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Lately, the debate over various public policies, such as immigration reform and tax policy, has heated up in the United States. This dissertation seeks to explore the different impacts that some of the policy changes have on different groups of people. In doing so, I am able to help better inform policymakers of the possible economic outcomes of future reforms. The first chapter examines the labor market impacts of two state-level immigration policies designed to reduce the presence of undocumented immigrants: E-Verify and "Show Me Your Papers" (SMYP). Using a difference-in-difference strategy, I examine the separate and combined effects of these laws on the employment and wages of likely unauthorized, working-age men and women and the groups of low-skill American workers with whom they are most likely to compete for jobs. I also look at how these laws impact state-level economic outcomes, including industry- specific GDP. I find that immigration reform reduces employment and hourly wages among undocumented men. Immigration reform also results in large, negative impacts on state GDP, especially in industries that rely more heavily on undocumented workers. The second chapter examines the questions of whether consumers respond differently to taxes of different salience levels and if there is heterogeneity in consumer tax salience across income groups and other categorical groups such as age and education groups. I find evidence supporting tax salience theory in the market for alcohol. Additionally, I find evidence of heterogeneity in tax salience effects across different education levels. In particular, more educated consumers are more responsive to changes in sales taxes. The third chapter focuses on the impacts of immigration reform on the children of undocumented immigrants. By comparing siblings in a difference-in-difference approach, I show that DACA, a policy that reduces legal barriers for young undocumented immigrants, increases the educational attainment of potentially eligible youth. Meanwhile, policies such as Alabama HB 56, which increase barriers for undocumented immigrants, reduce the enrollment rates and increase dropout rates for the children of undocumented immigrants.

Most of the research on treatment approaches for acute ischemic stroke have focused on the effect of thrombolysis (IVT) and thrombectomy (EVT) on survival and functional outcomes. Little is known about the cognitive outcomes after IVT and EVT following acute ischemic stroke. The objective of this systematic review was to determine the differential cognitive and functional outcomes following thrombolysis or thrombectomy after mild to severe ischemic stroke in adults. Data was sourced using seven online databases. The SITS Registry was also searched as well as the grey literature in the form of Open Grey and Google Scholar. Initially, 1,040 articles were identified from 2000-2020. After screening full text papers, a total of 7 articles were eligible for data synthesis. Cognitive impairment on the Montreal Cognitive Assessment (MoCA) at 90 days post stroke was evident in patients who received either IVT or EVT. On tasks of executive function in particular the Trail Making Test, impaired performance was observed for EVT at 90 days and 365 days post stroke and IVT at 180 days post-stroke. A higher percentage of patients treated with EVT achieved functional independence on activities of daily living on the Barthel Index (BI) at 90 days and 2190 days post stroke, compared to those treated with IVT.  The current empirical study examined predictors of post-acute memory impairment and the relative contributions of alcohol (intoxication at time of injury and history of problematic alcohol use) on memory during the post- acute recovery stage after Traumatic Brain Injury (TBI). Case files from 303 individuals admitted to inpatient neuro-rehabilitation after single incident TBI were reviewed. Approximately 40% had a documented history of problematic alcohol use and around one third were intoxicated at time of injury. Using hierarchical regression analyses, older age and history of problematic alcohol use significantly predicted poorer performance on measures of immediate memory and global memory. Having a high skilled occupation significantly predicted better performance on the immediate and delayed memory index on the RBANS. Both history of problematic alcohol use and intoxication at time injury provided a significant and unique contribution to the prediction of global memory performance on the RBMT in the post-acute recovery stage after TBI (F (9,167) = 6.24, p < .001), albeit accounting for a small variance. Being intoxicated at time of injury resulted in more intact global memory in this mild to severe TBI sample. Clinical implications and limitations are discussed.

A systematic review in chapter one examined the prevalence of insomnia and poor sleep quality within the prison population. The review synthesised the findings from twelve studies from various prisons internationally between 2014 and 2020. Wideranging prevalence rates were found from studies utilising self-report measures of sleep quality. Despite limitations in the literature reviewed, including the use of inconsistent parameters of standardised measures, the results suggest that the prevalence of insomnia and poor sleep quality in the prison population is higher than the general population. The review indicated an increase in the quantity and quality of studies compared to previous reviews. Areas for further research are discussed and recommendations for adequate identification and intervention of insomnia in prisons. An empirical study in chapter two explored the sleep quality and wellbeing of people in recovery from substance addiction, compared to a control sample. Fiftynine participants in recovery from substance addiction and fifty-seven comparison group participants were recruited and completed a battery of self-report measures on sleep quality, anxiety, depression and quality of life. Results indicated that the recovery group had significantly poorer reported measures in all areas. However, anxiety was found to be the biggest predictor of poor sleep across both participant groups. Clinical implications, considerations for future research and limitations of the study are discussed. The third and final chapter considers the theoretical, research and clinical implications that arose from the first two papers. A short reflective summary concludes the thesis.

Systematic review: Aim: The aim of this study was to conduct a systematic review to explore how attachment style is related to symptoms and functioning in early psychosis, specifically the At-Risk Mental State and First-episode Psychosis. Methods: A PRISMA-guided systematic search was conducted in PsycInfo, SCOPUS, and Web of Science between 1st January 1995 and 12th July 2019. The search was limited to original research that assessed attachment in participants who presented as At-Risk Mental State or First episode Psychosis. Results: Nine papers were included. Secure attachment was positively associated with better functioning in early psychosis. Mixed results were observed regarding the relationship between attachment and clinical symptoms in cross-sectional studies. Longitudinal research highlighted a significant association between higher levels of secure attachment and improved clinical outcomes in early psychosis. Conclusions: Cross-sectionally, the link between attachment and clinical symptoms appears tenuous in At-Risk Mental State and First-episode Psychosis. However, in longitudinal research, there was evidence of a stronger relationship between attachment and recovery from psychotic symptomatology. Clinical recommendations include interventions that enhance the development of secure relational patterns in At-Risk Mental State and First-episode Psychosis to promote long-term recovery. Future research recommendations include the creation of a standardised, reliable and validated measure of attachment in populations with psychosis. Large scale research project: Purpose: This study sought to investigate whether the experience of childhood trauma increases the likelihood that individuals with psychosis will be motivated to drink alcohol as an avoidant coping strategy and adopt a ‘sealing over’ recovery style. Method: Seventy-two participants with a diagnosis of a psychotic disorder completed assessments of childhood trauma, drinking motives, recovery style, and alcohol use. Results: Overall current alcohol use was low but 34.8% of respondents reported a history of alcohol-related problems. Childhood emotional abuse predicted motivation to drink alcohol to cope and a history of alcohol-related problems. The relationship between emotional abuse and history of alcohol-related problems was fully mediated by motivation to drink alcohol to cope. Recovery style was not observed to be related to any key variables. Conclusions: Findings highlight the need to routinely assess childhood trauma in clinical practice and to consider the impact of emotional abuse upon coping strategies in individuals with psychosis during treatment. Theoretical implications and recommendations for future research are suggested.

Background: In order to develop reliable preventive measures for heavy drinking, investigating the cognitive differences present in heavy drinkers may be crucial. The focus of this thesis is on impulsivity, executive function and attentional bias for alcohol. The thesis is formed by three parts; the first (Study 1) investigates how these mechanisms could be trained using neuropsychological tasks in order to reduce alcohol consumption. The second (Studies 2 and 3), focuses on applying those findings to the understanding and use of implementation intentions to reduce alcohol consumption. The third (Studies 4 and 5), focusses on the impact of impaired cognition in heavy drinkers in terms of violent offending. Study 1: A systematic review and meta-analysis to establish whether training heavy drinkers in cognitive tasks designed to improve impulsivity, executive control and biased attention for alcohol reduces subsequent alcohol consumption. Nine studies reported in eight papers met the inclusion criteria. There was a small effect of completion of cognitive tasks on reducing alcohol consumption. Study 2: An fMRI investigation conducted on 32 heavy drinkers using neuroimaging paradigms to assess the impact on alcohol consumption of including an implementation intention into the instructions of two cognitive training tasks. Results show a marked reduction in alcohol consumption. Study 3: Applying implementation intentions directly targeting alcohol behaviour to a heavy drinking population and investigating how facets of executive function, impulsivity and attentional bias mediate the effect of this intervention on alcohol consumption. Results show a significant reduction in alcohol consumption by implementation intentions proving their effectiveness for heavy drinkers. Study 4: A multi-dimensional investigation of impulsivity, executive function and attentional bias applying findings from the heavy drinking literature to a violent heavy drinking population using a combination of self-report measures and neuropsychological tasks. Results suggest that violent heavy drinkers show greater deficits in impulsivity than non-violent heavy drinkers and have approach and avoidance conflict tendencies similar to that of dependant alcohol users. Study 5: A large-scale study employing longitudinal data of sanctioned offenders, their criminogenic needs assessments and contact with criminal justice agencies to assess whether alcohol-using offenders have higher rates of prior violent offending than abstinent offenders. Results indicated higher rates of violent offending in alcohol using offenders. The difference was particularly pronounced in women, who had prior violent offending rates at three times higher than their gender-matched counterparts. Conclusions: This thesis has generated some important findings. Firstly, current neuropsychological measures of impulsivity, executive function and attentional bias are not specific enough to detect change brought about by brief alcohol interventions. Secondly, implementation intention formations are highly effective at reducing alcohol consumption in heavy drinkers. Thirdly, violent offending is likely influenced by the same cognitive deficits as heavy drinking. This has implications for future research that should enable better understanding, inform more effective neuropsychological identification measures of these cognitive facets and attempt to replicate the alcohol consumption reduction reported.

Objective: Much research has investigated the effect of adolescent substance use on neurocognitive abilities but the influence of neurocognition on later use behaviors has been relatively less studied, especially among youth who are already engaged in substance use. Hence, the goal of this dissertation project was to explore predictive associations of neurocognitive markers with substance use behaviors via the following 3 aims (Chapters).Methods: Chapter 1- A scoping review was conducted on the existing literature to synthesize current research on minimally reviewed neurocognitive domains and their predictive associations with substance use (hence papers on well-reviewed impulsivity facets were excluded). Secondary analyses were conducted in Chapters 2 and 3 with data from a longitudinal study for adolescents (Youth At Risk study) to investigate neurocognitive performance in late adolescence during maximum substance use, as predictors of changes in later use. Chapter 2- Hierarchical linear regression models with 4 neurocognitive abilities (inhibition/cognitive flexibility, visuospatial ability, verbal memory, working memory) predicting change in follow-up alcohol use (drinking days, average drinks per drinking day, peak drinks, binge episodes) were estimated while covarying for baseline age, follow-up duration, and sex. Chapter 3- To investigate relationships between neurocognition and cannabis and nicotine use, in addition to alcohol, hierarchical linear regression models predicting change in follow-up overall substance use frequency index scores and individual substance (alcohol, cannabis, nicotine) use outcomes were estimated. Follow-up analyses exploring this relationship within 3 groups of one-, co-, and tri-substance users were also conducted independently. Results: Our scoping review revealed a common theme where cognitive processing in constructs of working memory, attention, emotion regulation, and elevated reward circuit activity during decision-making in childhood and early adolescence predicted earlier onset, greater use escalation, and even development of substance use disorders in some instances. Findings from our 2 analytical aims suggest working memory, verbal memory, visuospatial ability, and inhibition/cognitive flexibility at maximum substance (alcohol, cannabis, and/or nicotine) use in late adolescence are useful as predictors of changes in later use behaviors. Conclusion: Our results have the potential to inform policies and intervention research on cognitive vulnerability markers in youth that predict substance use into adulthood.

This thesis describes medical aspects of the expeditions of the Heroic Age of Antarctic exploration (1895-1922). It is divided into three sections. Section 1 describes the drugs and medical equipment taken to the Antarctic by these expeditions. There is an introductory discussion followed by papers on ophthalmic drugs, injections, inhalations and suppositories, oral drugs and topical preparations. Sledging medical cases are considered separately. Brandy was often used as a medicine and the medical uses of alcohol are described. Some expeditions took what were described as “medical comforts”. This term was sometimes used as a euphemism for alcoholic beverages but, in fact, encompassed a wide range of foods for invalids. Burroughs Wellcome and Co. supplied many of the expeditions with drugs and their medical chests. They used the expedition link in their advertising and the relationship between the expeditions and drug companies is described. Section 2 describes some of the medical problems encountered. The most serious problems were scurvy and a condition often called “polar anaemia”, which seems to be the same as a condition known at the time as “ship beriberi” and what is now described as “wet beriberi”. The controversy as to whether Captain Scott and his colleagues died of scurvy is also discussed. Other problems included frostbite and snow blindness. At least 11 general anaesthetics were given, including two for amputation of frostbitten toes. Psychological problems were common and there was some serious psychiatric illness including alcohol abuse. Section 3 describes the doctors and some of the research that they carried out. The most common research done by doctors was bacteriological. Most doctors collected biological data on the explorers including weights and haemoglobin measurements. This was largely for health monitoring but one doctor pursued physiological research. Three doctors and a medical student studied geology.

Subjective Response and Self-Administration of Alcohol: Implications for Alcoholism EtiologybySpencer BujarskiDoctor of Philosophy in PsychologyUniversity of California, Los Angeles, 2017Professor Lara Allison Ray, ChairThe biobehavioral effects of alcohol have emerged as central components of alcoholism etiology in both clinical and preclinical research. To understand the biology of alcohol use disorder (AUD) preclinical researchers have developed animal models of drug and alcohol addiction, however, the translational applicability of these models is often assumed by face validity. The overarching aim of this dissertation is to advance a human laboratory framework for translating the preclinically derived Allostatic Model, and Incentive Salience Theory (IST) to clinical samples.Despite the central role subjective responses to alcohol (SR) in several etiological theories, relatively little is known about its structure. Therefore, prior to leveraging SR as a translational phenotype, Paper I examined the factor structure of SR using data from a large and well-controlled alcohol challenge study. Results suggested a 4-factor solution to SR along the domains of Stimulation/Hedonia, Negative Affect, Sedation/Motor Intoxication, and Craving/Motivation capturing positive reward, negative reward, punishment and subjective motivation respectively. This paper offers a synthesis of multiple SR measures and provides recommendations for consolidating these measures into four meaningful and interrelated constructs.In Paper II, predictions from the Allostatic Model regarding a transition from positive reinforcement to negative reinforcement in alcohol dependence were tested. Heavy drinking participants representing a range of AUD severity completed a novel alcohol administration paradigm designed to capture domains of alcohol reward and reinforcement via a standardized alcohol challenge and progressive ratio self-administration. Validating the laboratory paradigm, AUD predicted greater alcohol craving, and greater alcohol reinforcement. Furthermore, craving during the challenge robustly predicted subsequent reinforcement behavior. These data however, provided evidence for neither a transition from positively reinforced alcohol use, nor a transition to negative reinforcement. AUD severity did not predict stimulation/hedonia, and hedonic responses didn't predict self-administration regardless of AUD severity. While AUD severity was associated with greater basal negative affect, alleviation of negative affect by alcohol did not differ by AUD severity and negative affect did not predict self-administration at any level of AUD severity. Sedative response however did predict lower reinforcement behavior consistent with the Differentiator and Low-Level of Response models derived in human laboratory research. This study thus represented a novel approach to translating predictions from the Allostatic Model to a clinical sample. While the experimental paradigm did meaningfully capture domains of alcohol reward and reinforcement, hypotheses regarding allostatic processes were generally not supported. In Paper III, hypotheses from the Incentive Sensitization Theory were tested in terms of the dissociation between alcohol liking and wanting, and the role of incentive salience in motivating alcohol consumption. Overall the hypotheses based on IST were not supported. AUD severity predicted neither subjective liking nor wanting during the alcohol challenge, and these variables remained highly correlated across AUD severity. Utilizing an alcohol dot probe measure of attentional bias, AUD severity did not predict greater incentive salience, and incentive salience variables did not predict reinforcement. Of note however, these data were consistent with recent evidence suggesting the dot probe tasks may be unreliable. Therefore, it is possible that these null results are a consequence of poor reliability for the incentive salience measure. Thus, by examining a behavioral measure of incentive salience in addition to subjective liking and wanting, this paper advanced a more complete framework for translating IST to clinical populations, and highlighted the need for accurate behavioral measures of incentive salience in humans. In order to optimally benefit from the precision of preclinical research, it is necessary to establish that preclinical models accurately map onto key aspects of human AUD. Together these three papers advance a novel human laboratory framework for translating preclinical models of addiction to clinical samples. Factor analytic work validated SR as a translational phenotype capturing key aspects of reward and punishment. The novel experimental paradigm in Papers II and III captured variations in both alcohol reward and reinforcement and found results which were consistent with prominent human laboratory models of alcoholism risk. Conversely however, few of our hypotheses derived from the Allostatic Model or Incentive Sensitization Theory were supported highlighting the need for increased reverse translation efforts to promote consilience between preclinical and human subjects research. Ultimately, determining whether preclinical theories of alcoholism etiology accurately capture pathological processes in humans suffering from AUD is essential to fully understanding alcoholism etiology and developing efficacious treatments to alleviate the sizeable human cost of alcohol addiction.

A particularly high-risk time on campus is the alcohol consumption associated with collegiate sporting events, specifically tailgating. The purpose of this dissertation was twofold; first, to identify and critically examine the literature on alcohol use at college sporting events, specifically football games; second, to assess college presidents’ perceptions of alcohol policies regulating alcohol consumption during tailgating using the Health Belief Model. The literature review was accomplished by using multiple search engines, including Academic Search Complete, PubMed, CINAHL, ERIC, Health Source, Sociological Collection, SocINDEX, APA PsycINFO, MEDLINE, and Google Scholar to examine articles published on alcohol use among college students at collegiate sporting events, or football game-day. To be included in the literature review, articles must have been published in the United States within the year 2000 to 2019. A cross-sectional research design was used for the second study, which comprised of a 20-item survey questionnaire assessing college president’s perceptions of alcohol use during college sporting events. The survey instrument included items assessing the Stages of Change from the Transtheoretical Model, as well as the perceived benefits, barrier, severity, and susceptibility constructs from the Health Belief Model. A population census was conducted utilizing the 2019 NCAA Division-I Football Bowl Subdivision listing (N=130). The critical literature review search yielded 25, scientific, peer-reviewed articles involving alcohol use associated with college football games. In many of the studies, researchers used cross-sectional study designs (72%), obtained convenience samples (32%), and did not include reliability and/or validity measures (48%). Data were collected either online (36%), with a paper and pencil questionnaire (32%), hybrid (in-person and online) (12%), or case-study (12%). Three topics emerged from the literature, including alcohol related epidemiological trends (drinking behavior on game-day, negative consequences, and gender), social norm perceptions, and alcohol policies. In the second study, university presidents and chancellors from 130 Division I Football Subdivision (FBS) schools were selected to participate in a study assessing perceptions regarding safety issues pertaining to college sporting events. Respondents from 59 universities completed the survey, yielding a modest response rate of 49.6%. Collectively, respondents were categorized into senior-level administrators (presidents, chancellors, provosts), mid-level administrators (deans, department chairs, department directors), and specialists (substance abuse coordinators). Nearly two-thirds (62.7%; n=37) of the participants surveyed indicated their institution sold alcohol in the stadium, 12.5% (n=7) banned alcohol use during college sporting events, and the remaining schools allowed alcohol use with restrictions. Regarding tailgating, the majority (68.4%) of respondents indicated their institution had a policy regulating alcohol consumption. Multiple regression analyses were used to assess which constructs of the HBM were most predictive of presidential support for alcohol policies on game-day. The perceived benefits was the only construct yielding statistically significant results for both presidential support for restrictive alcohol polices as well as opposition for the sale of alcohol within the stadium. Notably, the enforcement of alcohol regulations during college football games varied across the spectrum (rarely, sometimes, often, always). Overall, event specific research, particularly studies addressing the alcohol use associated with college sporting events constitutes an emerging area of study. Results from the literature review demonstrate that college football games signify a time whereby fans consume alcohol at higher rates than they do during other social occasions. The scientific rigor employed by the researchers varied from study to study and several gaps in the literature were identified. In particular, a current national study identifying drinking patterns and alcohol related policies would allow universities to compare their institution to others and benchmark prevalence rates. Additionally, rigorous studies utilizing randomized control trials, thorough evaluation of interventions, especially related to policy implementation, and information from senior-level administrators about how to address game-day safety issues are lacking from the literature. Findings from the second study indicated that universities were at various stages in terms of their readiness to address the alcohol consumption associated with tailgating. Multivariate analysis revealed the perceived benefits construct from the HBM was associated with support for implementing restrictive alcohol polices. Thus, emphasizing the benefits of policy implementation should be used to generate policy change for college sporting events. While the opinions of university presidents and other senior administrators are essential, additional information could be obtained by assessing athletic directors and prevention specialists. Qualitative data may also provide information on why key stakeholders feel the way they do about various game-day prevention related policies. Ultimately the results from both studies can be used to create a safer game-day environment and reduce the liability universities may incur for the alcohol consumption that frequently occurs during college sporting events.

Excessive alcohol consumption is a worldwide social problem that has greatly contributed to the global burden of disease, disability and death. Overall volume of alcohol consumption and prevalence of alcohol-related problems in China have remained relatively low in comparison to many western countries until recent years. Since the liberal economic reforms of the early 1980s, China has witnessed an alarmingly increasing rate of alcohol consumption, and as a result, increasing incidence of alcohol-related injuries and morbidity. However, comprehensive alcohol policy and public health infrastructure to address the problems associated with these changes have not yet been established. Using data from the China Health and Nutrition Survey, this dissertation - comprised of three papers - utilizes quantitative methods to examine alcohol consumption behaviors in China, in order to identify alcohol policies and interventions that are both applicable to and appropriate for the Chinese context and to recommend next steps for alcohol control policy and intervention areas in China. The first paper explores the socio-demographic and other factors that are associated with alcohol consumption behaviors in order to identify populations that are at risk for problem alcohol use and that may be targeted for prevention/public health education programs. The second paper establishes evidence regarding alcohol consumption behaviors and its association with community-level alcohol access characteristics, such as proximity of alcohol outlets and price of different types of alcohol. The third examines the association between alcohol consumption and healthcare utilization, in order to identify health policy needs for persons at risk for the development of costly chronic diseases. The three principal conclusions from the three papers are: (1) there is strong evidence of a closing gender gap in problematic alcohol consumption behaviors between men and women - although men are still more likely to consume more alcohol and be frequent and heavy drinkers than women, alcohol consumption levels and rates of heavy drinking among women are significantly increasing; (2) absence of alcohol vendor availability is associated with decreased alcohol consumption, and cost of beer and aged liquor is inversely associated amount of alcohol consumed and heavy drinking; and (3) problematic drinkers in China appear to under-utilize preventive healthcare services and possibly formal medical care in general.

Alcohol misuse imposes a disproportionately high burden of harm on Indigenous Australians. Alcohol-related harms affect the physical, psychological, and spiritual wellbeing of Indigenous Australians. Harms extend beyond the problem drinker to their families and communities. The primary aim of this thesis was to develop and implement a process of researchers, health care providers and Indigenous Australians working in partnership to more effectively respond to the deleterious impact of alcohol misuse on Indigenous families and communities. The process was highly interactive in that it sought to combine the methodological skills of researchers, the clinical knowledge and skills of health care providers, and the community knowledge and experience of Indigenous Australians. Specifically, research was used to identify interventions with potential to address alcohol-related harms that could be tailored to be consistent with Indigenous Australians’ concepts of health and wellbeing (Papers 1 and 6), to ensure the reliability and validity of potential measures of impact (Paper 2), and to identify more precisely the nature of alcohol-related harm experienced by Indigenous Australians (Paper 5). Indigenous Australians’ perceptions of the acceptability of potential interventions were obtained (Paper 4). Health care providers’ views on how the potential interventions might best be tailored for routine delivery (Paper 3), and on undertaking a certification process to improve and standardise their skills in delivering the potential interventions (Paper 3), were also obtained. This thesis is presented for examination as a series of publications, which means it presents a series of papers that were published in, or submitted for editorial review to, a peer-reviewed journal during the student’s candidature, rather than the traditional model of presenting thesis chapters. Consistent with the University of New South Wales’ thesis requirements, preambles have been added to the papers to facilitate a coherent logical flow across the thesis, and appendices are included to complement the published content, but otherwise the papers are unaltered from the published or submitted versions. Papers 1, 4, 5 and 6 are published and Papers 2 and 3 are currently under editorial review. The introduction, and the implications and future directions chapter, provide a broader context for this thesis.

It is widely believed that activities such as drinking alcohol, smoking cigarettes, and using marijuana during the teenage years have a harmful effect on a youth's development, thus damaging his or her value in the labor market once the individual reaches adulthood. There have been several studies in the past that have looked into the consequences of partaking in such activities during both the adult and college years, but this paper will investigate how the use of alcohol, marijuana, and cigarettes at the age of 16 affects the average individual's future income and the amount of education completed by the time he or she becomes a young adult. Using data from the National Longitudinal Survey of Youth 1997 (NLSY97), this paper will examine not only how having tried each of the aforementioned substances affects one's future outlook, but also the effect that various levels of drug or alcohol use at the age of 16 has on both the number of grades completed and the amount of money earned in the past year when the individual hits the ages of 23 and 25. Through regression analysis, the study finds that the net effect of using alcohol as a teenager on income as a young adult is generally positive for the sample. However, alcohol use as a teenager tended to have a negative effect on the amount of schooling finished. Both marijuana and cigarette use as a teen are met with a decrease in earnings and a reduction in the amount of education completed.

ABSTRACTProblems associated with alcohol affect individuals, families and communities. Alcohol-related community problems include underage and excessive drinking, driving under the influence (DUI) crashes and injuries, violence, crime and negative effects on quality of life. Policy interventions to reduce and prevent community-level alcohol-related problems have been the focus of much research, resulting in the recognition of effective and promising prevention practices. Alcohol policies include laws: establishing a maximum blood alcohol concentration (BAC) allowed for driving, a minimum age for purchase and consumption of alcohol; and limiting sales to underage or intoxicated persons. Policy enforcement can deter DUI, sales of alcohol to underage or intoxicated persons, underage and excessive drinking, especially if the enforcement is highly visible to the public. A growing body of literature examines the amount and frequency, or “dosage” of interventions that is associated with improved health or reductions in problems. Much of the dosage research involves educational or treatment interventions that focus on individual or group behavior change, rather than on policy interventions designed to make change at the community level. The overarching goals of this dissertation research are to: 1) examine the existing alcohol policy enforcement literature; 2) explore certain community factors that may be associated with higher levels of dosage; and 3) compare how varying levels of alcohol policy enforcement dosage affect community alcohol-related outcomes.Paper 1 examines research literature regarding the association between dosage of high-visibility alcohol policy enforcement and alcohol-related problems at the community level. A systematic review found support for consistent enforcement to achieve desired alcohol-related outcomes, and for “high” versus “low” levels of enforcement. However, there was no consensus found among the studies for a necessary threshold of enforcement dosage, due in part to the differences in problems addressed, existing policies in study communities, types of enforcement interventions used, and the designs and sizes of the studies. Findings support the need for additional research with rigorous study designs to determine effective levels of dosage of high-visibility alcohol policy enforcement. Paper 2 investigates the association between dosage of high-visibility alcohol enforcement interventions and: level of alcohol problems at baseline, interagency collaboration, and additional grant funding from two state agencies, in 12 intervention cities funded by the California Strategic Prevention Framework State Incentive Grant (SPF SIG). Multi-level modeling is used to study the effects of these three community characteristics on levels of dosage over 12 months. Findings indicate that funding may lead to more high-visibility enforcement to reduce crashes, injury, and mortality associated with driving under the influence (DUI). Interagency collaboration may lead to more enforcement and visibility to reduce retail availability of alcohol (e.g., at convenience stores) to underage persons. Baseline levels of alcohol-related problems were not found to be significantly associated with higher levels of enforcement. None of the community characteristics studied here was significantly associated with higher levels of enforcement to reduce social availability of alcohol (e.g., at parties). Future studies that include larger samples of cities are needed to help explain how these and other community factors may influence implementation of high-visibility alcohol enforcement interventions.Paper 3 focuses on the effects of four levels of dosage (zero, low, medium, and high) of a high-visibility DUI enforcement intervention on changes over 58 months in the proportion of DUI crashes and DUI injury crashes in the 24 cities of the California SPF SIG project. Multi-level modeling is used to examine the moderating effect of dosage level on the relationship between time and DUI crash and injury rates. Findings reveal a statistically significant moderating effect of medium dosage level (i.e., approximately 1 intervention per month) on the negative relationship between time and DUI crashes. Although not statistically significant, a high level of dosage is associated with an increase in the proportion of DUI crashes, while a low dosage level results in no change in the proportion of DUI crashes. Statistically significant moderating effects of both medium and high dosage levels are found on the negative relationship between time and injury DUI crashes. These findings suggest that implementing approximately 1 DUI enforcement intervention per month may be best for reducing both DUI crashes and DUI injury crashes, and that a higher number of interventions per month does not lead to better outcomes. Replication can help strengthen these findings, and may lead to practical policy enforcement recommendations for communities to reduce DUI injuries and related crashes.

The current study examined the relative effectiveness of motivational feedback compared to cognitive-behavioral skills training delivered in bibliotherapy format to college students. The effectiveness of matching alcohol abuse interventions with participant's stage of change was also explored. The study's design utilized an assessment only control group and collateral informants to strengthen the validity of the conclusions. Participation in the cognitive-behavioral skills training and motivational feedback interventions did not lead to greater reductions in participants' alcohol use and alcohol related problems than assignment to an assessment only control group. No significant differences were found between these three groups on any of the drinking measures from pre-test to l-month and from pre-test to the 2- month follow-up. Only time effects were observed on alcohol related problems and frequency of heavy alcohol use across the 3 experimental conditions. Tentative explanations for the lack of support for the effectiveness of these interventions are discussed in the paper including sample size and statistical power, intervention compliance, and intervention fidelity. A number of changes which might enhance the effectiveness of these interventions are also discussed in the paper. The study also found no significant Intervention X stage of Change X Time interactions to support the effectiveness of matching intervention to participants' stage of change. Tentative hypotheses for this finding are discussed in the paper including issues related to the measurement of stages of change. Competing hypothesis regarding the relative and incremental utility of outcome and self-efficacy expectancies were also examined in the study. Pre-test efficacy expectancies consistently predicted a significant proportion in participants' frequency of alcohol use and moderate use at 1 and 2-month follow-ups beyond concurrent use outcome expectancies were unable to add to the prediction of drinking behavior beyond self-efficacy and concurrent drinking behavior. This pattern of results support Bandura's (1986) view that efficacy expectancies subsume most of the predictive power of outcome expectancies. Further, as predicted by Bandura, prior drinking behavior alone did not fully explain future use, rather students perceptions of efficacy also guided future use.

This paper reports on a meta-analysis performed on forty one studies evaluating classroom-based substance abuse primary prevention programs. Studies included were delivered in a classroom to the general student body, had a primary focus of substance abuse prevention, measured behavior change, and were published in peer-reviewed outlets between 2000 and 2011. Comprehensive Meta-Analysis was used to calculate a random effects Cohen’s d and moderator analyses. Results indicated a significant effect for alcohol (d=0.10) and tobacco (d=0.09) in multi-target interventions. Specific program components and characteristics associated with more effective prevention programs are discussed. Despite the best efforts of those who develop and deliver intervention programs, as a whole, the impact is smaller than “small.” New or evolved programs should seek to incorporate the best predictors of effectiveness thereby improving efficacy.

The following is a literature review aiming to examine the use of alcohol by rural youth. The use of alcohol by American youth is prevalent with an abundance of literature concentrating on the generalized subject of youth alcohol use and urban youth use. In the subsequent paper I focus on the existing literature that describes the trends of youth alcohol use with the goal of concentrating mostly on those youths living in rural areas of the United States. Three national surveys were referenced as well as numerous publications on the subjects of youth drinking and rural areas. I combined the literature on rural areas and youth drinking to create a generalized understanding of youth drinking in rural areas.

Using data from the National Comorbidity Survey (NCS) from the Fall of 1990 to the Spring of 1992 among respondents between the ages of 15 and 54 in 48 of the contiguous United States, this paper hypothesized an increase in serious drug problems and serious alcohol problems when a combination approach was used regarding home and work stressors. Results indicate support for the hypotheses that the combination of home and work stressors leads to an increase in both serious drug and alcohol problems (each measured separately). These findings are important especially since they suggest that stressors from home affecting work are significant and positively related to problems with both alcohol and drugs and stressors from work affecting home are not. In addition to demographic controls and stress scales of work and home, the model takes into account other possible explanations. These include past traumatic or recent life events that are considered high in stress, the family background of the parents of the respondents with regard to past psychiatric disorders, and the comorbidity of the respondents themselves. Results imply that stressors from home affecting work are significant and matter more than work stressors affecting home in every model. This research improves upon previous research by both exploring the inter-relationship between home and work stress and controlling for alternative explanations. Although more research needs to be carried out in the area of "home stressors," these results suggest previous conflicting findings within the work stress literature may be due in part to too narrow of a focus on stressors at the workplace or related to the job environment separate from home stressors.

Higher education in America has attempted to define the relationships it has with both students and parents for many years. While some argue that the philosophy of in loco parentis has seemingly disappeared, others suggest that its return is imminent on American college campuses. One example of this return is the trend among campuses towards notifying parents when students are involved in judicial matters. Recent changes in federal privacy laws have clarified the right of colleges and universities to notify parents when their son or daughter is involved in a violation of the university alcohol policy. There is an assumption that parents will intervene with their students and help the university promote a more responsible use of alcohol. Many colleges are debating the value of such notifications, but little is known as to whether or not the inclusion of parents in university discipline affects the decisions college students make about their alcohol consumption. The present study used qualitative and quantitative means to address this gap in literature. Students whose parents were notified of their alcohol violation were interviewed in the qualitative component of the study. The interviews explored the relationships between students and parents before entering college, immediately after enrolling in college, and after parental notification. Students were then assigned positions within three categories of parenting styles (General Relationships, Level of Parental Involvement, and Parental Attitudes Toward Alcohol) for the three time periods explored in this study. The quantitative component explored students' experience with alcohol during the same three time periods. Students completed a pencil and paper survey about their drinking behaviors and were assigned to categories of alcohol consumption for each time period. This enabled the researcher to evaluate whether certain parenting styles were associated with certain drinking patterns. In addition, the researcher examined the results to identify trends in parental relationships and alcohol consumption over the three time periods in question. The study revealed some interesting findings. First, parent and student relationships appear to improve over time, while the parents' Level of Involvement with their student remains the same. Second, during all time periods, the participants indicated that their parents had little control over their alcohol consumption. Third, while students may have experienced frustration with the parental notification process, most were comfortable with the concept of parents being notified when students have violated university policy with respect to alcohol. Finally, most students came to college with experience drinking alcohol, and most had parents who were permissive in their attitudes towards drinking once students arrived at college. Although the study examined only a limited number of students, the results indicate that universities may want to re-evaluate the way in which they educate students about alcohol.

Problems presented in this paper concern the chemical equilibrium of methyl alcohol, formic acid, and methyl formate when combined.