Abstract According to Bowlby, infants have a universal need to seek close proximity with their caregiver when under distress or threatened. This study seeks to look at attachment in a population that is undergoing extreme distress as they suffer from opioid withdrawal within the first few weeks of life. It aims to explore the role touch (kangaroo care) can have in creating the secure base that attachment theorists describe as the basis for all future attachments, and in reducing the length of Neonatal Abstinence Syndrome. It is hypothesized that infants born with drug dependencies who receive increased touch and holding throughout their withdrawal will have a shorter duration of Neonatal Abstinence Syndrome and will be more securely attached at 18 months than those who do not receive increased touch. It is also hypothesized that infants whose caregivers reported high scores of bonding with their infants in the first year of life will be more securely attached than those with lower scores of bonding. Infants who were sent home with their birth parents after discharge are hypothesized to be more securely attached at 18 months with their caregiver than infants who were sent home to a foster family. The results of this study will contribute to attachment literature in a population where research is lacking, and will add to the knowledge on Neonatal Abstinence Syndrome treatment.

(DSM-IV-TR/) nor in withdrawal scales. However, a related term, "impatience" is listed in some nicotine withdrawal scales. (Hughes J. R., Measurements of the Effects of Abstinence from Tobacco: A Qualitative Review, 2007). Although impatience is not a synonym of impulsivity, both share the synonym "impetuous". Therefore, impatience can be considered a measure of impulsivity. Although some reviews of the effect of smoking cessation on impatience have occurred, we know of no quantitative review of prospective studies of whether smoking cessation increases impatience. Purpose: To evaluate the effect of smoking cessation on impatience as measured by the Minnesota Nicotine Withdrawal Scale-Revised (MNWS). Methods: A literature search of MEDLINE (PubMED), EMBASE, and PsychInfo was conducted. Articles containing relevant keywords were reviewed by two evaluators independently. To be considered for inclusion in the meta-analysis, studies had to be prospective studies, had to have pre-cessation impatience measurements, to include at least overnight abstinence, had to have smoking abstinence biochemically verified, and had to include effect size as an outcome measure. Results: All pooled analyses were based on random-effects models. Seven trials met the selection criteria. The total number of subjects was 426. There was a significant level of heterogeneity among studies (X2(6), pI2= 89%). The summary mean effect for impatience after tobacco cessation was an increase of .44 on a 0-3 scale (95% confidence interval [CI], 0.21-0.67) and a p-value Conclusion: The meta-analysis shows that impulsivity increases post smoking cessation. These findings imply that smoking cessation may have an effect on decision making. Additionally higher rates of impulsivity have been associated with smoking relapse. (Doran, Spring, McChargue, Peradia, & Richmond, 2004). In order to better assist in the development of individual treatments, a better understanding is needed of how increased impulsivity influences cognitive behavior and relapse rates. These findings support the inclusion of impulsivity as a criterion for nicotine withdrawal.

Dans cette thèse, nous avons examiné la pensée sociale de l’alcoolisme féminin (N=726). En effet, il nous semble qu’elle puisse être impliquée dans le maintien de représentations négatives de l’alcoolisme, allant de pair avec une dépréciation de la femme alcoolique (N=80). De plus, il nous semble que cette pensée sociale implique de prendre en compte les images et les émotions utilisées dans les messages de santé portants sur la consommation d’alcool chez les jeunes femmes (N=80). Enfin, sur le plan de la prise en charge, cette pensée sociale nous a amené à nous interroger sur les difficultés à être abstinent, particulièrement lorsque les attentes vis-à-vis de l’alcool sont positives chez les patients alcooliques. Aussi, nous sommes-nous intéressés à un autre objectif thérapeutique plus contesté, celui de la consommation contrôlée (N=15) en le comparant à celui de l’abstinence (N=15).Premièrement, les résultats ont mis en évidence que l’alcoolisme féminin apparait comme jugé plus négativement que l’alcoolisme masculin. Deuxièmement, on a observé que les femmes alcooliques tendent à être plus « sensibles » à ressentir de la honte. Ces résultats semblent attester d’un travail thérapeutique indispensable sur cet affect dans la prise en charge de l’alcoolisme féminin. Troisièmement, nos résultats sur les techniques de prévention dans le cadre de la TCP ont mis en évidence le rôle essentiel que joue le cadrage des messages de santé auprès d’une population spécifique comme celle des jeunes femmes. Enfin, les résultats nous ont offert des perspectives intéressantes sur les bénéfices cognitifs et comportementaux liés au processus d’abstinence. / This thesis has four main objectives in the study of public health issue represented byfemale alcoholism: (1) to explore the representational and attributional specificities of femalealcoholism in general population (Women = 492; Men = 234) and the influence of alcoholconsumption practices on its construction as a “social” object by comparing it to malealcoholism, (2) to evaluate, from a clinical point of view, the predisposition to shame andguilt in a group of patients with an Alcohol Use Disorder (AUD; criteria DSM-5) (Women =20; Men = 20) compared to a control group (Women = 20; Men = 20), (3) to devise, withinthe model of the Theory of Planned Behaviour (TPB), a primary prevention technique foroccasional heavy alcohol use or binge drinking and drunkenness amongst students between 18and 25 years old (Women = 80) by testing the effect of images and texts, positive vs.negative, and finally, (4) to assess, from a therapeutic point of view, amongst women with anAUD (Women: n = 16 and Men: n = 14), on the one hand, cognitive changes through thedevelopment of addictive beliefs regarding alcohol, and on the other hand, behaviouralchanges through the development of coping strategies, in relation to the two main treatmentgoals offered in Substance Abuse Departments in France: abstinence (n = 15) and controlleddrinking (n = 15).First, we observed the duality of alcohol consumption for the two objects of femaleand male alcoholism and the major influence on these results exercised by the participants’drinking habits. Second, we noted a greater predisposition to shame and guilt amongst womenwith an AUD. Therefore, on the one hand, female alcoholism appears to be judged morenegatively than male alcoholism and on the other hand, female alcoholics tend to be moresusceptible to suffering this negative affect. These results seem to attest a necessarytherapeutic work on the affect of shame in the treatment of female alcoholism. Third, ourfindings on prevention techniques within the model of the TPB highlighted the essential roleof the framing of health messages and the positive or negative emotions they arouse amongsta specific population considered "at risk" of developing pathologies due to alcoholconsumption, even though young women consume less than men. Last, our results offeredinteresting perspectives on the cognitive benefits related to the abstinence process and thedecision to abstain, compared to controlled consumption, as well as on the motivationsassociated with alcohol consumption and its relinquishment.

Substance use disorders (SUDs) are a serious public health concern contributing to health risks for individuals and communities. Recovery capital are client strengths associated with SUD recovery. Employment represents recovery capital associated with positive SUD treatment outcomes. However, the relationship between employment mechanisms and SUDs are not well understood. The present study investigates how specific employment variables at SUD treatment intake predict (a) successful treatment completion, (b) abstinence at six-month treatment follow-up, (c) reduced use at six-month treatment follow-up. Additionally, employment variable change is explored. A retrospective, cross-sectional investigation with logistic regression modeling to predict substance use at six-months post SUD treatment follow-up was used. Clients in the study period (1999-2016, N = 8,925) were a mean age of 31.7 (SD=11.8), mostly male (67.2%), and primarily White (86.6%). Results demonstrated that employment variables at intake predicted greater successful treatment completion, Wald χ2[36]=185.3, p<0.0001. However, greater employment strengths were predictive of maintained use at six-month follow-up rather than abstinence or reduced use. Further investigation showed, the best predictors of post-treatment recovery were months employed change (AOR=1.53, 95% CI=1.34-1.75) and days missed from work change (AOR=2.43, 95% CI=2.00-2.96). Counseling psychologists can help to improve substance use outcomes and the quality of life for those in SUD treatment by becoming involved in intervention design, consultation, and policy making that focuses on increasing employment length and reducing absenteeism due to substance use. Employment is one route to engagement that can help to improve the lives for those involved.

The research problem in this study addressed the lack of evaluation criteria used to assess the LIFE curriculum's alignment with the A-H guidelines of the federally funded Title V abstinence education program. These A-H guidelines have existed for almost two decades but no evaluation has been done that measured the degree of alignment between a specific curriculum and the federal A-H guidelines. Using Lewis' theory of the culture of poverty as the foundation, the purpose of this qualitative study that used a constant comparison analysis was to evaluate the level of alignment of the LIFE curriculum with each of the eight guidelines (A-H) of the Federal Title V abstinence education program. The research question that this study sought to address was: Is there is an alignment between the LIFE abstinence education curriculum and the Title V abstinence education Federal Guidelines A-H. The data was collected from the 8 lessons within the LIFE curriculum documents, were then coded using a deductive reasoning strategy. The data was then subjected to content analysis using a qualitative software program, which was Atlas.ti. Learning outcomes from each of the eight LIFE curriculum lessons were listed in a six-column table that showed the alignment of the desired outcome with the evaluation criteria of the A-H guidelines. Overall, the LIFE curriculum was found to be 71% in alignment with the A-H guidelines. This study has policy implications such that it may provide insight to policymakers, parents, and communities regarding the need for further alignment between federal guidelines and abstinence education curriculum. Attention to alignment issues may impact positive social change by assisting in the reduction of pregnancy rates among those ages 10-19 years old.

Background: The opioid epidemic is particularly worrisome in the pregnant population, wherein concerns are raised about the health of a mother and her child, resulting in an alarming incidence and prevalence of Neonatal Abstinence Syndrome (NAS). The 2016 National Survey on Drug Use and Health (NSDUH) show the rate of illicit psychoactive substance use among the females aged 12 or older was 15.5% in the past year. Among pregnant women aged 15 to 44, 6.3% were illicit psychoactive substance users. In Tennessee, the number of hospital discharged NAS cases from 2002 to 2013 increased from 1.50 to 16.6 cases per 1,000 live births. This number is triple the national incidence of NAS cases over the same time period. Between 2013 and 2016, at least 52.5% of children diagnosed with NAS in Tennessee have had exposure to one prescription drug, while 27.2% were exposed to a combination of prescribed medications and illicit substances. We examined the behavioral correlates that determine the wish to quit opioids or not to quit opioids among opioid-dependent pregnant and non-pregnant women in rural Appalachia. Methods: Ten women of childbearing age, whether pregnant or not, who were receiving prescribed opioids, were recruited to join the study. All the participating women were also receiving physician-managed Medication Assisted Treatment (MAT) therapy for the treatment of severe opioid use disorder, or are currently being prescribed an opioid medication. Study variables included age, Hamilton Depression Rating Scale (HAM-D), Visual Analogue Scale – Pain (VAS-P), the Modified Opiate Craving Scale (MOCS), the Visual Analog Commitment to Quit Opiates, the McGill Pain Index (MPI), prescriptions, tobacco and nicotine use, illicit substance use, the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), and the Adverse Childhood Experience (ACE) questionnaire. The HAM-D, MOCS, MPI, and SOCRATES scores were log-transformed to approximate a normal distribution. Descriptive statistics and the Spearman’s rank correlation (with a 95% Confidence Interval) were conducted to examine significant behavioral correlates for quitting opioids. Results: Descriptive statistics show that women with higher HAM-D and MOCS scores are not likely to express willingness to quit opioids. There is a statistically significant strong positive correlation of 0.679 (pppp Conclusion: Women who recognize the need to quit opioids or are “taking steps” to quit are more likely to quit opioids. Women with high depression and pain scores are not likely to quit opioids. Non-opioid medications may reduce the number of opioid-dependent pregnant and non-pregnant women of childbearing age, and, in turn, lower the currently high incidence and prevalence rates of NAS.

Thesis (Ph.D.)--Baylor University, 2005. / Includes bibliographical references (p. 205-219).

Sexuality education continues to be an extremely emotional and polarizing issue in the United States. The U.S. leads developed countries with the highest rates of teenage pregnancy and STI acquisition, as well as teenage abortions. Additionally, costs to society are tremendous—experts estimate unplanned pregnancy costs the federal government up to $12 billion annually. Now more than ever, there is a dire need for medically accurate, high-quality sex education in this country. This thesis explores the history of sexuality education policy in the United States, as well as recent legal developments. It highlights the arguments of those in favor of comprehensive as well as abstinence-only education. Finally, it discusses the pertinent needs of society today, parents' opinions regarding the topic and the risky behavior trends of adolescents. Based on numerous academic studies regarding different curricula types, as well as adolescent behavior, it makes broad policy recommendations to decrease unintended pregnancy and STI acquisition in the U.S.

none

Sexual education has been a much-debated topic in the United States since it was instated in light of the HIV/AID pandemic of the 1980s. The debate has always centered on the role of sexual education: should it act to objectively relay the facts about sexual health? Or should it be utilized as a moral purveyor of teen’s sexual behavior? During the second Bush Administration it seemed as if the conservative right had won and sexual education adopted a role policing teen’s morality with $1.5 billion in federal funding for abstinence-only education. This study aims to provide evidence against abstinence-only education by highlighting its ineffectiveness to meet its own standards of success (preventing teen pregnancy and STI infection), as well as its violation of legal human rights standards. As well, this study will provide an alternative to abstinence-only education, comprehensive sexual education, which provides students with accurate information about sexual health (including information about contraception, abortion, etc.) while still emphasizing abstinence as the preferred sexual behavior in teens.