudinal, smoking cessation study were compared for five substances (cannabinoids [marijuana or other cannabinoids], benz/barb/sed [including benzodiazepines, barbiturates, or any sedative], opioids [including heroin, methadone or other medication-assisted treatment medications, or other opiates], crack/cocaine [crack or cocaine], and meth/amph [including methamphetamine or any other amphetamine]). Women who attend church frequently reported lower rates of substance use than infrequent or nonattenders, as did women who rated themselves as high in intrinsic religiosity (IR), although the difference between high and low groups is less extreme for IR as opposed to attendance. Women who attended church frequently were far less likely to report use or to have use confirmed than any of the other groups including those high in IR. Rates of positive toxicology screens did not differ statistically across religiousness groupings, but the pattern of proportionally fewer positive toxicology results was seen in frequent attenders but not in women self-reporting as high IR. Women’s tendency to underreport substance use was unrelated to religiousness variables, indicating underreporting is not necessarily driving this difference in reported substance use.

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.

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 study focuses on street-involved youth’s experiences with substance use and how it may impact their access to social services, specifically their access to housing and shelter services. I chose to use narrative interviews when speaking with the youth and it was through the sharing of their narratives that different themes, and recommendations for practice were revealed. During the analysis of the data, critical theories were applied, specifically a post-structural and intersectional framework. The youth who participated in this study shared experiences of their hardships, feelings of low motivation in seeking housing, feelings of self-agency regarding their substance use, and the need for more anti-oppressive approaches within housing and shelter services. These anti-oppressive approaches were described by the youth to include more flexible hours, less restrictive shelter rules and a need for more understanding and empathetic service providers. This research highlights important overall insights on the experiences of these youth and how they make sense of their substance use and life on the street. / Thesis / Master of Social Work (MSW)

Social desirability has been offered as an explanation for observed self-reported levels of substance use within specific populations (i.e., inpatient, court referred) and it has been identified as a possible threat to the validity of self-report prevalence studies, but it has not been tested as a variable that could be manipulated to directly affect reporting. The present study assessed the effects of a simple social desirability manipulation on self-report of substance use. Participants consisted of 389 late adolescents aged 18 to 25 who were enrolled at a large southeastern university. Results indicate that presenting a drug as socially desirable does not lead participants to report higher levels of substance use. Furthermore, participants reported that peer reports, rather than their own, were more often distorted on the present study. The results have implications for enhancing procedures for both clinicians and social scientists who survey youth about substance use.

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