Date of Award

2019

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Psychology

Specialization

Clinical Psychology

Department

Psychology

First Advisor

Nichea Spillane

Abstract

Adolescent suicide is a serious public health issue, given that it is the second most common cause of death among individuals aged 10 to 24 years in the United States. Substance use is among the major risk factors for continued adolescent suicidal behavior and having a substance use disorder (SUD), has been identified as a risk factor for adolescents being readmitted to acute psychiatric care. However, adolescents often do not receive treatment that adequately addresses substance use in the same setting. The primary purpose of this study was to examine whether or not adding a Brief Motivational Interviewing intervention (BMI) addressing adolescent substance use (e.g., alcohol and marijuana use) in an adolescent acute psychiatric setting was associated with lowered prospective risk of rehospitalization. A retrospective cohort study design was used, and patients (N=158), admitted between July 2016 and October 2017, were 16 years old on average and were 66.7% White, 13.2% Black, and 19.5% other; ethnic makeup included 22.0% Hispanic adolescents. Cox proportional hazard regression (survival) analyses revealed that BMI completion did not significantly predict days to rehospitalization, nor did declining the BMI significantly predict hospital readmission, however, some of the sociodemographic and treatment factors did significantly predict higher risk of rehospitalization (i.e., greater severity of diagnosis, being male, older age, and greater length of stay). It is crucial for there to be more aggressive outreach and follow-up, following psychiatric hospitalizations, particularly for high-risk youth with prior suicidal behavior. More research is needed to examine the effectiveness of substance use interventions such as BMI in acute psychiatric settings in order to reduce substance use among adolescents.

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