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Objectives: We investigated the prevalence of substance use disorders among emerging adults and quantified the extent to which emerging adults, compared to young adults, are at increased odds for substance use disorders. Methods: Data come from the 2012 Canadian Community Health Survey – Mental Health (CCHS-MH). Respondents were 15–39 years of age (n=9228) and were categorized as: early emerging adults (15-22 years); late emerging adults (23-29 years); and, young adults (30-39 years). Substance use disorders (alcohol or drug abuse/dependence) were measured using the Composite International Diagnostic Interview 3.0. The prevalence of substance use disorders was compared across age groups using design-based χ2 analyses. Odds ratios (OR) and 95% confidence intervals (CI) were computed from logistic regression models adjusting for sociodemographic and health covariates. All analyses were weighted to maintain representativeness of the study sample to the Canadian population. Results: The prevalence of alcohol use disorder was 8.0%, 6.6%, and 2.7% for early emerging adults, late emerging adults, and young adults respectively. For drug use disorder, the prevalence was 6.4%, 3.6%, and 1.3%. Compared to young adults, early and late emerging adults were more likely to report substance use disorders (p<0.01). The prevalence of drug use disorder was higher among early versus late emerging adults (χ2=119.8, p=0.01). Among all age groups, males were more likely to report alcohol or drug use disorders (p≤0.01 for all). After covariate adjustment, early and late emerging adults had greater odds of reporting alcohol (OR=3.2, 95% CI=2.2-4.9 and OR=2.4, 95% CI=1.6-3.4, respectively) or drug (OR=4.2, 95% CI=2.5-7.0 and OR=2.5, 95% CI=1.6-4.1, respectively) use disorders compared to young adults. Conclusion: Emerging adulthood represents an important developmental period in which individuals are at increased odds of reporting substance use disorders. This finding has implications for the provision of screening and treatment of substance use disorders as these individuals transition from the pediatric to adult healthcare system. / Thesis / Master of Health Sciences (MSc)

Rationale: Individuals with addictive disorders commonly exhibit a shortened temporal window, which interferes with treatment focusing on long-term sobriety. Episodic Future Thinking (EFT) involves generating personalized cues related to anticipated, positive events at various future time points. EFT has been shown to reduce the reinforcing value of addictive substances; however, this has only been shown in non-treatment samples. Purpose: To examine the feasibility, cumulative, and sustained effects of implementing EFT in a treatment seeking addiction sample over a 1-week protocol on decision-making and alcohol motivation. Methods: Twenty-eight treatment seeking individuals were randomly assigned to either undergo an EFT intervention or a control Episodic Recent Thinking (ERT) protocol. Assessments were completed at baseline, end of week 1, and a 1-week follow-up. Measures included a delay discounting task, hypothetical alcohol purchase task, clinical outcome measures, and cognitive mechanism measures. Results: There were significant reductions in alcohol demand indices, delay discounting rates, and an increase in mindful attention awareness after both acute and extended exposure to EFT. Furthermore, the EFT group showed greater reductions compared to the ERT group after extended exposure to their cues. Conclusion: The results suggest that early implementation of EFT in a treatment seeking addiction sample is beneficial to counteract motivating factors for relapse. This study lays the foundation for future clinical trials for EFT as a supplemental therapy for addictions treatment. / Thesis / Master of Science (MSc) / People with substance use disorders have a significantly shortened time perspective compared to healthy controls. This means that these individuals struggle with thinking about future events beyond several days to a week. Shortened time perspective can be a significant barrier to addiction treatments that typically focus on long-term positive benefits of sobriety or low-risk use. This study examined whether mindful thinking about future events impacted decision-making and motivation for alcohol and drugs. The study used an experimental protocol known as Episodic Future Thinking (EFT) that involves participants interacting with personalized cues related to positive future events. Prior research using EFT in addiction samples has found that interacting with future cues significantly increases delay of gratification, reduces cigarette use, and decreases reinforcing value of alcohol. In this study, we recruited 28 participants with an alcohol use disorder (AUD). Participants practiced EFT training over a two-week protocol. We tested decision making, alcohol craving, and other variables following a single EFT protocol, and changes in these measures over repeated practice. We found significant changes in alcohol craving, decision making, and mindfulness awareness. The study provides proof-of-concept for using EFT in an AUD treatment population and lays the foundation for future clinical trials of EFT as a complement to existing addiction treatments.

Undergraduates at Virginia Polytechnic Institute and State University (N = 306) were surveyed to investigate the formation of alcohol and marijuana use motives. Based upon a hypothesized path model effect expectancies, use motives, use frequencies, and use-related problems for alcohol and marijuana were assessed via self-report. Personality factors of sensation-seeking, sociability, and neuroticism-anxiety were also assessed during this single session. Many of the hypothesized pathways were confirmed via multiple regression methods for path analysis. The findings indicated that use motives are related to theoretically more distal influences such as related personality factors and drug effect expectancies. Motives were found to consistently account for substantial variation in use and the development of problems related to alcohol and marijuana in the sample. In some cases these motives not only predicted use, but also appeared to mediate the influences of personality factors and expectancies. Finally, specific motives were found to account for significant variation in the development of substance-related problems even after controlling for the frequency of use. / Master of Science