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Adolescent motherhood, depression, and delinquency

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Although recent studies have report that many stressors and strains (i.e., financial, educational and psychological) arise from being an adolescent mother, whether adolescent motherhood influences delinquency remains an unanswered empirical question. Using data from a nationally representative sample of adolescents

Although recent studies have report that many stressors and strains (i.e., financial, educational and psychological) arise from being an adolescent mother, whether adolescent motherhood influences delinquency remains an unanswered empirical question. Using data from a nationally representative sample of adolescents (National Longitudinal Study of Adolescent Health), the current study examines the relationship between motherhood, depression, and delinquency (N = 676). The sample is comprised of solely females between ages 13 and 21-years-old. The female subjects were categorized either as an adolescent mothers, non-mother adolescents, or adult mothers. This study tests the following hypotheses: (1) adolescent mothers are prone to involvement in delinquent behavior; and, (2) adolescent mothers who experience depression are at greater risk of delinquent behavior. The results indicate that there is a decrease in delinquency among adolescent mothers who do not experience depression. However, there is an increase in delinquency among adolescent mothers who experience depression.

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2014

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Conceptualizing Offending, Victimization, and Gender: Three Studies on Juveniles

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General theories of crime have frequently been used to explain a variety of offending and victimization experiences for a wide range of samples. However, feminist criminologists question whether the same causal mechanisms exert similar effects for males and females—a criticism

General theories of crime have frequently been used to explain a variety of offending and victimization experiences for a wide range of samples. However, feminist criminologists question whether the same causal mechanisms exert similar effects for males and females—a criticism that points to the need for sex-specific analyses. Toward that end, this dissertation examines variables derived from several different general theories of crime in three separate studies. Each of the studies uses split-sample analyses to investigate potential sex-based differences. The first study uses three-level meta-analytic methods to determine if predictor variables derived from general theories explain victimization for both adolescent males (n = 138,848) and adolescent females (n = 176,611). Additionally, it examines both within-dataset and between-dataset differences. The second study uses a sample of high school students in Arizona (n = 2,738 males, n = 2,932 females). It examines the role of parental social ties in explaining the overlap of adolescent dating violence (ADV) offending and victimization. The third study uses two waves of a longitudinal dataset of high-risk adolescents (n = 182 males, n = 203 females). It focuses on the relationship between negative emotions and delinquency, and the role of avoidant coping. In each of the studies, both gender-neutral and gender-specific explanations of offending and victimization were found. In the first study, while predictor variables derived from criminological theory explained victimization for both males and females, larger effect sizes were found for risky lifestyle variables. In the second study, an overlap between ADV offending and victimization was found for both males and females, and social ties explained some of the overlap. However, paternal attachment was only significant for females, and involvement was only significant for males. In the third study, avoidant coping was associated with an increase in substance abuse, and anger was associated with an increase in violent behavior for both males and females. Avoidant coping partially mediated the relationship between anger and substance use, but only for males. Implications for practice and future research are discussed.

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2020

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Screening, Brief Intervention and Referral to Treatment (SBIRT): Implementation in the Adolescent Inpatient Psychiatric Setting

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Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT) provides an evidence-based (EB) framework to detect and treat SU. Evidence shows that mental health (MH) providers are not providing EB SU management. Federally grant-funded SBIRT demonstrated evidence of decreased SU and prevention of full disorders. Implementation outcomes in smaller-scale projects have included increased clinician knowledge, documentation and interdisciplinary teamwork.

Objective: To improve quality of care (QOC) for adolescents who use substances in the inpatient psychiatric setting by implementing EB SBIRT practices.

Methods: Research questions focused on whether the number of SBIRT notes documented (N=170 charts) increased and whether training of the interdisciplinary team (N=26 clinicians) increased SBIRT knowledge. Individualized interventions used existing processes, training and a new SBIRT Note template. An SBIRT knowledge survey was adapted from a similar study. A pre-and post-chart audit was conducted to show increase in SBIRT documentation. The rationale for the latter was not only for compliance, but also so that all team members can know the status of SBIRT services. Thus, increased interdisciplinary teamwork was an intentional, though indirect, outcome.

Results: A paired-samples t-test indicated clinician SBIRT knowledge significantly increased, with a large effect size. The results suggest that a short, 45-60-minute tailored education module can significantly increase clinician SBIRT knowledge. Auditing screening & BI notes both before and after the study period yielded important patient SU information and which types of SBIRT documentation increased post-implementation. The CRAFFT scores of the patients were quite high from a SU perspective, averaging over 3/6 both pre- and post-implementation, revealing over an 80% chance that the adolescent patient had a SU disorder. Most patients were positive for at least one substance (pre- = 47.1%; post- = 65.2%), with cannabis and alcohol being the most commonly used substances. Completed CRAFFT screenings increased from 62.5% to 72.7% of audited patients. Post-implementation, there were two types of BI notes: the preexisting Progress Note BI (PN BI) and the new Auto-Text BI (AT BI), part of the new SBIRT Note template introduced during implementation. The PN BIs not completed despite a positive screen increased from 79.6% to 83.7%. PN BIs increased 1%. The option for AT BI notes ameliorated this effect. Total BI notes completed for a patient positive for a substance increased from 20.4% to 32.6%, with 67.4% not receiving a documented BI. Total BIs completed for all patients was 21.2% post-implementation.

Conclusion: This project is scalable throughout the U.S. in MH settings and will provide crucial knowledge about positive and negative drivers in small-scale SBIRT implementations. The role of registered nurses (RNs), social workers and psychiatrists in providing SBIRT services as an interdisciplinary team will be enhanced. Likely conclusions are that short trainings can significantly increase clinician knowledge about SBIRT and compliance with standards. Consistent with prior evidence, significant management involvement, SBIRT champions, thought leaders and other consistent emphasis is necessary to continue improving SBIRT practice in the target setting.

Keywords: adolescents, teenagers, youth, alcohol, behavioral health, cannabis, crisis, documentation, drug use, epidemic, high-risk use, illicit drugs, implementation, mental health, opiates, opioid, pilot study, psychiatric inpatient hospital, quality improvement, SBIRT, Screening, Brief Intervention and Referral to Treatment, substance use, unhealthy alcohol use, use disorders

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2019-05-02