Mental disorders cost the United States approximately 170 billion dollars in just one year (HHS, 2002). The onset of a diagnosable mental disorder such as anxiety, depression, and substance abuse can begin in adolescence. Rural adolescents are at risk for negative outcomes due to psychosocial/socioeconomic stressors and a lack of access to health care.
This secondary data analysis used a cross-sectional sample of 466 adolescents from four rural high schools in western Pennsylvania to examine the relationships among demographic variables (age, gender, birth order, parents present in household, subject having a job), stress (life events), psychosocial factors (optimism, perceived social support, coping), and the outcomes of anxiety, depression, and substance abuse (alcohol, drugs, smoking). Lazarus Theory of Stress and Coping and Lerners Developmental Contextualism was used to form the theoretical framework. Descriptive statistics, correlational and regression analysis were the primary methods of analysis.
Over 33% of the subjects reported depressive symptoms; 20% reported higher levels of anxiety symptoms. Approximately 74% report that they have used alcohol at least once; 53% report having tried at least one other drug such as cocaine or marijuana. Over 38% smoke cigarettes at least occasionally.
Gender differences were found in the sample. Females reported greater anxiety and depressive symptoms than males. Gender had both a direct and indirect effect on the outcomes of anxiety and depression with negative life events and psychosocial factors (optimism, social support, and coping) acting as mediators. Stress, optimism, perceived social support of family, and avoidance coping were found to have a mediating effect on the relationship between demographics and substance abuse. The results of this study support the proposed model and the hypotheses that stress and psychosocial factors are mediators between the relationships among the demographic and outcome variables.
Empirical data gathered and reported in this and other studies will assist health care professionals (e.g., physicians, nurse practitioners, and school nurses) to develop and implement interventions that target mediating variables such as coping. These interventions have the potential to improve rural adolescents ability to socialize, adapt, and cope; assisting them in making better decisions and growing into productive, healthier adults.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-08282005-203115 |
| Date | 01 September 2005 |
| Creators | Tickerhoof George, Nickole Marie |
| Contributors | Yookyung Kim, Ph.D, Willa Doswell, Ph.D., FAAN, Susan Sereika, Ph.D., Kathryn Puskar, DrP.H., C.S., F.A.A.N., Carl I. Fertman, Ph.D., MBA, CHES |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-08282005-203115/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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