Substance use and substance use disorders (SUDs) pose a significant health and economic concern in the United States. Conditions and comorbidities exist that are associated with substance use onset, continuation, and outcomes. In the theory of Reinforcer Pathology, we can categorize these conditions into vulnerabilities, or factors that may be associated with susceptibility to substance use onset and poorer outcomes in substance use recovery. The theory of vulnerabilities and reinforcer pathology is tested through three investigations. The first investigation sought to establish the relationship between cumulative vulnerabilities and adolescent substance use in a cross-sectional analysis. The second investigation evaluates the temporal relationship of cumulative vulnerabilities and substance use among adolescents. The final investigation establishes the relationship of cumulative vulnerabilities and substance use among individuals in recovery from Opioid Use Disorder. Collectively, these reports suggest that the intersection and cumulation of vulnerabilities to substance use and substance use disorders are directly related to substance use outcomes. Future research and reports in the substance use domain should consider these constructs, their accumulation, and their co-occurrence patterns. / Doctor of Philosophy / Substance use and substance use disorders are a great health and economic concern in the United States. Conditions that are related to trying substances, using substances, and outcomes of this substance use. In the theory of Reinforcer Pathology, we can call these conditions vulnerabilities, or conditions that may be associated with the likelihood of starting to use substances and having poorer substance use outcomes in the long-term. Three studies investigate the theory of vulnerabilities and Reinforcer Pathology. First, the relationship between cumulative vulnerabilities and substance use among adolescents is assessed cross-sectionally or simultaneously. The second study examines the relationship between cumulative vulnerabilities and adolescent substance use over time. The third study examines the relationship between cumulative vulnerabilities and substance use among individuals in recovery from Opioid Use Disorder. Collectively, the studies in this report suggest that the overlap and cumulation of vulnerabilities to substance use and substance use disorders is related to substance use outcomes. Future research and other reports in the substance use domain should consider these constructs, their accumulation, and their co-occurrence patterns.
| Identifer | oai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/115903 |
| Date | 27 July 2023 |
| Creators | Tomlinson, Devin Christine |
| Contributors | Graduate School, Bickel, Warren K., Trestman, Robert L., LaConte, Stephen M., Stein, Jeffrey S. |
| Publisher | Virginia Tech |
| Source Sets | Virginia Tech Theses and Dissertation |
| Language | English |
| Detected Language | English |
| Type | Dissertation |
| Format | ETD, application/pdf |
| Rights | In Copyright, http://rightsstatements.org/vocab/InC/1.0/ |
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