The purpose of the study was to explore the complex ways in which chemsex and internalised homophobia may be linked. The study sought to: Elucidate the concept of internalised homophobia; determine the challenges experienced by gay men and how psychoactive drugs influence their sexual relationships with other men; and also explore a possible relationship between chemsex and internalised homophobia. The study hopes to contribute to a better understanding of the challenges that are faced by gay people and the reasons why some gay men participate in chemsex. A total of eleven participants were identified from an LGBTIQ+ friendly drug rehabilitation centre and a gay bath house in Cape Town. A qualitative approach was used to conduct the study by conducting semi structured interviews with each participant. The theoretical framework used to elucidate the concept of internalised homophobia among the LGBTIQ+ community was underpinned by the minority stress model. This model was used to explain the concepts of homophobia and internalised homophobia. The methodological framework used was qualitative research, which focuses on the stories of individuals and is concerned with the social construction of the individual’s life, and specifically Thematic Analysis which assisted in identifying patterns or themes in people’s accounts. The findings were that even though there is a relationship between internalise homophobia and chemsex, there are many other factors and influences that play a role, such as the individuals' backgrounds, their experiences in coming out as gay, and other life circumstances. In conclusion, the study suggests that there is much more that can be done to break down the stigma and prejudice facing the LGBTIQ+ community, which is a first step towards addressing the chemsex phenomenon and related psychological consequences. / Psychology / M.A. (Psychology)

Introduction. Prior research has found high rates of behavioral health concerns, including several forms of substance use, among community college students. However, the prevalence of non-medical use of prescription stimulants (NMUS) as well as the motivations driving NMUS among community college students is unknown. Methods. Survey results from 13 community colleges within the Tennessee Board of Regents school system were evaluated to explore 1) rates of NMUS, 2) reported motivations for NMUS, and 3) how demographic characteristics including race, age, and income differ based on self-reported reasons for NMUS. Results. NMUS was reported by approximately 9% of the overall sample. The most common motivation for NMUS was to focus on studies or to improve academic performance reported by 67.5% of participants. Demographic characteristics varied between individuals reporting/denying NMUS and reported motivations for NMUS, with younger and urban-residing participants at the highest risk. Conclusions. NMUS is occurring in non-negligible amounts by community college students. Understanding motivations for use provides insight into possible mechanisms for behavior change. Future research should examine the efficacy of challenging specific motivations and expectancies in effort of preventing NMUS among community college students.

No description available.

Of the 3.5 million persons infected with chronic HCV in the United States, the African American population is the largest racial group with chronic HCV. Disparities in access to care and treatment involve a complex set of individual, interpersonal, socioeconomic, and environmental factors that influence the course of HCV infection in the African American population, resulting in poorer outcomes and survival. Drawing upon both the theory of reasoned action and the theory of planned behavior, this study was conducted to determine whether the seeking of health care by HCV-positive African Americans and the responses of health care providers to HCV-positive African Americans had improved since 2008 following the introduction of new treatment options, as compared to other HCV-positive racial/ethnic groups, using secondary data analyses with survey datasets from the National Health and Nutrition Examination Survey, 2005-2012. Using chi-square test of difference and logistic regression analyses, the study did not identify a statistically significant relationship between health care seeking behavior and responses from health care providers for HCV-positive African Americans before (2005-2008) and after (2009-2012) the introduction of new treatment options as compared to other HCV-positive racial/ethnic groups. Given the ongoing development of new and improved drugs to treat HCV infection, further research might focus on the HCV-infected population as a whole to ascertain whether differences exist as compared to earlier therapies before 2013. This study may drive social change within the health care community by raising awareness of the risks of HCV infection resulting in less provider bias and the introduction of resources into the African American and underserved communities that will improve outcomes and reduce barriers to care.

The current research analyzed the relationship between methamphetamine use, cocaine use and marijuana use within the last 12 months and crime committed within the last 12 months. Crime is defined as drug sales, property and violent crime. The research design is a quantitative approach which uses secondary data analysis of the National Longitudinal Survey of Adolescent Health (Add Health) to provide evidence toward the research question; does illegal drug use increase the risk of committing a crime?The public access, 2008 Wave III data results of this nationally representative sample of adolescents in grades 7 through 12 in the US in the 1994-95 school year was used for analysis. Methamphetamine use was associated with an increased risk of committing all crime, only until cocaine use was controlled for. Once cocaine use was controlled for, methamphetamine use became non-significant. Cocaine use and marijuana use were significant and associated with an increased use of committing a crime.

Objective: To determine the prevalence and odds ratios for cleft lip and/or palate (CL/P) among infants prenatally exposed to opioids with or without neonatal opioid withdrawal syndrome (NOWS). Design: This study represents an exploratory, retrospective cohort study design of newborn medical health records from 2011 to 2016. Setting: Records were drawn from a regional health system located in South Central Appalachia. Population and study sample: The original population yielded 3 cohorts of infants: (1) infants with opioid exposure (OE) but not requiring pharmacological intervention (OE; N = 168); (2) infants with NOWS requiring pharmacological intervention (N = 294); and (3) infants with no opioid exposure (NOE; N = 16 090), the primary comparison group. Main outcome: Infants in the NOWS and OE groups showed significantly increased prevalence and odds ratios for CL/P when compared to those in the NOE group. Results: Prevalence rates per 1000 live births for infants with OE (35.71) and infants with NOWS (6.80) were significantly higher than those for infants with NOE (1.37). Comparison of infants with OE to the NOE group revealed significantly increased odds for CL/P, isolated cleft palate (CP), cleft lip (CL), and cleft lip and palate (CLP) (27.05, 41.81, 19.26, 19.37, respectively; all Ps < .008). The odds ratios for infants with NOWS compared to the NOE group were significantly higher for CL/P and CP (5.00 and 10.98, respectively; Ps < .03) but not for CL and CLP. Conclusion: The results provide additional evidence that prenatal OE should be considered among the critical environmental risk factors that can contribute to CL/P.

Indiana University-Purdue University Indianapolis (IUPUI) / People with severe mental illness (SMI) often suffer from comorbid physical conditions that result in chronic morbidity and early mortality. Physical health decision-making is one area that has been largely unexplored with the SMI population. This study aimed to identify what factors contribute to the physical healthcare decision-making autonomy preferences of persons with SMI, and to identify the impact of these autonomy preferences on medication adherence. Ninety-five adults with SMI were recruited from an integrated care clinic located in a community mental health center. Fifty-six completed a three-month follow-up. Multiple linear regression for hypothesis 1 (n=95) and hierarchical regression for hypothesis 2 (n=56) were used to analyze data on personal characteristics, physical health decision-making autonomy preferences and medication adherence. For the open-ended questions, thematic analysis was used to uncover facilitators and barriers to medication adherence. With this sample, being male predicted greater desired autonomy, and having less social support predicted less desired autonomy. When background characteristics were held constant, autonomy preferences and perceived autonomy support from the physician only contributed an additional 1% of the variance in medication adherence. Lastly, participants reported behavioral factors and having family/personal support to take medications as facilitators to medication adherence for physical health care, while citing financial and other resource limitations as barriers.

No description available.

No description available.

Adolescence is a sensitive developmental period encompassing neural maturation that is critical for an individual’s behavioral transition into adulthood. Due to widespread physiological changes attributed to this period, adolescents are also vulnerable to the initiation of risky behaviors, such as drug experimentation and use, as well as the emergence of various neuropsychiatric disorders. The mesocorticolimbic dopamine (DA) system in the brain undergoes a transient peak in activity and continues to mature during adolescence, potentially mediating adolescent hypersensitivity to social, appetitive, and drug-associated rewards. Simultaneously, the serotonin (5-HT) system exerts its influence on the dopamine system throughout adolescence, a process vital for proper impulse control and emotional regulation in adulthood. Substance use disorders (SUDs) are multifaceted and are comprised of diverse maladaptive behaviors that promote compulsive drug seeking, including loss of control and the propensity to engage in drug use irrespective of personal risks and/or consequences. Drug addiction and substance use have a large negative impact globally both economically and with regards to public health outcomes, representing approximately 1.3% of the global burden of disease. Furthermore, dopamine reward pathways are heavily impacted by drug use, particularly with respect to stimulants, and the level of drug-induced dopamine release in the ventral striatum can be correlated with a drug’s perceived “high.” Certain experiences and adverse behaviors linked to refinement of monoamine connectivity in the brain during adolescence, such as heightened stress and sensation seeking, may predispose individuals for developing SUDs in adulthood. However, how drug reward sensitivity and associated activity of the dopamine system is altered in adulthood as a consequence of interfering with monoamine neurodevelopment during adolescence has not been clarified. To this end, I aim to understand how imbalanced monoamine development during adolescence contributes to stimulant-mediated behaviors in adulthood, specifically contextual reward associations, in relation to in vivo activity of the dopamine reward system. I introduce a sensitive peri-adolescent (PA) period in mice, during which blockade of the serotonin transporter (SERT) via fluoxetine administration during postnatal (P) days 22-41 leads to inhibited adult aggression and locomotor response to stimulants. Conversely, I describe a more refined PA (P32-41) period during which systemic dopamine transporter (DAT) blockade via GBR12909 administration leads to enhanced aggression and stimulant-induced locomotor activity in adulthood. Utilizing these behaviorally opposing models characterized in our lab, I describe the diverging effects of systemic DAT and SERT blockade from P32-41 on cocaine-induced locomotor response as well as cocaine-mediated contextual preference. I administered cocaine intraperitoneally (i.p.) at doses of 5 and 10 mg/kg, applying the open field test and cocaine conditioned place preference (CPP) paradigm to assess stimulant-induced locomotor response and environmental reward associations, respectively. Potentiation of serotonergic tone during P32-41 via fluoxetine administration leads to decreased cocaine-induced locomotor response and a lack of preference for a cocaine-associated context in adulthood at a dose of 10 mg/kg, compared to controls and PA GBR treated subjects. Conversely, potentiation of dopaminergic tone by administering GBR12909 during P32-41 is associated with enhanced cocaine-induced locomotor reactivity at 10 mg/kg and greater contextual preference at lower doses of cocaine (5 mg/kg), in comparison to PA fluoxetine treated mice and controls. To understand how in vivo VTA dopamine population activity is altered in both PA models during cocaine-associated behaviors in adulthood, I performed cocaine CPP while recording calcium signals in VTA dopamine neurons using fiber photometry in freely behaving subjects. Importantly, I utilize these recordings as a proxy for measuring changes in VTA dopamine activity as the subjects engage with a cocaine-paired environment. I found that PA DAT blockade was associated with greater baseline VTA dopamine activity in adulthood compared to controls, as well as heightened VTA dopamine activity while the subjects were in a cocaine-paired context during selected portions of the behavioral task compared to control subjects. Additionally, we found a significant positive correlation between the magnitude of preference for a cocaine-associated context and the frequency of VTA dopamine calcium signals recorded while the subject is engaged with a cocaine-paired environment. Adult mice following PA DAT blockade displayed a greater frequency of recorded VTA dopamine calcium signals while in a cocaine-paired environment compared to PA fluoxetine treated mice. Supporting our correlational analysis, I detected a decreased preference for a cocaine-paired context in PA fluoxetine treated subjects compared to both controls and PA GBR12909 mice, when using a dose of cocaine in between the previous concentrations tested (7.5 mg/kg). Interestingly, PA fluoxetine treated subjects showed transition-dependent differences in VTA dopamine calcium activity during the final five-minute portion of our behavioral task, displaying less activity shortly post-entry into the cocaine-paired environment compared to pre-entry. In congruence, PA fluoxetine subjects showed enhanced VTA dopamine calcium activity on the saline-paired side shortly post-entry compared to pre-entry. In collaboration with the Sulzer Lab, we also probed the effects of both PA manipulations on electrically evoked dopamine release in the ventral striatum of adult anesthetized mice using fast-scan cyclic voltammetry. Electrical stimulation was targeted to the midbrain and evoked dopamine release was recorded in the ventral striatum both at baseline and in response to cocaine injection, using the same 7.5 mg/kg dose applied in the calcium imaging study. Overall, we found a significant increase in dopamine release at baseline in the ventral striatum of adult PA GBR12909 treated subjects compared to both PA fluoxetine subjects and controls. Moreover, we found significantly greater cocaine-induced dopamine release in our PA GBR12909 mice compared to controls in adulthood. These findings are consistent with the imaging and behavioral data, highlighting the persistence of an elevated dopaminergic phenotype due to systemic PA DAT blockade. Conversely, systemic PA SERT blockade leads to behaviorally opposing effects and generally lower VTA DA activity dynamics in comparison to PA GBR12909 treated subjects in adulthood. The unique, combinatorial approach applied in this dissertation work further our knowledge of how sensitive developmental periods influence the emergence of complex behaviors in adulthood, which is vital to improving treatment approaches for neuropsychiatric disorders.