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Publication Date


Document Type


Degree Name

Doctor of Philosophy


School for Social Work


Opioid use, Protective factors, Substance use severity, Female, Trauma


ished, few studies have examined influence of co-occurring risk factors, depression and trauma, on substance use severity within populations of rurally based women who report opioid use. A sample of 86 opioid users who reported use in the preceding 30 days, was conscripted from an original study of the Penquis Regional Linking Project. Participants completed a battery of clinician-rated and self-report measures that were administered to examine depression severity, level of trauma, prevalence of protective factors and substance use severity. Women were similar in several demographic characteristics: single, Caucasian, unemployed, high school education, parenting and lived in rented housing. Women who were separated had higher levels of substance use severity while women with some college reported lower levels of substance use severity. Data analyses found that when depression symptoms increased, substance use severity increased. No correlations were found between lifetime trauma and substance use severity. Family functioning/resilience was the only protective factor with statistically significant effect on substance use severity. Size and homogeneity of the sample limited findings with variables, and produced type II errors. Prevention modalities for opioid using women must include therapies for depression, assessment for PTSD symptoms, and the engagement of family members and other significant social supports. Further research on how family functioning/resilience could inform prevention strategies for this population as well as other individual protective factors is recommended.


©2017 Judith Avery Josiah-Martin. Access is limited to the Smith College community and other researchers on campus. The Smith College community members also may access from off-campus using a Smith College log-in. Other off-campus researchers may request a copy through Interlibrary Loan for personal use.




x, 196 pages : color illustrations. Includes bibliographical references (pages 144-177)