Adolescent substance use is a complex and significant public health concern that has received considerable attention among researchers and practitioners (Gray & Squeglia, 2018). The purpose of this dissertation was to examine factors associated with substance use intervention effects and to develop subgroups of risk factors for Mexican adolescents. This dissertation utilizes secondary data from a randomized controlled trial of the school-based substance use universal prevention program, keepin’ it REAL (kiR). The dissertation included two studies. Study 1: This study tested a model on the efficacy of the school-based substance use universal prevention program, keepin’ it REAL, among a sample of Mexican adolescents (N = 3,742, 11-17 years old). Study 1 analysis included Structural Equation Modeling and results demonstrated that participation in kiR positively predicted alcohol resistance strategies and those alcohol resistance strategies were negatively and significantly associated with alcohol use. Further, depressive symptomology was a moderator of intervention effects as the effects of kiR on resistance strategies increased as the level of depressive symptomology increased. Study 2: this study explored subgroups (classes) of Mexican adolescents (N = 5,520, 11-14 years old) based on their experiences with violence (witnessing, victimization, and perpetration), depressive symptomology, and substance use (alcohol, tobacco, and marijuana). Using Latent Class Analysis (LCA) four empirically, well-differentiated classes emerged representing adolescents various risk typologies (Moderate Risk-Violence at 55% of the sample, Low Risk at 35%, High Risk at ~8%; and Moderate Risk-Substance Use at ~2%) Implications for research and practice are discussed across both studies.

Women in the military work in a hypermasculine environment and may have experiences with gender microaggressions that contribute poorly to their mental health. In this quantitative study, the author assessed active duty U.S. military women’s (N = 683) reports of experiences with eight types of gender microaggressions (traditional gender roles, sexual objectification, second class citizen, sexist language, explicit threat to physical safety, implicit threat to physical safety, invalidation of sexism, and environmental; Capodilupo et al., 2010). Participants reported around a little or rarely having experiences with such microaggressions. Exploratory analyses demonstrated that Navy and junior enlisted women reported significantly higher frequencies of gender microaggressions compared to other groups. Using hierarchical regression analysis, controlling for general levels of stress, branch, rank, and sexual orientation, the author also examined whether the eight gender microaggressions explained scores on a measure of depression. Results suggested that only second class citizen explained a significant proportion of variance in depression. Therefore, the author examined whether coping style moderated the association between the gender microaggression subscales and depression as proposed. Results indicated problem focused engagement and emotion focused disengagement both moderated the link between second class citizen and depression. Findings from the current study have the potential to inform military programs, specifically around bringing awareness to subtle forms of sexism and ways to engage in coping. Limitation and directions for future research also are discussed.

Over 25% of children in the United States suffer from a chronic illness, and close to 70% of all childhood deaths are due to chronic illness. Prevalence of childhood chronic illness continues to increase, and as a result, the pervasiveness of parents faced with stress associated with caregiving for their child with a chronic illness is also rising. The Stress Process Model (SPM) conceptualizes the caregiving experience as a multidimensional process influenced by the caregiving context, primary and secondary stressors, resources, and caregiver outcomes. Utilizing the SPM, the goals of this study were to examine the relations between caregiving stress (role overload and role strain) and resources (instrumental support, social support, and positive attitudes) and psychological outcomes (depression and anxiety) to determine whether resources moderated the associations between caregiving stress and psychological outcomes.

Participants included 200 parent caregivers of a child with a chronic illness. Participants responded to an online survey that measured demographics, role overload (Role Overload scale), role strain (The Revised Caregiver Burden Measure), instrumental support and social support (Medical Outcomes Survey), positive attitudes about caregiving (Brief Assessment Scale for Caregivers), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder scale-7). Pearson correlations and six hierarchical regression models were tested to examine caregiving stress, resources, and psychological outcomes.

Consistent with the study hypotheses, positive correlations between caregiving stress (role overload and role strain) and depression and anxiety were found. Negative correlations were found between resources (instrumental support, social support, positive attitudes) and depression and anxiety. Both instrumental support and social support had negative moderating effects on the relations between role overload and psychological outcomes (depression and anxiety). Positive attitudes also negatively moderated the relations between role strain and psychological outcomes. Thus, when participants reported high instrumental and social support, they also reported low depression and anxiety, even when role overload was high. Participants also reported low anxiety and depression when they reported high positive attitudes, even when role strain was high. Implications of these findings are discussed.

Effective communication plays a major role in the psychological adjustment and quality of the relationship of couples coping with cancer, yet only a few communicative behaviors have been examined in the context of a cancer diagnosis and treatment. This study sought to expand the extant literature by describing a wider range of communicative behaviors (beyond the frequently researched withdraw, disclosure/holding back, and avoidance behaviors) through an observable measure, as previous research has relied heavily on self-report. Couples (134 cancer patients and their caregiving partners) were video-taped discussing a cancer-related concern in the laboratory. Discussions were coded separately for patients and caregivers using the Asymmetrical Behavioral Coding System which captures 22 communicative behaviors. These behaviors contribute to four higher-level scales: positive approach, negative approach, positive avoidance, and negative avoidance. Area under the curve was calculated to describe each factor. The most frequently observed behavior was positive approach, followed by negative avoidance, negative approach, and positive avoidance.

Paired samples t-test analyses examining the factors by moderating variables revealed that women engaged in more positive approach behaviors than did men; men engaged in more avoidant behaviors (both positive and negative) than did women; and caregivers engaged in more avoidant behaviors (both positive and negative) than did patients.

Findings are consistent with prior research in the field and suggest consideration of tailoring possible future interventions. Further investigation is needed to assess possible interactional effects to ultimately help couples better communicate about the challenges associated with cancer treatment and recovery.

Despite the growing numbers of foreign-born Latina young adult immigrants in the United States, this population is underrepresented in psychological science. Building upon previous literature, this study examines the moderating effect of acculturation and enculturation on the relationship between depression and alcohol use quantity and frequency among 530 young Latina women (ages 18-23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Acculturation (i.e., the process of immersion into

another culture) lessened the positive link between depression and alcohol use quantity and frequency. Those with higher levels of acculturation reported less symptoms of depression and alcohol use. Enculturation (i.e., the process of immersion to one’s own ethnic culture) increased the positive link between depression and alcohol quantity and frequency. Implications for culturally competent counseling for this underserved and understudied population are discussed.