Points Research Bibliography: Addiction Stigma, Support, and Spirituality in the Americas

Editor’s Note:  These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Does Perceived Faculty Support Moderate the Effects of Stress on Student Nurse Substance Use?

Author: Boulton, Martha Ann

Publication info: Teachers College, Columbia University, ProQuest Dissertations Publishing, 2016. 10126378.

Abstract: Purpose: Nurses who abuse substances are a threat to patients, colleagues, society, and themselves. The purpose of this research, guided by Hildegard Peplau’s Interpersonal Theory in Nursing, was to identify rates of substance misuse by student nurses and determine whether a relationship exists between stress and substance misuse and whether perceived faculty support moderates the effect of stress on substance misuse. In addition, the relationship among perception of peer use, perception of harmfulness, and substance use was explored. Method: A quantitative, cross-sectional, correlational design was used to determine whether a relationship exists between stress and substance abuse and whether perceived faculty support moderates the effect of stress and substance misuse in student nurses. The convenience sample of National Student Nurses’ Association members yielded 4,033 completed surveys. Students were given the Student Nurse Stress Index and Perceived Faculty Support Scale, and asked about their past-year substance use, perceived peer substance use, and perceived harmfulness of substance use, via Survey Monkey. Responses were analyzed through exploratory data analysis and logistic regression. Results: Binge drinking was reported by 61% of the student nurses; 18% reported using marijuana; 5% reported using illegal drugs, excluding marijuana; 8% reported using non-prescribed stimulants to enhance academic performance; and 10% reported using non-prescribed prescription pills. Students with higher stress scores had a higher incidence of substance use. Most participants reported moderate faculty support. Those who had higher perceptions of faculty support tended to use fewer non-prescribed stimulants for academic enhancement. The hypothesized interaction was non-significant. This model accounted for 1.6% of the variance. Students tended to overestimate their peers’ substance use. Perceived harmfulness of a substance was related to a decrease in binge drinking, marijuana use, illegal drug use, stimulant use for academic enhancement, and non-prescribed prescription drug use. Conclusions: The results suggest that student nurses tend to use fewer drugs than their college counterparts but are slightly more likely to binge drink. Perception of peer use and perceived harmfulness accounted for 30% of the variance. They reported a moderate level of stress and used non-prescribed prescription drugs more as the stress scores increased. Perceived faculty support seems to be inversely related to use of non-prescribed stimulants and does not appear to moderate the effect of stress on substance misuse.

Publication year: 2016

ISBN: 9781339844183

Advisor: O’Connell, Kathleen A.

University/institution: Teachers College, Columbia University

Department: Health and Behavior Studies

A Qualitative Study on the Role of Grace in Recovery from Addiction as Experienced through Participation in Alcoholics Anonymous or Other Twelve Step Programs

Author: Glerup, Kate Dalthorp

Publication info: Eastern University, ProQuest Dissertations Publishing, 2016. 10128209.

Abstract: This is a qualitative study on the role of the spiritual concept of grace in one’s recovery from addiction as experienced in Alcoholics Anonymous (AA) or other Twelve Step recovery programs. The purpose of the study is to identify if a persons’ experience of the spiritual concept of grace (as defined by a Christian worldview) plays a role in recovery from addiction. And if so, to better understand why and how grace functions in this capacity in the experience of participants in this study. Because the founders of AA were heavily influenced by a Christian worldview, a Christian understanding of grace was of primary consideration. Using five focus groups from two different states, a total of twenty participants, who found AA helpful, were asked to respond to a set of questions related to grace. The groups were recorded and transcribed; results were then coded and analyzed. Findings from this study indicate that not only do addicts experience grace “in the rooms” of AA, through the fellowship and community of other addicts and through working the Twelve Steps of recovery, but this experience of grace plays a significant and positive role in the recovery process as experienced by participants. This study attempts to clarify more specific spiritual aspects that support the effectiveness of AA (Kelly & Beresin, 2014).


Publication year: 2016


ISBN: 9781339862217

Advisor: White, Gwen

Committee members: Peterson, Margaret; Tucker, Martha

University/institution: Eastern University

Department: Marriage and Family

Smoking-Related Stigma: A Public Health Tool or a Damaging Force?

Author: Lozano, Paula A.

Publication info: University of South Carolina, ProQuest Dissertations Publishing, 2016. 10126987.

Abstract: Cigarette smoking is the leading cause of preventable death in the world. In an effort to address the tobacco epidemic, the World Health Organization’s Framework Convention on Tobacco Control (FCTC) has formulated a number of policies that are thought to reduce cigarette consumption by making smoking socially unacceptable. It is possible that tobacco control policies that aim to make smoking soially unacceptable may also result in the stigmatization of smokers. Social factors such as social norms and socioeconomic status may also influence the development of smoking-related stigma. While some researchers suggest that smoking-related stigma may be an important public health tool to reduce smoking consumption and increase smoking cessation; there are no studies that have evaluated the relationship between smoking behavior and cessation and smoking-related stigma, using panel data. This dissertation used data from a population-based, longitudinal survey (2008-2012) of adult smokers in Mexico and Uruguay to evaluate three aims. First, we evaluated how social norms (i.e., close social network, friend number and societal norms) and socioeconomic status (SES) are associated with smoking-related stigma (i.e., feeling uncomfortable, perception of a negative stereotype of smokers and perception that smokers are marginalized). Second, we examined the relationship between exposure to tobacco control policy (i.e., perceived exposure to health warning labels and exposure to second hand smoking (SHS) in restaurants/cafes, enclosed workplaces and bars) and smoking-related stigma. For the first and second aim, we also investigated the role of nicotine dependence as an effect modifier on these associations. Finally, in the third aim, we evaluated the association between smoking-related stigma and smoking behavior and smoking cessation. Results from the first aim suggest that strong anti-smoking injunctive norms (i.e., close social network and societal norms) were associated with higher levels of all indicators of perceived stigma in Mexico and Uruguay. Furthermore, we found that nicotine dependence modified the association between friend norms and stigma in Mexico and societal norms and stigma in Uruguay. In this study, we found that while Mexican smokers with lower education and lower income were less likely to be stigmatized (perceiving a negative stereotype), Uruguayan smokers with lower education and lower income were more likely to be stigmatized (perceiving a negative stereotype). Nicotine dependence was found to be an important effect modifier between SES and stigma in Uruguay. In the second aim, we found that perceived attention to HWLs on cigarette packages was positively associated with all aspects of smoking-related stigma in both Mexico and Uruguay. This study also suggests that while Mexican smokers exposed to SHS in enclosed working areas were more likely to feel stigmatized (feeling uncomfortable), Uruguayan smokers exposed to SHS in enclosed working areas were less likely to feel stigmatize (perceiving a negative stereotype) when compared to smokers not exposed to SHS. Finally, we found that Smoking-related stigma was associated with a higher likelihood of making a quit attempt, in both Mexico and Uruguay and quitting among Mexican participants. Smoking-related stigma (negative stereotype) was also associated with less relapse among Mexican respondents. Results from this dissertation suggest that factors that drive the social unacceptability of tobacco (i.e.; social norms and exposure to tobacco control policy) may also produce stigmatization among smokers. Future studies need to consider smoking-related stigma when developing the next generation of tobacco control policies and programs that promote smoking cessation as, smoking-related stigma may be an important factor influencing smoking cessation.

Publication year: 2016

ISBN: 9781339850252

Advisor: Fleischer, Nancy

Committee members: Forthofer, Lyndie; Hardin, James; Thrasher, James

University/institution: University of South Carolina

Department: Epidemiology

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