There is current widespread acceptance that persons with severe mental disorders are at increased risk to develop substance use disorders. The need for a theoretical framework to assist clinicians in assessing substance use disorders is critical. This study examined a piece of a popular theory of addiction, the Self-Medication Hypothesis. This theory is frequently cited among clinicians but lacks scientific support through objective studies. This study examined whether mood disorders, anxiety disorders and traumas precede the onset of alcohol, cocaine and nicotine use. Data from the National Comorbidity Survey (NCS), which is a nationally representative household survey conducted from September 1990 to February 1992 and included 8,098 respondents between the ages of 15 and 54, were used for the secondary data analyses. Diagnoses were based on the Composite International Diagnostic Interview (CIDI) and DSM-III-R criteria. Results of this study suggest that some psychiatric diagnoses and traumas precede substance usage. The Self-Medication Hypothesis may explain a small subset of cases in this study. For those who reported alcohol abuse, respondents with simple phobia, social phobia, and sexual molestation reported the alcohol abuse occurred second. For those who reported cocaine abuse, respondents who reported simple phobia, social phobia, physical assault, sexual molestation and rape reported the cocaine abuse occurred second. For those who reported nicotine usage, respondents with simple phobia, social phobia and sexual molestation reported the nicotine usage occurred second. While these findings are consistent with the Self-Medication Hypothesis, the Gateway model of substance use and developmental maturation are also possible explanations for this pattern of results. The Self-Medication Hypothesis may be descriptive of some clinical samples, but it is very limited and does not appear to be descriptive of general population samples such as that of the NCS. Overall, this study's results are not sufficiently supportive of the Self-Medication Hypothesis.
This study had two primary purposes: First, to explore a new methodology to conduct studies of studies of social work research status that might provide better reliability, minimize validity threats, and require less resources; and secondly, to utilize that new methodology to examine the current status of geriatric social work research. A multi-stage sampling process was utilized in order to isolate and obtain 248 unique aging focused peer reviewed articles published from 1999 to 2003 by self-identified geriatric social work scholars. Articles were content coded using typologies borrowed from prior studies. Five waves of inter-rater, and one intra-rater, checks were utilized to maximize reliability. Descriptive, bivariate, and multiple regression analyses were conducted to examine the current status of geriatric social work research. Bivariate analyses (e.g., chi square and independent t-tests) were utilized to examine whether random sampling produced results than would have been obtained from a convenience total sample. Findings from this study indicated a significantly higher proportion of empirical research (71.4%) within social work gerontology than found in other prior studies. Findings also indicated that while survey research designs continue to dominate the research literature, utilization of more sophisticated statistical techniques and research focused on explanatory knowledge vs. descriptive knowledge were significantly higher than in prior studies. Findings also indicated that the new random sampling methodology produced virtually identical findings to prior methodologies, while increasing reliability, at approximately one-fifth of the resource utilization in prior studies.;This study provides a cost-effective methodology to conduct future studies of social work research status that focus either on social work overall, or on a specific subject area within the discipline (e.g., gerontology). Findings were also supportive of a call for increased interdisciplinary collaboration. Interdisciplinary collaboration was significantly associated with increased external funding, and the development of explanatory vs. descriptive knowledge. It is hoped that this new methodology will provide a means to conduct periodic systematic reviews of research status over time that are comparable to each other. The methodology is both more reliable and cost-effective, and will allow for longitudinal trend analyses.
Over the past decade, the public child welfare system has increasingly relied upon female African American caregivers to provide out-of-home placements for relative children removed from their homes because of child maltreatment. African American women who care for relative children are also known as "Othermothers" (Troester, 1984) and a growing body of research reveals that this population is at risk for psychological distress, particularly depression. Depressed Othermothers can pose a serious public health concern for women and children in state care. African American women often use social support and spirituality to foster emotional resilience. Drawing upon concepts of the Transactional Stress-Coping Model and the Africentric Paradigm, this study examined the role social support and spirituality played in mediating or moderating the relationship between caregiver stress and depressive symptomatology. Data from an on-going Title IV-E federal demonstration project on families in Maryland's foster care system were analyzed. The sample included 116 African American Othermothers. A Social Embeddedness/Sense of Community scale and Density of Support scale measured social support; the Short Form of the Brief RCOPE, Daily Spiritual Experiences Scale and Organizational Religiousness Items measured spirituality; a Cumulative Stress Index measured caregiver stressors; the CES-D measured depressive symptomatology. Twenty-seven percent of the Othermothers had a positive screening for depression. Increased caregiver stress was associated with increased levels of depressive symptomatology (r = .373, p < .0005). Spirituality in the form of negative spiritual coping strategies and church attendance partially mediated the relationship between caregiver stress and depressive symptomatology. Lower levels of church attendance and neighborhood involvement were associated with elevated levels of depressive symptomatology (p < .10). This research suggests that spirituality and neighborhood factors play important roles in the psychological adjustment of African American Other-mothers. Maternal and child health, social work education, as well as child welfare implications are reviewed for African American caregivers and families in foster care.
Passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, more popularly known as "welfare reform", has been considered the most drastic overhaul of the welfare system since its inception. Perhaps the most radical feature of this legislation is limiting adults to a total of five years of welfare benefits, which can either be five consecutive years, or an accumulation of sixty months with the recipient's status periodically moving from welfare dependent to independent. Lost in the public affirmations of the success of welfare reform is the fact that Temporary Assistance for Needy Families (TANF) presents a swinging door for many people. Estimates of the number of welfare recidivists are universally high, ranging from 34% to more than 50%. Given these high numbers, and the ticking of the five year clock imposed by the TANF legislation, it is imperative to identify individuals most likely to become recidivists, and to develop appropriate intervention strategies to help them reach financial independence. While most of the extant research associates the return to welfare with a number of demographic and human capital characteristics, this dissertation explores the question of whether or not certain interpersonal factors act as barriers to success, that is as factors which have an effect on recidivism or returns to welfare (TANF) among those who have exited. This research examines locus of control, perceived social support from family, and coping skills, measured using Rotter's Internal-External Locus of Control, the Coping Responses Inventory-Adult, and the Perceived Social Support of Family scales, as possible explanations of recidivism by comparing a sample of recidivists and nonrecidivists. Using Expectancy Theory as a social-psychological framework for understanding how poverty might affect a person's behavior, it was hypothesized that those individuals with a more internal locus of control, higher levels of perceived social support from their families, and better coping skills, would be more likely to avoid returning to public assistance after an exit. Logistical regression analyses indicated that the two groups differed on one variable: coping skills. Individuals who did not return to welfare were significantly more likely to use approach coping (problem-focused cognitive and behavioral attempts to resolve or master a problem), than were individuals who returned to welfare.
In general, social science researchers agree that there is a need for culturally and linguistically appropriate instruments if findings are to reflect what they are intended to measure. This study examines if the Rosenberg Self-Esteem Scale (RSES) can be translated into American Sign Language, yield an instrument with internal consistency of .80, and produce an instrument with one underlying construct as was originally designed. The was translated into American Sign Language using the backtranslation method and an expert panel of raters to examine conceptual equivalence. Once conceptual equivalence was agreed upon by the raters, the instrument was given to participants. There were 185 participants in this study, after those with missing data were excluded. Results suggested that the translated version yielded an internal consistency of .7838, which is comparable to other studies involving translated versions of the RSES. The principal components analysis revealed three underlying components, labeled competence, negative self-evaluation, and positive self-evaluation, that accounted for 55.58% of the variance in the set of components. This finding is inconsistent with other studies. Discussion of these findings suggests that translation error is unlikely given the protocol for the backtranslation. A more likely source for this finding may be that the construct of self-esteem in deaf individuals may be multi-dimensional. Further research is indicated to examine the concept of self-esteem in deaf persons.
Measuring family preservation outcomes has challenged child welfare professionals, policymakers, and researchers for over a decade. Most agree that a change from the traditional service delivery model was warranted, but there is little agreement on a model to replace the traditional model. Defining family preservation services, determining what outcome measures to use other than out of home placement prevention, and deciding how to measure effectiveness are at the center of the debate. This pilot study addresses all three of these issues. In 1993, Virginia was the first state in the US to uniformly legislate a family preservation service system of care. Using the flexible, community-specific, wraparound definition of family preservation services espoused by Virginia's Comprehensive Services Act for At Risk Youth and Families (SA), this study examines the impact of family preservation services on 23 rural Virginia communities. With the community as the unit of analysis and through the use of a hierarchical linear model analysis, four predictors of community well being (low birth weight, school drop out, births to girls, and poverty) were compared with five factors traditionally considered to be risks for children (early school failure, juvenile arrests, child maltreatment, violent teen deaths, and foster care placement). In a time series design, these comparisons were made at six points in time: two years prior to implementation of the CSA, the year the CSA was implemented, and three years after implementation of CSA legislation. The findings in this pilot study demonstrated that the community is an appropriate unit of analysis to study but that evaluation of individual success must also be considered. School drop out rate was found to be a statistically significant predictor of early school failure. Low birth weight and poverty were found to be statistically significant predictors of foster care placement. Measuring change through the use of the two-level hierarchical linear model appears to be a promising model compared to analyses more commonly used in time series designs. Low power due to small sample size and only three years under a new service paradigm signal the need for further study using larger samples and a longer period of observation.
More than half of spouses of U. S. Army active duty soldiers are overweight or obese. In the U.S. almost a half million people die annually because of health related problems to being overweight or obese (Robbins, Chao, Baumgartner, Runyan, Oordt, & Foneseca, 2006). The military spends $1.1 billion a year on problems related to being overweight or obese for active duty military personnel, retirees, and their families (Dall et al., 2007). Method: Permission was granted from the Department of Defense (DoD) and the University of Maryland Institutional Review Board (IRB) to use the 2008 Active Duty Spouses Survey (ADSS) for the secondary data analyses used in this dissertation. Multiple and logistic regression analyses of U.S. Army spouses (n = 1863) examine the association of deployment status within the last year (not deployed, deployed but not to a combat zone, and deployed to a combat zone) with weight status, as measured with body mass index (BMI) scores (healthy weight versus overweight or obese). The independent variables examined were gender, age, race, rank of soldier, education, psychological distress, and perceived social support scores. Results: Deployment status and weight status were not related (p = .097). Three-quarters of the male spouses and almost half of the female spouses were overweight or obese. Spouses of soldiers in the enlisted ranks (E5-E9), minority spouses, and those without at least a four-year college degree are more likely to be overweight or obese. As spouses' age and psychological distress increases and perceived social support decreases their BMI increases. Conclusions: Findings suggest the risk factors associated with being overweight or obese are minorities; male spouses; the ranks of E5 - E9; less than a four-year degree; as age and psychological distress scores increase so does BMI; and as perceived social support scores increase the BMI decreases. The risk factors may contribute to the Army Surgeon General's Performance Triad of sleep, activity, and nutrition and be used to assist Army personnel and Department of the Army (DA) civilians to teach spouses awareness and methods of changing behaviors that result in choosing healthy options.
As mentoring is receiving increasing attention as a method to improve youth educational outcomes, it is important to continue to examine the effects of mentoring on these youth outcomes. This study uses secondary data from Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health) and transcript data from the Adolescent Health and Academic Achievement Study (AHAA). In seeking support for the compensatory model of resilience, this dissertation uses multiple and logistic regression analyses to examine the direct effects of youth risk factors and the compensatory factor (mentoring) on the educational outcomes: cumulative grade point average (GPA) and graduation from high school. The moderating effects of mentoring on the relationship between youth risk factors and these educational outcomes are also examined. The findings from this study suggest the following characteristics are risk factors for a lower cumulative GPA: younger age, academic risk, racial/ethnic minority status, low maternal education, living with less than both biological parents, lower levels of parental closeness, and lower levels of parental school involvement. On the other hand, only academic risk, low maternal education, and lack of parental participation in school fundraising and volunteering appear to be risk factors for not graduating from high school. Findings also indicate that the compensatory factor, mentoring, is significantly associated with a higher GPA, but is not significantly associated with graduation after controlling for youth risk factors and demographic factors. In support of the protective factor model, two significant moderating relationships were found in terms of predicting graduation between mentoring and the risk factors of living with less than both biological parents and lack of parental participation in school fundraising and volunteering. This study also found that cumulative risk (cumulative risk score was composed of 5 of the risk factors examined) is significantly related to both GPA and graduation, suggesting that youth with more risk factors have worse educational outcomes. The findings of this dissertation add to the existing literature on mentoring and youth educational outcomes. This dissertation's implications for theory, social work, educational practice, policy, and research are discussed as well as this dissertation's strengths and limitations.
Problem statement. Childhood poverty and child maltreatment are problems that affect millions of children, and often result in a range of negative sequelae. Yet, some individuals do well despite hardship. Understanding resilient survivors of child maltreatment and factors that contribute to their resilience is needed to best serve others who have been abused and neglected. Methods. Young adults (age 18-35) enrolled in college and in a Temporary Assistance to Needy Families (TANF) welfare to work job training program were surveyed on demographic, risk and protective factors, and indicators of resilience. Resilience was measured using a composite score composed of seven indicators of resilience (college and employment participation, scholastic achievement, self esteem, postponing childbearing, avoiding early drug and alcohol use, avoiding post traumatic stress disorder, and avoiding depression). Results. An internal locus of control, the presence of a familial mentor, religious involvement and a positive high school experience were all significant protective factors that contributed to resilience against child maltreatment and childhood poverty. As expected, recruitment site also significantly predicted resilience. Conclusion. An internal locus of control, the presence of a familial mentor, religious involvement and a positive high school experience are all associated with global resilience in young adults.
Though professional socialization is considered an essential aspect of social work education (Barretti, 2004a; Merdinger, 1982; Varley, 1963), there has been scant recent systematic inquiry in this area (Barretti). The existing literature does not provide conclusive information about the role of social work education in the professional socialization process (Weiss et al., 2004). This dissertation is grounded in an adapted theoretical model that synthesizes structural functionalist and symbolic interactionist descriptions of professional socialization and defines the process comprehensively. Data were collected from seven groups of undergraduate and graduate students, and graduate alumni representing key points along the social work education/practice trajectory. Surveys included measures derived from the social work literature, demographics, and exploratory questions. The survey was administered one time and was anonymous and confidential. The study contains four research objectives focused on adherence to the traditional mission of the profession, the degree to which the variables that comprise the professional socialization construct (commitment to social work values, idealistic social work attitude, and professional identity) are related, factors that predict socialization to the profession, and differences between groups.;Respondents are generally adherent to the traditional mission of social work and appear to be socialized to the profession. Findings indicate that the variables that comprise the professional socialization construct are separate facets of a larger whole, and that a number of factors are predictive of socialization with no discernable pattern across dependent variables. Differences emerged between groups across the set of dependent variables pointing to a pattern that suggests that the strongest differences lie at both ends of the education/practice continuum. Findings support the utility of the theoretical model for social work with additional refinement recommended. The study has implications for recruitment and retention of the social work workforce in this era of increasing need for social services. Implications for social work education and educational policy focus on the impacts of key socializing agents and venues including classroom and field experiences. Suggestions for future research include longitudinal studies, refinement of the survey instrument, replication with broader samples, comparing multiple schools of social work, and qualitative studies.
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