Substance use disorders (SUDs) are often comorbid with other psychopathology such as mood disorders, anxiety disorders, and personality disorders. While some research suggests individuals with comorbid psychopathology are more likely to seek substance use treatment than those with independent disorders, other studies have also shown many individuals with dual diagnoses still never seek treatment. Moreover, few studies have tried to elucidate the underlying structure of SUD treatment rejection, and instead examined it in more simplistic terms. In addition, studies have tended to examine the impact of individual disorders on treatment rejection, but have not incorporated an empirically supported approach to conceptualizing psychopathology in terms of comorbidity between broad latent dimensions referred to as internalizing (e.g., depression, anxiety) and externalizing (e.g., antisocial personality disorder, polysubstance use) psychopathology. Modeling psychopathology in terms of internalizing and externalizing psychopathology is becoming a prominent approach to understanding mental disorders, yet little research to date has investigated the effects these broad dimensions have on SUD treatment rejection. The current study utilized latent variable modeling techniques to (1) determine the latent structure of SUD treatment rejection in a large U.S. sample, and investigate whether treatment rejection is a multidimensional construct; and (2), to explore the ability of internalizing psychopathology, externalizing psychopathology, and personality pathology to predict the SUD treatment rejection factor(s). The current study relied on use of a general population sample of 43,093 individuals from the first wave of National Institute on Alcohol Abuse and Alcoholism's National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study. Support was found for the hypothesis that SUD treatment rejection would be a multidimensional construct.  Exploratory structural equation modeling indicated a three-factor model best fit the data. Operational definitions and clinical implications of these three treatment rejection factors ("Objective barriers," "Psychological barriers," and "Self-focused barriers") are discussed. Among internalizing psychopathology, externalizing psychopathology, and personality pathology, structural equation modeling identified internalizing psychopathology as the most robust predictor of these three factors for alcohol treatment rejection (n = 1063), indicating endorsement of treatment barriers increased as levels of internalizing psychopathology increased. This pattern also held true for externalizing psychopathology, while personality pathology only negatively predicted objective treatment barriers.  For drug treatment rejection (n = 562), only internalizing psychopathology significantly predicted the treatment rejection factors, indicating treatment endorsement of drug treatment barriers increased as levels of internalizing psychopathology increased. Implications of these findings and directions for future research are discussed.

Researchers have previously identified substance use and borderline personality disorder as factors that increase risk for suicidal thoughts and behaviors. This study explored the relationship between these factors in samples of students and individuals seeking outpatient treatment. Supplemental data collected via the internet (MTurk) also looked at experiential avoidance (EA) with the Avoidance and Fusion Questionnaire for Youth. The Structured Clinical Interview for the DSM-IV, Alcohol Use Disorders Identification Test, Scale for Suicide Ideation, and Personality Assessment Inventory- Borderline Features Scale elicited information regarding severity and/or frequency of substance use, suicidal thoughts, and borderline features respectively. Additionally, the Psychiatric Diagnostic Screening Questionnaire was administered to the UNT sample. The UNT sample analyses indicate substance use moderates, strengthening, the relationship between borderline features and current suicidal thoughts. However, severity of suicidal thoughts was lower for individuals high in both borderline features and substance use disorder symptoms compared to those low in borderline features and high in substance use symptoms. The MTurk sample analyses suggest substance use functions as a mediator. A robust relationship existed between substance use severity and EA, showing substance use as a behavioral marker for EA. In conclusion, concurrent treatment of substance use and borderline personality features would be beneficial in reducing risk for suicidal thoughts. Further investigation into the role and utility of addressing EA is warranted.

A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Arts in Clinical Psychology. Johannesburg, 2016 / Substance dependence is a global issue that is becoming significantly more problematic. This is due to the fact that it does not just have a devastating effect on the individual but results in profound spin-off effects, which impact society as a whole. Much research has been conducted within this area and contemporary research has seemed to focus on the link between attachment styles and substance abuse. Since its conception by John Bowlby, attachment theory has achieved an empirical authority that has contributed to its popularity in modern times. However, despite this renewed interest there still exists a gap in the literature around the role that relationships, throughout the lifespan, play in areas such as pathology and recovery. Consequently, this research embarked on an interpretive phenomenological exploration of the way relationships impact the lives of individuals suffering from substance dependence. Adults in recovery from substance dependence were individually interviewed about their experiences of their relationships during and after their years of abusing substances. Hermeneutical phenomenological analysis was used to analyse this data and it revealed a typical model of pathology where a negative childhood experience had cascading effects that culminated in the later dependence on substances. Participants all highlighted relationships with themselves or others as pivotal to either seeking substances or to going into recovery. These themes were then located within Bowlby’s (1976, 1980) developmental pathways framework in order to make sense of the progression of substance dependence along the lifespan as it manifested in these participants. / MT2017

The physical effects of substance use (tobacco, alcohol, and marijuana) are well known, but it is not clear whether the use of these substances can be a warning sign for psychological or emotional problems in high school students. The Youth Risk Behavior Survey (YRBS) is a nationwide survey conducted by the Centers for Disease Control and Prevention every other year which asks students questions about risk behaviors such as substance use, sexual activity, the amount of violence in their lives, and suicide attempts. We examined students who were involved in the use of substances more commonly found in high schools (tobacco, alcohol, and marijuana) to see if they were significantly more likely to attempt suicide than their peers who were not involved in this type of activity. A multiple logistic regression analysis was performed on the 2013 Nationwide YRBS data (n = 13,583) to examine this effect while controlling for the following possible covariates: depression, gender, age, race, lack of sleep, and access to weapons. Results of this analysis showed a significant increase in suicide attempts among students who used tobacco and marijuana (OR = 1.987, 95%CI = 1.638, 2.411; OR = 1.273, 95%CI = 1.038, 1.561, respectively). However, the results of this analysis did not show a significant increase in suicide attempts for students that consumed alcohol. It was interesting to see that while possession and use of marijuana for a high school student is a more highly punishable crime, tobacco use is a better indicator for possible attempts at suicide. While there are many variables at play when it comes to substance use and suicide risk, these results indicate that students who are identified as users of tobacco and marijuana should be looked at more closely as they represent a population more susceptible to attempting suicide.

Background: Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. Objective: The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Methods: Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Results: Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. Conclusion: It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community’s environment, especially if older persons are involved. Scientific Significance: Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.

Thesis (MPH.) -- University of Limpopo, 2015 / Refere to document

Disparities between the substance use rates of sexual or gender minority (SGM) youth and the rates of youth identifying as heterosexual (i.e., attracted to the opposite sex) and cisgender (i.e., gender identity corresponds to birth sex) have given rise to calls for 1) research to understand the specific risk and protective factors relating to substance use in SGM youth and 2) the development of corresponding intervention programming In three papers, this dissertation explores predictors for substance use among SGM youth and describes methods of targeted recruitment for a prevention intervention program tailored to SGM youth. In the first paper, comparing the contributing factors of substance use between sexual minority and heterosexual youth revealed that although many predictors were associated with use in both groups, sadness, suicidal ideation, difficulty concentrating, and forced sexual encounters were the most consistent and substantial contributors to the explanation of the difference in use rates between groups. In the second paper, risk and protective factors identified from social learning theory and minority stress theory, including perceived stress, problem-solving skills, self-esteem, self-efficacy, substance refusal skills, and peer use of substance, were generally associated with past-month substance use. Peer use of substance and substance refusal skills, in particular, were consistently and robustly associated with substance use in the sample of SGM youth, and their intersection provides insight into themes to address in future intervention development. Issues of disclosure and parental permission have made recruiting representative samples of SGM youth challenging, and the third paper offers insight into an inexpensive and time-efficient means of recruiting SGM youth for participation in such research. The specificity with which Facebook ads can be targeted to hard-to-reach populations makes it a preferred tool for researchers who seek to recruit SGM youth. Taken together, the three papers of this dissertation can serve as a guide for the development and execution of substance use prevention research that is tailored to the specific needs of SGM youth.

Treating people with co-occurring or dual diagnosis disorders requires an integrated treatment approach due to the complex health and social needs of people who suffer from mental illness and drug addiction. An integrated approach is not only necessary but crucial to treat both the drug addiction and mental illness concurrently. The aim of this study is to explore the impact that non- integrated care can have on the number of relapses that dually diagnosed people can have. The study found that there is no correlation between concurrent treatment and the number of relapses that dually diagnosed people may have. Social workers will need to be able to recognize mental illness that co-occurs with substance use in order to effectively treat clients to determine what treatment approach should be used. Social workers are trained to use a biopsychosocial approach to capture all aspects of the client’s life. This I especially important for clients that may be dually diagnosed.

Thesis (M.A.(Social Work)) --University of Limpopo, 2006 / The problem of alcohol and other drugs abuse as well as HIV/AIDS exists globally. This problem does not, spare any institution. It occurs even in primary schools. It cuts across the colour, creed, age and ethnicity lines. The high rate of infection and death of youth in South Africa has devastating consequences, which in turn has led to a destruction of individuals, families and communities. In other words, HIV/AIDS poses a serious threat to the health and welfare of South Africans. Heightened concern about the damage brought by alcohol and other drugs as well as HIV/AIDS has led researchers, educators, social service providers and health service providers to develop an array of diversified programmes to discourage the youth from engaging in unprotected sex and abusing drugs and alcohol. However the problems persist despite measures suggested in a plethora of research studies, reports and inquiries that have been mounted towards alleviating them. An investigation of knowledge on HIV/AIDS and substance abuse was conducted among Grade 6 & 7 learners from three different primary schools in Sefateng Village, Motsepe, Bogalatladi; and Mafise. The ages of respondents ranged from 12 to 16 years of age. The findings in the study shows that primary school learners indulge in sexual activities and use of substances from as early as 12 years of age.

Thesis (M. Ed. (Educational Management)) --University of Limpopo, 2011