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Articles 1 - 30 of 34
Full-Text Articles in Medicine and Health Sciences
Intolerance Of Uncertainty Specific To Compulsive Exercise : Development And Preliminary Validation Of The Exercise-Specific Intolerance Of Uncertainty Scale, Christina Scharmer
Intolerance Of Uncertainty Specific To Compulsive Exercise : Development And Preliminary Validation Of The Exercise-Specific Intolerance Of Uncertainty Scale, Christina Scharmer
Legacy Theses & Dissertations (2009 - 2024)
Compulsive exercise is poorly understood and difficult to treat. Overlap between definitions of compulsive exercise, eating disorders and OCD suggests that conceptualizations of these disorders may include shared underlying mechanisms, including intolerance of uncertainty. Although intolerance of uncertainty is traditionally conceptualized as a non-specific construct representing an individual’s dispositional distress in the face of general uncertainty, identifying specific forms of intolerance of uncertainty may further assist in understanding the specific factors that contribute to the development and maintenance of problematic behaviors, including compulsive exercise. The current study aimed to develop an assessment instrument that captures exercise-specific variations in intolerance of …
Evaluating The Relationship Between Orthorexia Nervosa, Eating Disorder Symptomatology, And Related Psychological Constructs In An Undergraduate Mixed-Gender Sample, Kimberly Marie Martinez
Evaluating The Relationship Between Orthorexia Nervosa, Eating Disorder Symptomatology, And Related Psychological Constructs In An Undergraduate Mixed-Gender Sample, Kimberly Marie Martinez
Legacy Theses & Dissertations (2009 - 2024)
The pursuit of a healthy lifestyle has become a central focus of Western societies over the past few decades. As rates of chronic conditions, such as obesity and type II diabetes, continue to rise, so too has the desire to maintain one’s optimal state of health. For some, the pursuit of a healthy diet becomes an obsession that interferes with one’s physical and psychological wellbeing. Orthorexia Nervosa (ON) is a proposed eating disorder characterized by a pathological fixation on healthy eating. Unlike other established eating disorders (EDs), ON is focused on the quality of one’s diet, rather than the quantity …
Doctor Recommendations Are Related To Patient Interest And Use Of Behavioral Treatment For Chronic Pain And Addiction, Lisa M. Mcandrew, Alexandria Brunkow, Margeaux Cannon, Fiona S. Graff, Jessica L. Martin, Leslie R.M. Hausmann
Doctor Recommendations Are Related To Patient Interest And Use Of Behavioral Treatment For Chronic Pain And Addiction, Lisa M. Mcandrew, Alexandria Brunkow, Margeaux Cannon, Fiona S. Graff, Jessica L. Martin, Leslie R.M. Hausmann
Educational & Counseling Psychology Faculty Scholarship
The opioid crisis has highlighted the importance of improving patients’ access to behavioral treatments for chronic pain and addiction. What is not known is if patients are interested in receiving these treatments. In this cross-sectional study, over 1000 participants with chronic pain were surveyed using an anonymous online questionnaire on Amazon Mechanical Turk (Mturk) to investigate participants’ use of and interest in pharmacological and behavioral treatments for chronic pain and addiction. Participants also indicated whether their doctor had recommended these treatments. The majority of participants reported using medication for their pain (83.19%) and that their doctor recommended medication (85.05%), whereas …
Does Common-Sense Communication And The Interpersonal Relationship Predict Oral Health Self-Management?, Kieran J. Maestro
Does Common-Sense Communication And The Interpersonal Relationship Predict Oral Health Self-Management?, Kieran J. Maestro
Legacy Theses & Dissertations (2009 - 2024)
This study sought to understand how patients’ perceptions of the nature and manner of communication with dental health professionals may impact their health self-management quality and habits in the context of preventable illness. Specifically, this study investigated the distinct and overlapping impacts of (a) communication based in the Common Sense Self-Regulation Model (CSM; Leventhal et al., 1980), and (b) the interpersonal relationship between the patient and the dental health professional provider on patients’ oral hygiene quality and habits. It was hypothesized that the interpersonal relationship would positively moderate a positive relation between CSM-based communication and patients' oral health self-management and …
Traditional Latinx Gender Role Norms And Exposure To Sexual Health Programming For Latinx Men Who Have Sex With Men (Lmsm), Austin Connor Eklund
Traditional Latinx Gender Role Norms And Exposure To Sexual Health Programming For Latinx Men Who Have Sex With Men (Lmsm), Austin Connor Eklund
Legacy Theses & Dissertations (2009 - 2024)
Latinx men who have sex with men (LMSM) are at significantly greater risk for HIV infection than their non-Latinx peers. One important way of helping prevent the spread of HIV is exposing vulnerable populations to HIV prevention programming. Little is known about what factors predict exposure to HIV prevention programming for LMSM. Given extant links between traditional masculine gender role norms and health outcomes, this study sought to examine possible relations between constructs of machismo, caballerismo, and heterosexual self-presentation, along with demographic covariates, and exposure to HIV prevention programming among LMSM. Among the 530 LMSM in our sample, 89% reported …
Do Racial Stereotypes Contribute To Medical Misdiagnosis Of Child Abuse? Investigating Tunnel Vision In The Emergency Room, Cynthia J. Najdowski, Kimberly M. Bernstein, Katherine S. Wahrer
Do Racial Stereotypes Contribute To Medical Misdiagnosis Of Child Abuse? Investigating Tunnel Vision In The Emergency Room, Cynthia J. Najdowski, Kimberly M. Bernstein, Katherine S. Wahrer
Psychology Faculty Scholarship
Despite growing recognition that misdiagnoses of child abuse can lead to wrongful convictions, little empirical work has examined how the medical community may contribute to these errors. Previous research has documented the existence and content of stereotypes that associate race with child abuse. The current study examines whether emergency medical professionals rely on this stereotype to fill in gaps in ambiguous cases involving Black children, thereby increasing the potential for misdiagnoses of child abuse. Specifically, we tested whether the race-abuse stereotype led participants to attend to more abuse-related details than infection-related details when an infant patient was Black versus White. …
Development Of The Sexual Minority Affirmative Practice Scale, Ryan Craig Ebersole
Development Of The Sexual Minority Affirmative Practice Scale, Ryan Craig Ebersole
Legacy Theses & Dissertations (2009 - 2024)
Literature on the practice of affirmative psychotherapy with sexual minority (SM) clients has steadily increased over the past two decades in recognition of the unique experiences and mental health needs of this marginalized population. SM-affirmative psychotherapy is an approach to psychotherapy that is culturally-responsive, actively affirms the validity of SM identities and experiences, and promotes the resilience of SM clients in the face of stigma. To date, much of the extant research on SM-affirmative psychotherapy has focused on therapist factors and perspectives. Further, most previous research on SM clients’ experiences in therapy has been qualitative, due in part to the …
The Cognitive And Contextual Underpinnings Of Food Cravings : A Multi-Method Exploration, Martha Niemiec
The Cognitive And Contextual Underpinnings Of Food Cravings : A Multi-Method Exploration, Martha Niemiec
Legacy Theses & Dissertations (2009 - 2024)
The notion of addiction pervades Western vernacular. While firmly established in the substance and drug literature, the concept of addiction is now increasingly associated with other ingested substances (coffee, chocolate, highly processed foods) and a range of compulsive behaviors (gambling, sex, online social networking, gaming). Addiction is associated with substantial morbidity and mortality, and a greater understanding of its etiology has significant public health implications. The physiological mechanisms thought to contribute to the development and maintenance of addiction (tolerance, withdrawal, and, possibly, craving) are widely considered hallmark features and primary treatment targets, while psychological and contextual factors are often underappreciated …
The Long-Term Consequences Of Adolescents' Comparative Economic Position In School, Kiwoong Park
The Long-Term Consequences Of Adolescents' Comparative Economic Position In School, Kiwoong Park
Legacy Theses & Dissertations (2009 - 2024)
The goal of this dissertation project is to investigate how adolescents’ comparative socioeconomic positions within their schools shape their short- and long-term outcomes, including later health, educational expectations and attainment, and the risk of having a nonmarital first birth. Although social comparison theory posits that individual well-being depends on the standings of others with whom one compares oneself, as well as on one’s own absolute standing, the empirical evidence of the theory has been mixed and controversial. This project argues that inconsistent findings may arise from difficulty in measuring reference groups, temporal ambiguity between exposures and outcomes, and methodological limitations.
Race, Social Class, And Child Abuse: Content And Strength Of Medical Professionals’ Stereotypes, Cynthia J. Najdowski, Kimberly M. Bernstein
Race, Social Class, And Child Abuse: Content And Strength Of Medical Professionals’ Stereotypes, Cynthia J. Najdowski, Kimberly M. Bernstein
Psychology Faculty Scholarship
Black and poor children are overrepresented at every stage of the child welfare system, from suspicion of abuse to substantiation. Focusing on stereotypes as a source of bias that leads to these disparities, the current study examines the content and strength of stereotypes relating race and social class to child abuse as viewed by medical professionals. Doctors, nurses, and other medical professionals (Study 1: N = 53; Study 2: N = 40) were recruited in local hospitals and online through snowball sampling. Study 1 identified stereotype content by asking participants to list words associated with the stereotype that …
The Impact Of Adverse Childhood Experiences On Mental Health, Executive Functioning, And Emotion Regulation Across Childhood : Which Family And Community Factors Mitigate Risk?, Atara Siegel
Legacy Theses & Dissertations (2009 - 2024)
It is well established that adverse childhood experiences (ACEs) increase risk of developing mental health disorders later in life. It is unclear how early in childhood these effects can be seen. Executive functioning (EF) and emotion regulation (ER) have been proposed as potential mechanisms which mediate the effect of ACEs on mental health. Individual ACEs have been associated with poor EF and ER. It is unclear whether ACE scores impact EF and ER in a graded, dose-response manner. It is also unclear how early in childhood these effects can be seen. Finally, more research is needed to identify family and …
The Effects Of Pre-Pregnancy Tobacco Use On Food Cravings And Weight Gain In Pregnancy, Lauren E. Blau
The Effects Of Pre-Pregnancy Tobacco Use On Food Cravings And Weight Gain In Pregnancy, Lauren E. Blau
Legacy Theses & Dissertations (2009 - 2024)
Smoking cessation is associated with greater frequency of food cravings, even when controlling for body mass index. Recent studies have indicated similarities between obese women and women who smoke tobacco in mood states and food craving frequency. This is consistent with the common substrate hypothesis, which postulates that shared neural pathways mediate craving across multiple domains, and could explain why it is common for women attempting to quit smoking to gain weight. Smoking cessation prior to pregnancy is strongly encouraged due to the adverse effects of tobacco use on the developing fetus. Studies have shown that women who quit smoking …
Does What You Think You Feel, Impact What You Actually Eat? : An Examination Of Alexithymia, Interoceptive Awareness, And Loss Of Control Eating In Young Women, Lisa Marie Anderson
Does What You Think You Feel, Impact What You Actually Eat? : An Examination Of Alexithymia, Interoceptive Awareness, And Loss Of Control Eating In Young Women, Lisa Marie Anderson
Legacy Theses & Dissertations (2009 - 2024)
Affect regulation theories posit that loss of control (LOC) and binge eating are maintained via an emotion regulation process, through which eating relieves negative affect and aversive mood states. LOC has been identified as a key binge eating characteristic associated with psychopathology and poor psychological outcomes. As such, maladaptive emotion regulation has been identified as a central risk factor for binge eating, as theories posit that individuals binge eat in response to negative mood states. However, empirical studies testing the link between induced negative mood and subsequent food intake in people with LOC and binge eating have yielded inconsistent findings. …
Using Technologies To Support The Social And Academic Engagement Of Young People With Cancer, Owen Michael Donovan
Using Technologies To Support The Social And Academic Engagement Of Young People With Cancer, Owen Michael Donovan
Legacy Theses & Dissertations (2009 - 2024)
Situated in the larger questions of how to support the educational engagement and positive psychosocial development of young people with cancer, the purpose of this exploratory study was to address gaps in the literature and build understanding of how young people use digital and Internet-connected technologies in ways that support their social and academic engagement. Through a multiple case-design, I examined the school-based and everyday (outside of school) technology uses of five young people. This study found that the cancer experience changed or reframed a young person’s motivational engagement with school. Doing well academically was a sign of a normalcy …
A Brief Motivational Intervention For Marijuana Use In College Students, Vivian S. Hwang
A Brief Motivational Intervention For Marijuana Use In College Students, Vivian S. Hwang
Legacy Theses & Dissertations (2009 - 2024)
The prevalence of marijuana use has risen among young adults, and marijuana is
Exploring The Role Of Escapism In The Dsm-V Criteria For Internet Gaming Disorder : A Meta-Analytic Investigation, Yeonggeul Lee
Exploring The Role Of Escapism In The Dsm-V Criteria For Internet Gaming Disorder : A Meta-Analytic Investigation, Yeonggeul Lee
Legacy Theses & Dissertations (2009 - 2024)
Internet gaming disorder (IGD) has been included in the DSM-5 in a preliminary endorsement of excessive video gaming as a behavioral disorder. Further research is required to validate IGD because some criteria are controversial in diagnostic accuracy. Escapism is one such criterion. Despite some research evidence of escapism as the strongest motivational predictor of IGD, recent investigations found that the escapism criterion is highly questionable. Because of the inclusion of escapism in initial IGD measures, previous studies have produced evidence of escapism as a predictor of IGD owing to a tautology. Thus, the present study examined the effect of gaming …
Cumulative Risk And Chinese Adolescent Problematic Internet Use : The Mediating Role Of Self-Esteem, Xian Li
Cumulative Risk And Chinese Adolescent Problematic Internet Use : The Mediating Role Of Self-Esteem, Xian Li
Legacy Theses & Dissertations (2009 - 2024)
A decade of research has documented the adverse effect of multiple ecological risks on adolescent problematic Internet use (PIU), yet existing research provides rather segmental explanations, and few studies offer a comprehensive and integrated account. A better theoretical and empirical understanding of the associations of multiple ecological risks and PIU, as well as the underlying mechanisms, could help inform intervention practices and policies to mitigate adolescent PIU.
Mediating And Moderating Factors Of The Relationship Between Sexual Orientation And Eating Pathology And Body Satisfaction In Sexual Minority And Heterosexual Men, Andrea Denae Murray
Mediating And Moderating Factors Of The Relationship Between Sexual Orientation And Eating Pathology And Body Satisfaction In Sexual Minority And Heterosexual Men, Andrea Denae Murray
Legacy Theses & Dissertations (2009 - 2024)
Most research on body image and disordered eating has focused largely on women, as women are at higher risk than men for eating disorders. In recent years research has revealed that men are at increasing risk for these outcomes, especially as the ideal male body represented in media images and therefore frequently internalized among men is becoming so lean and muscular as to make it very difficult for most men to realistically achieve. Sexual minority men in particular have been found to be at increased risk for body dissatisfaction, body shame, and disordered eating than their heterosexual counterparts. The research …
The Impact Of Stress On Steroid Hormones And Cue Reactivity In Smokers And Gamblers, Stephanie Elaine Wemm
The Impact Of Stress On Steroid Hormones And Cue Reactivity In Smokers And Gamblers, Stephanie Elaine Wemm
Legacy Theses & Dissertations (2009 - 2024)
Addictions, both substance and behavioral, have been conceptualized as having similar biopsychosocial processes with different opportunistic expressions (Shaffer et al., 2004). Biological processes such as the hormonal response to stress as measured by cortisol, dehydroepiandrosterone (DHEA), and the ratio of the DHEA/cortisol may be among the variables underlying the disposition to develop an addictive disorder, regardless of whether it is a substance-based or a so-called behavioral addiction. The current study aimed to examine whether physiological and psychological reactions to stress are similar in high-frequency smokers and gamblers. The subjective (urges, cravings) and physiological responses (skin conductance and heart rate) of …
The Association Of Internalized Stigmas, Culture-Specific Coping, And Depression In Gay And Bisexual Black Men, Duane Glen Khan
The Association Of Internalized Stigmas, Culture-Specific Coping, And Depression In Gay And Bisexual Black Men, Duane Glen Khan
Legacy Theses & Dissertations (2009 - 2024)
Gay and bisexual Black men experience higher lifetime depression rates than both White and Black heterosexual men. Some social stress researchers argued that this rate may be due to having two stigmatized minority identities and therefore being at greater risk. However, gay and bisexual Black men also experience lifetime depression rates significantly below White LGB people, suggesting resilience to depression for those with these intersecting identities, race and sexuality. This study attempted to address the debate between greater risk versus resilience in gay and bisexual Black men.
A Qualitative Analysis Of Clinician Attitudes And Experiences Learning And Implementing Transdiagnostic Evidence-Based Practices For Eating Disorders, Jennifer Marie Oswald
A Qualitative Analysis Of Clinician Attitudes And Experiences Learning And Implementing Transdiagnostic Evidence-Based Practices For Eating Disorders, Jennifer Marie Oswald
Legacy Theses & Dissertations (2009 - 2024)
Clinician experiences with the implementation of new practices are important factors in facilitating the use of new treatment models and evidence-based practices (EBPs). As such, they provide crucial information to behavioral health dissemination and implementation research. Qualitative interviewing allows researchers to learn from clinician experiences with greater depth and nuance. The present study qualitatively analyzed 8 clinicians’ experiences with the implementation of a new transdiagnostic treatment model for eating disorders (ED) at an intensive residential treatment center. Participating clinicians completed a semi-structured interview based on constructs from the Consolidated Framework for Implementation Research (CFIR), an organizing framework with demonstrated utility …
Exposure To Interparental Aggression During Youth And Internalizing Psychopathology In Adulthood : The Moderating Role Of The Autonomic Nervous System, Alison J. Rivers
Exposure To Interparental Aggression During Youth And Internalizing Psychopathology In Adulthood : The Moderating Role Of The Autonomic Nervous System, Alison J. Rivers
Legacy Theses & Dissertations (2009 - 2024)
The present study examines the impact of respiratory sinus arrhythmia (RSA), an indicator of parasympathetic nervous system (PNS) activity, and skin conductance level (SCL), an indicator of sympathetic nervous systems (SNS) activity, on the relationship between interparental aggression exposure in childhood and adolescence and internalizing psychopathology (anxiety, depression symptoms, and posttraumatic stress disorder symptoms) in young adulthood. Participants completed self-report questionnaires regarding youth interparental aggression exposure and current young adult psychopathology. Participants included 188 adults (mean age = 19.45 years old; 72% Caucasian/white; 55% female). Results demonstrate that co-activation of the PNS and SNS in the context of high interparental …
Relation Between Harsh Parenting Exposure In Childhood And Adult Externalizing Symptoms : Moderating Role Of The Autonomic Nervous System, Samantha Aldea Barry
Relation Between Harsh Parenting Exposure In Childhood And Adult Externalizing Symptoms : Moderating Role Of The Autonomic Nervous System, Samantha Aldea Barry
Legacy Theses & Dissertations (2009 - 2024)
Though literature suggests that many individuals with childhood attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) report having symptoms of the respective disorder as adults, little is known about potential predictors of adulthood externalizing symptoms. The proposed study examines the impact of the parasympathetic nervous system (PNS), as measured by respiratory sinus arrhythmia (RSA), and the sympathetic nervous system (SNS), as measured by skin conductance levels (SCL), on the link between harsh parenting experienced during childhood and ADHD and ODD symptoms during young adulthood. Results yielded a significant two-way interaction between harsh parenting and resting RSA, which significantly accounted for …
The Contribution Of Mindfulness Meditation And Values Clarification To The Treatment Of Anxiety : An Experience Sampling Study, Christopher Robert Berghoff
The Contribution Of Mindfulness Meditation And Values Clarification To The Treatment Of Anxiety : An Experience Sampling Study, Christopher Robert Berghoff
Legacy Theses & Dissertations (2009 - 2024)
Anxiety disorders are the most prevalent mental health concern in the United States. Yet, many who suffer from anxiety do not receive treatment or fail to respond to well-established cognitive and behavioral interventions. Mindfulness- and values-based strategies are possible alternatives for these individuals. However, values-based approaches have not been adequately studied in anxious populations and it is unclear how they may interact with mindfulness-based approaches. Moreover, little is understood about the mechanisms of action underlying behavioral changes resulting from mindfulness meditation (MM) practices. Acceptance and Commitment Therapy (ACT) is one approach that employs values clarification (VC) and mindfulness to bring …
Relationships Between Breastfeeding, Maternal Cigarette Smoking During Pregnancy, And The Cognitive Functioning Of Akwesasne Mohawk Adolescents Exposed To Environmental Pollution, Georgia Brooke
Legacy Theses & Dissertations (2009 - 2024)
Previous research has suggested that breastfeeding is beneficial for children's health and that maternal cigarette smoking during pregnancy is harmful for children's health. However, there is not a consensus in the existing literature about whether or not these two maternal behaviors impact the cognitive development of children. Furthermore, understanding the role of breastfeeding in children's development is complicated by the fact that breastfeeding transmits toxicants that are stored in the mother's body, including polychlorinated biphenyls (PCBs), to the infant. Existing research suggests that PCBs negatively impact children's cognitive functioning. The current study examined relationships between breastfeeding, maternal cigarette smoking during …
African American Families' Expectations And Intentions For Mental Health Services, Cynthia J. Najdowski, Richard Thompson, Barbara L. Dancy, Tisha R. A. Wiley, Sylvia P. Perry, Jason Wallis, Yara Mekawi, Kathleen Knafl
African American Families' Expectations And Intentions For Mental Health Services, Cynthia J. Najdowski, Richard Thompson, Barbara L. Dancy, Tisha R. A. Wiley, Sylvia P. Perry, Jason Wallis, Yara Mekawi, Kathleen Knafl
Psychology Faculty Scholarship
A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans’ engagement in mental health services.
Investigating The Main Effects And Interactions Of Induced Mood And Emotional Urgency On Self-Report Cannabis Craving And Consumption, Joseph Anthony De Leo
Investigating The Main Effects And Interactions Of Induced Mood And Emotional Urgency On Self-Report Cannabis Craving And Consumption, Joseph Anthony De Leo
Legacy Theses & Dissertations (2009 - 2024)
The current research investigates the role of induced mood states and emotional urgency - a mood-based facet of impulsivity, on cannabis use behaviors. Specifically, this research aims to extend previous work linking impulsivity and substance use behaviors by examining the relation of `emotional urgency' on cannabis craving and consumption.
Participation In Immersion Weight Loss Treatment May Benefit, Not Harm, Young Adult Staff Members, Katherine Elizabeth Schaumberg
Participation In Immersion Weight Loss Treatment May Benefit, Not Harm, Young Adult Staff Members, Katherine Elizabeth Schaumberg
Legacy Theses & Dissertations (2009 - 2024)
American teens and young adults are at risk for developing pathological eating patterns, which can lead to eating disorders and obesity. Despite the success of weight management programs for obese individuals, some researchers caution that participation in an aggressive approach to weight management could promote the development of eating disorders. The current study evaluated the risks of following a weight management program for healthy young adults who served as staff members in immersion treatment of obesity over the course of a summer. Participants included Wellspring staff members (n = 108) along with a comparison group of young adults with similar …
Self-Modeling As An Intervention For Stuttering In Elementary Students, Jason Northrup
Self-Modeling As An Intervention For Stuttering In Elementary Students, Jason Northrup
Legacy Theses & Dissertations (2009 - 2024)
Stuttering is a disorder involving disruptions and disfluencies in speech that impacts overall communication and affects approximately 1% of the population. In addition to speech disfluency, stuttering is often related to physical tension, embarrassment, fear, anxiety, and other negative social-emotional problems, especially for children and adolescents. Fortunately, research indicates that stuttering can be alleviated before becoming more advanced and complex as individuals enter adolescence and adulthood. Self-modeling, an intervention that involves individuals watching themselves engage in exemplary behavior, appears to be particularly effective for individuals who stutter and can be implemented in a school setting. The purpose of this study …
Comparing Collocated And Non-Collocated Licensed Substance Abuse Outpatient Clinics In New York State : A Program Level Analysis, Bradley R. White
Comparing Collocated And Non-Collocated Licensed Substance Abuse Outpatient Clinics In New York State : A Program Level Analysis, Bradley R. White
Legacy Theses & Dissertations (2009 - 2024)
Objective. The study addresses two research aims: (1) to examine the extent to which caseload and program characteristics differ across substance abuse outpatient programs with respect to collocation with licensed mental health outpatient clinic programs and (2) to investigate the relationship between collocation and program level service outcomes.