Theses and Dissertations from UMD
Permanent URI for this communityhttp://hdl.handle.net/1903/2
New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
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Item Sleep, Alcohol, and Cannabis Use in College Student Drinkers with and without ADHD(2022) Marsh, Nicholas Patrick; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Heavy drinking college students are at risk for experiencing poor sleep and negative alcohol-and cannabis-related consequences. College students with attention-deficit/hyperactivity disorder (ADHD) are uniquely vulnerable to both poor sleep and negative consequences from alcohol and cannabis use. Thus, it is critical to consider relations between ADHD, sleep and alcohol-related negative consequences together in a single study. In the present study, we examined: (1) the associations among ADHD status, sleep and alcohol- and cannabis-related consequences; (2) the independent and interactive effects of sleep and ADHD on negative alcohol-related consequences. Finally, we explored the independent and interactive effects of sleep and ADHD on negative cannabis-related consequences. Method: College student drinkers with (n=51) and without (n=50) ADHD completed a 2-hour assessment that included measures of sleep quality, alcohol and cannabis use, and alcohol/cannabis-related negative consequences. Analyses utilized a series of hierarchical linear regression models to examine study aims. Results: College student drinkers with ADHD reported significantly worse sleep quality relative to non-ADHD student drinkers. Students with ADHD also experienced more negative alcohol-related consequences, relative to student drinkers without ADHD. When ADHD and sleep quality were included in the model together, ADHD—but not sleep quality—was independently associated with negative alcohol consequences, but not negative cannabis consequences. There were no moderating effects of ADHD on the associations among sleep and negative consequences resulting from either alcohol or cannabis use. Conclusion: This is the first study to examine sleep quality in college students with and without ADHD engaging in heavy drinking, as well as the first to examine the independent and interactive effects of sleep and ADHD on alcohol- and cannabis-related consequences. Results demonstrated that college drinkers with ADHD are particularly vulnerable to experiencing poor sleep and negative consequences from their alcohol and cannabis use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk.Item Co-occurring Tobacco and Marijuana Use among Young Adults: A Sequential Explanatory Mixed Methods Study(2018) Seaman, Elizabeth Lucy; Fryer, Craig S.; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Tobacco use is the greatest cause of preventable death in the United States and an important health behavior to study among young adults. Prior research has suggested that there is an association between tobacco and marijuana use. Studying these two substances together can provide important insight into patterns of young adult tobacco and marijuana initiation and continuation. This dissertation employed a Sequential Explanatory Mixed Methods design to study tobacco and marijuana co-use among young adults 21-30 years old. Quantitative data analyses used National Health and Nutrition Examination Survey (NHANES) data to assess prevalence of cigarette and marijuana co-use (Aim 1), and characteristics of co-users (Aim 2) over a 10-year period (2005-2014). Prevalence of past-month cigarette use decreased from 30.9% in 2005-2006 to 23.7% in 2013-2014 (p = 0.024) while both past-month marijuana use (average 18.0%) and past-month co-use (average 9.8%) remained stable between 2005 and 2014. Prevalence of past-month co-use differed significantly by gender (p < 0.001) and racial and ethnic group (p < 0.001). Education level, marital status, race and ethnicity, ratio of income to the poverty level, depressive symptoms, non-marijuana illicit drug use, alcohol use, and household tobacco exposure differentiated co-users from neither users in a multinomial regression. Results from analyses of NHANES data, prior literature, and theoretical constructs were used to develop a guide for 20 in-depth interviews with young adult co-users living in the state of Maryland (Aim 3). Interviewees reported two modes of co-use: simultaneous and sequential. Participants reporting using tobacco as a replacement for marijuana in situations where they cannot access or use marijuana, suggesting the two products play similar yet distinct roles in co-use. Influences across levels of the Social Ecological Model were salient in young adults’ co-use. Quantitative results and qualitative findings were interpreted together, and five mixed methods meta-inferences emerged as important in understanding co-use. The co-use of tobacco and marijuana is an important behavioral phenomenon to study among young adults. Tobacco and marijuana co-users have unique characteristics compared to tobacco-only and marijuana-only users. Qualitatively, co-users described patterns of product use and replacement that illustrate the complexity of co-use behaviors.