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Substance Abuse and Addiction

2014

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Articles 1 - 30 of 42

Full-Text Articles in Social and Behavioral Sciences

Implementing Outside The Box: Community-Based Social Service Provider Experiences With Using An Alcohol Screening And Intervention, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Alex T. Ramsey, Carissa Van Den Berk-Clark Dec 2014

Implementing Outside The Box: Community-Based Social Service Provider Experiences With Using An Alcohol Screening And Intervention, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Alex T. Ramsey, Carissa Van Den Berk-Clark

Brown School Faculty Publications

Objective: The aim of this study is better understand perceptions of front-line social service workers who are not addiction specialists, but have to address addiction-related issues during their standard services. Method: Six social service organizations implemented a validated alcohol assessment and brief education intervention. After a 3-month trial implementation period, a convenience sample of 64 front-line providers participated in six focus groups to examine barriers and facilitators to the implementation of an alcohol screening and brief intervention. Results: Three themes emerged: (1) usefulness of the intervention, (2) intervention being an appropriate fit with the agency and client population, and (3) …


The Swedish Studies Of The Adopted Children Of Alcoholics, Jill Littrell Dec 2014

The Swedish Studies Of The Adopted Children Of Alcoholics, Jill Littrell

jill l littrell Dr.

The authors of the widely cited studies analyzing the Swedish adoption records of the children of alcoholics have advanced the notion that there are three distinct paths for the inheritance of alcoholism. One path results in moderate alcoholism in men and a form of somatization but no alcoholism in women. A second path results in severe and mild alcoholism in men and alcoholism in women. The third path results in a particular variety of alcohol abuse in men and a particular variety of somatization in women. This article analyzes the authors' claims. It is argued that the data were improperly …


Perspectives Emerging From Neuroscience On Why People Become Addicted And What To Do About It, Jill Littrell Dec 2014

Perspectives Emerging From Neuroscience On Why People Become Addicted And What To Do About It, Jill Littrell

jill l littrell Dr.

This paper reviews the new ideas emerging from neuroscience regarding the question of why some people are compelled to use drugs. During the process of drug exposure, the brain’s motivational system is changed in ways that co-opts the individual’s motivational system. Changes in the brain’s motivational structures along with changes in the brain’s self-regulatory structures compel an individual to drug use. Ways to reverse those changes in an addicted brain have been identified, as have ways to enhance self-regulatory control. The information from neuroscience offers a new perspective on “loss of control” as well as offering implications for treatment.


How Addiction Happens, How Change Happens, And What Social Workers Need To Know To Be Effective Facilitators Of Change, Jill Littrell Dec 2014

How Addiction Happens, How Change Happens, And What Social Workers Need To Know To Be Effective Facilitators Of Change, Jill Littrell

jill l littrell Dr.

During the last two decades, neuroscience research has proliferated examining brain mechanisms that explain why some people are compelled to pursue drugs and alcohol. The findings suggest that addiction is independent of pleasure, and that drug seeking can be triggered outside of conscious awareness (Berridge, Robinson, & Aldridge, 2009; Goldstein et al., 2009; Kalivas, Volkow, & Seamans, 2005). The observations and conclusions from this research can be used to advantage in treating addiction. The use of social psychological principles, in the context of motivational interviewing, offers a platform for taking advantage of these new insights. After a brief sketch of …


Adjusting Learning Parameters To Increase Cognitive Resource Allocation In Persons With Alcoholism Risk, Brooke Snelgrove, Taylor Stephens, Yasmin Akbari, Reyn Yoshiura, Lilian Andrade Dec 2014

Adjusting Learning Parameters To Increase Cognitive Resource Allocation In Persons With Alcoholism Risk, Brooke Snelgrove, Taylor Stephens, Yasmin Akbari, Reyn Yoshiura, Lilian Andrade

Student Scholar Symposium Abstracts and Posters

Parental history of alcoholism is associated with increased alcoholism risk in their children. One factor increasing alcoholism risk is the presence of attention and information encoding disruptions in adult children of alcoholics (ACOA) compared to persons who are not ACOAs (NACOA). Alcohol ingestion reduces these disruptions in ACOAs. This study examined whether alterations of information processing parameters can function like alcohol and reduce processing disruptions experienced by the ACOA. Participants were 80 ACOAs and 80 NACOAs, partitioned into four groups of 20 participants. During learning, subjects studied presentations of stimulus items followed by the presentation of associated response items. The …


Increasing Response Time And Response Evaluation Time Compensates For Information Processing Difficulties In Persons At Risk For Alcoholism, Yasmin Akbari Dec 2014

Increasing Response Time And Response Evaluation Time Compensates For Information Processing Difficulties In Persons At Risk For Alcoholism, Yasmin Akbari

Student Scholar Symposium Abstracts and Posters

Parental history of alcoholism is associated with increased alcoholism risk in their children. One factor increasing alcoholism risk is the presence of attention and information encoding disruptions in adult children of alcoholics (ACOA) compared to persons who are not ACOAs (NACOA). Alcohol ingestion reduces these disruptions in ACOAs. This study examined whether alterations of information processing parameters can function like alcohol and reduce processing disruptions experienced by the ACOA.

Participants were 80 ACOAs and 80 NACOAs, partitioned into four groups of 20 participants. During learning, subjects studied presentations of stimulus items followed by the presentation of associated response items. The …


Alcohol And Drug Use Amongst College Students In Relation To Sexual Abuse, Christyn Hollingsworth Dec 2014

Alcohol And Drug Use Amongst College Students In Relation To Sexual Abuse, Christyn Hollingsworth

Honors College Theses

The impact of child sexual abuse (CSA) and traumatic sexual experiences has been the subject of multiple studies in which harm was found. Among these harms are emotional distress, psychological issues, and substance abuse. This research analyzed and compared the responses to questions pertaining to substance use and attitudes regarding sexual interactions between college aged students with and without a history of sexual abuse. The participant’s answers were run through an ANOVA to determine statistical variance. Based on prior research, it was expected that victims consume alcohol and use drugs more frequently than non-victims in significant amounts. The findings in …


Exploring The Use Patterns Of A Mobile Health Application For Alcohol Addiction Before The Initial Lapse After Detoxification, Ming-Yuan Chih Nov 2014

Exploring The Use Patterns Of A Mobile Health Application For Alcohol Addiction Before The Initial Lapse After Detoxification, Ming-Yuan Chih

Health and Clinical Sciences Faculty Publications

How patients used Addiction-Comprehensive Health Enhancement Support System (A-CHESS), a mobile health intervention, while quitting drinking is worthy exploring. This study is to explore A-CHESS use patterns prior to the initial lapse reported after discharge from inpatient detoxification programs. 142 patients with alcohol addiction from two treatment agencies in the U.S. were included. A comprehensive set of A-CHESS use measures were developed based on a three-level system use framework and three A-CHESS service categories. In latent profile analyses, three A-CHESS system use patterns-inactive, passive, and active users-were found. Compared to the passive users (with the highest chance of the initial …


Developing An Animal Model Of Polysubstance Abuse In Adolescence: The Role Of Nmda Receptors In Alcohol/Cocaine Reward, Adriana Rebecca Uruena-Agnes Nov 2014

Developing An Animal Model Of Polysubstance Abuse In Adolescence: The Role Of Nmda Receptors In Alcohol/Cocaine Reward, Adriana Rebecca Uruena-Agnes

USF Tampa Graduate Theses and Dissertations

Repeated exposure to drugs of abuse conditions individuals to anticipate the behavioral consequences of drug use specifically in the presence of a drug-associated context. In rodents, preferences and aversions for alcohol and cocaine have been conditioned; however, the mechanisms underlying the expression of these conditioned effects remain unknown. Given that alcohol and cocaine polysubstance abuse is prevalent in young individuals, with more than 50% of these polysubstance abusers reporting to be under the age of 21, it is important to understand the mechanisms contributing to the behavioral effects of alcohol and cocaine co-dependency. Aim 1 determined if age differentially impacted …


Research Brief: "Veterans’ Attitudes Toward Work And Disability Compensation: Associations With Substance Abuse", Institute For Veterans And Military Families At Syracuse University Oct 2014

Research Brief: "Veterans’ Attitudes Toward Work And Disability Compensation: Associations With Substance Abuse", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study compares attitudes towards employment and service-connected disabilities among substance using and non-using veterans. In practice, veterans place a high value on being employed, regardless of whether they use substances; however, veterans who used substances were more likely to express fear of losing disability benefits if they became employed. In policy, state-level agencies and programs might work with counseling centers to determine the most productive ways to address the specific employment needs of veterans with disabilities and/or substance use issues. Suggestions for future study include sampling larger populations on a randomized basis to ensure that the results found here …


Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams Oct 2014

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …


The Capus Project-Innovative Solutions For Hiv/Aids Linkage To Care, Melanie Gwynn, Jamila Ealey, Kate Racoff Musgrove Sep 2014

The Capus Project-Innovative Solutions For Hiv/Aids Linkage To Care, Melanie Gwynn, Jamila Ealey, Kate Racoff Musgrove

9th Annual Rural HIV Research and Training Conference (2014-2019)

“The CAPUS Project-Innovative Solutions for HIV/AIDS Linkage to Care”

Objectives: 1) Expand knowledge of the current linkage to care landscape within Georgia; 2) Identify essential components of the Resource Hub to enhance linkage to care efforts throughout Georgia; and 3)Promote effective use of the Resource Hub to facilitate HIV/AIDS linkage to care within highly impacted communities


First-Year Students' Perspectives On Reasons For And Prevention Of Their Own Alcohol Overdose, Janet Reis Sep 2014

First-Year Students' Perspectives On Reasons For And Prevention Of Their Own Alcohol Overdose, Janet Reis

Janet Reis

Two hundred twenty-six first-year students enrolled at a large, public Midwest university and deemed to require an emergency transport for a potential alcohol overdose completed a brief questionnaire on the student's perceptions of why the event occurred, what might have happened to prevent the overdose situation, and personal assessment of experience with alcohol. The explanations for the event revolve around personal decision making (made decision to drink too much, absence of drinking control behaviors) as opposed to peer influence. Similarly, factors selected as preventing an alcohol overdose focused on knowing one's own tolerance, plus having a buddy system to slow …


Personal Network Recovery Enablers And Relapse Risks For Women With Substance Dependence, Suzanne Brown, Elizabeth M. Tracy, Min Kyoung Jun, Hyunyong Park, Meeyoung O. Min Sep 2014

Personal Network Recovery Enablers And Relapse Risks For Women With Substance Dependence, Suzanne Brown, Elizabeth M. Tracy, Min Kyoung Jun, Hyunyong Park, Meeyoung O. Min

Social Work Faculty Publications

We examined the experiences of women in treatment for substance dependence and their treatment providers about personal networks and recovery. We conducted six focus groups at three women’s intensive substance abuse treatment programs. Four coders used thematic analysis to guide the data coding and an iterative process to identify major themes. Coders identified social network characteristics that enabled and impeded recovery and a reciprocal relationship between internal states, relationship management, and recovery. Although women described adding individuals to their networks, they also described managing existing relationships through distancing from or isolating some members to diminish their negative impact on recovery. …


An Introduction To Drugs And The Neuroscience Of Behavior, Adam Prus Aug 2014

An Introduction To Drugs And The Neuroscience Of Behavior, Adam Prus

Adam J Prus

This up-to-date new text provides an introductory overview of the nervous system actions and behavioral effects of the major classes of psychoactive drugs. Appropriate for undergraduate students who have an introductory level background in psychology or other areas within the social sciences, AN INTRODUCTION TO DRUGS AND THE NEUROSCIENCE OF BEHAVIOR illustrates concepts and highlights research techniques. The book's most important feature is its pedagogical elements, which are not found in other psychopharmacology texts, but are particularly important for making this specialized topic approachable for undergraduates. Charts and diagrams illustrate basic concepts and processes important for understanding the actions and …


Honorable Mention: 27th Annual No Big Heads Exhibition, Adam Prus Aug 2014

Honorable Mention: 27th Annual No Big Heads Exhibition, Adam Prus

Adam J Prus

This up-to-date new text provides an introductory overview of the nervous system actions and behavioral effects of the major classes of psychoactive drugs. Appropriate for undergraduate students who have an introductory level background in psychology or other areas within the social sciences, AN INTRODUCTION TO DRUGS AND THE NEUROSCIENCE OF BEHAVIOR illustrates concepts and highlights research techniques. The book's most important feature is its pedagogical elements, which are not found in other psychopharmacology texts, but are particularly important for making this specialized topic approachable for undergraduates. Charts and diagrams illustrate basic concepts and processes important for understanding the actions and …


Gender And Prescription Painkiller Misuse: Findings From The 2011 National Survey On Drug Use And Health, Robin Jo Clough Aug 2014

Gender And Prescription Painkiller Misuse: Findings From The 2011 National Survey On Drug Use And Health, Robin Jo Clough

Dissertations and Theses

This study examines the effects of gender and social bonds on the experience of prescription painkiller misuse for men and women. The theoretical framework for the project is Travis Hirschi's social control theory (1969), and the social bond elements of attachment, commitment, involvement, and belief, which emphasizes the importance of these bonds in creating a "stake in conformity" for the individual, leading to acceptance of social norms and desistence from deviance. This theory, however, is relatively silent with regard to gender differences and was developed to examine delinquency in an all male sample of adolescents. The elements of this theory …


First-Year Students' Perspectives On Reasons For And Prevention Of Their Own Alcohol Overdose, Janet Reis Aug 2014

First-Year Students' Perspectives On Reasons For And Prevention Of Their Own Alcohol Overdose, Janet Reis

University Author Recognition Bibliography: 2014

Two hundred twenty-six first-year students enrolled at a large, public Midwest university and deemed to require an emergency transport for a potential alcohol overdose completed a brief questionnaire on the student's perceptions of why the event occurred, what might have happened to prevent the overdose situation, and personal assessment of experience with alcohol. The explanations for the event revolve around personal decision making (made decision to drink too much, absence of drinking control behaviors) as opposed to peer influence. Similarly, factors selected as preventing an alcohol overdose focused on knowing one's own tolerance, plus having a buddy system to slow …


The Fatherhood Factor: The Impact Of The Father-Child Relationship On The Social, Interpersonal, And Recidivism Risk Factors Of Previously Incarcerated Men, Larissa A. Maley Aug 2014

The Fatherhood Factor: The Impact Of The Father-Child Relationship On The Social, Interpersonal, And Recidivism Risk Factors Of Previously Incarcerated Men, Larissa A. Maley

Seton Hall University Dissertations and Theses (ETDs)

Of the men who return home from prison, nearly 7 out of 10 will be re-arrested and sent back within 3 years of their release (Travis, Solomon, & Waul, 2001). This trend has large- scale implications, not just for individuals, but for their families and communities as well. Clearly, understanding the factors that contribute to a man’s success or failure in staying out of prison is extremely important in constructing policy and programs to assist these at-risk individuals and communities. Of the few studies that have explored the lives of previously incarcerated men, some have found fatherhood to be a …


Strengthening A Social Justice Lens For Addictions Practice: Exploration, Reflections, Possibilities And A Challenge To Our Shared Work To Promote Recovery Among The Most Vulnerable, Laura Burney Nissen Aug 2014

Strengthening A Social Justice Lens For Addictions Practice: Exploration, Reflections, Possibilities And A Challenge To Our Shared Work To Promote Recovery Among The Most Vulnerable, Laura Burney Nissen

School of Social Work Faculty Publications and Presentations

Addiction is commonly conceptualized as a personal problem, a family problem, a neighborhood problem, a community problem, and even a social problem. But how might addiction be understood as a social justice problem?

Substance abuse problems, addictions, and addiction treatment and the related preparation of professionals to fill its treatment ranks exist within an ideological and political infrastructure. Issues of social justice are often conspicuously absent as a primary consideration of the experience of people seeking treatment (acknowledging the treatment gap that impacts some people more than others), for communities ravaged by addiction (acknowledging that some communities are affected more …


The Influence Of Childhood Maltreatment On Substance Abuse In Adulthood, James Michael Blinco Jul 2014

The Influence Of Childhood Maltreatment On Substance Abuse In Adulthood, James Michael Blinco

Sociology & Criminal Justice Theses & Dissertations

This study examines the relationship between suffering physical or sexual abuse as a child and drug or alcohol use in adulthood. Data was used from the first three waves of the National Longitudinal Study of Adolescent Health survey. This study found that being a victim of childhood physical abuse can lead to abuse of alcohol later in life. In addition being male and African American are key factors in predicting alcohol abuse and other illegal drug use in adulthood. No significant relationship was found between being a victim of sexual abuse and abusing alcohol, using marijuana, or using any other …


Combined Effects Of Mdma And Ethanol On Locomotor Activity And Place Conditioning In Male And Female Adolescent Sprague-Dawley Rats, Keli A. Herr Jun 2014

Combined Effects Of Mdma And Ethanol On Locomotor Activity And Place Conditioning In Male And Female Adolescent Sprague-Dawley Rats, Keli A. Herr

Masters Theses

MDMA, ("Ecstasy") is commonly abused in combination with ethanol (EtOH). Relatively few preclinical studies have investigated sex differences in animal models of polysubstance use. The current study employed a conditioned place preference (CPP) procedure to assess the behavioral effects of the co-administration ofMDMA /EtOH in 32 male and 32 female adolescent Sprague-Dawley rats. Following a 15 min habituation trial, eight 30-min conditioning trials were conducted in two- compartment chambers with different environmental cues. Before each drug conditioning trials, rats were administered intraperitoneal (i.p.) injections of MDMA(6.6 mg/kg), EtOH (1.5 g/kg), MDMA (6.6 mg/kg) and EtOH (1.5 g/kg), or saline. Prior …


Comparing Perceptions Of Motivation To Change: Clinicians Versus Their Substance-Abuse Clients, Arthur Tabrizi Apr 2014

Comparing Perceptions Of Motivation To Change: Clinicians Versus Their Substance-Abuse Clients, Arthur Tabrizi

Graduate Research Symposium (2010 - 2017)

Although some clients enter treatment voluntarily to seek intervention for their substance abuse problems, most enter under coercive external pressures that may be perceived by clinicians as less influenced by addressing substance abuse than by appeasing mandates from the judicial system, family, or employers. Little research has examined and compared how clinicians assess clients’ extrinsic and intrinsic motivation to change as opposed to how the clients assess themselves. A congruency between the two parties’ assessments may inform the quality of the therapeutic relationship and facilitate an effective treatment plan. Using the Circumstance, Motivation, and Readiness Scales (CMR) and availability sampling …


Depression Is More Prevalent Throughout Pregnancy And The First Six Months Postpartum In Women Low In Religious Commitment And Social Support, Andrea D. Clements, Tifani A. Fletcher, Beth A. Bailey Apr 2014

Depression Is More Prevalent Throughout Pregnancy And The First Six Months Postpartum In Women Low In Religious Commitment And Social Support, Andrea D. Clements, Tifani A. Fletcher, Beth A. Bailey

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.


The Use Of The Term "Paco" By Street Youth In The City Of Buenos Aires And The Strategies Used By The Center For Integral Attention On Childhood And Adolescence To Help In Treating The Problematic Consumption Of Drugs, Sophie Kligler Apr 2014

The Use Of The Term "Paco" By Street Youth In The City Of Buenos Aires And The Strategies Used By The Center For Integral Attention On Childhood And Adolescence To Help In Treating The Problematic Consumption Of Drugs, Sophie Kligler

Independent Study Project (ISP) Collection

Información contextual: En los últimos años, Argentina ha experimentado un aumento rápido en la prevalencia y uso del paco, la pasta base de la cocaína. Esta droga se ha convertido en una de las drogas más comunes en la calle debido a su precio bajo, su accesibilidad y sus cualidades adictivas. El paco es particularmente prevalente entre los chicos que viven en la situación de calle porque su acceso es muy fácil y barato y les ayuda escapar, por algunos momentos, de la dura realidad de sus vidas. La droga puede tener consecuencias graves para la salud de un consumidor, …


Alcohol And Drug Prevention, Intervention, And Treatment Literature: A Bibliography For Best Practices, Laura Burney Nissen Apr 2014

Alcohol And Drug Prevention, Intervention, And Treatment Literature: A Bibliography For Best Practices, Laura Burney Nissen

School of Social Work Faculty Publications and Presentations

Addictions remain a persistent challenge to mental health practice. There is a need for mental health educators, students, and practitioners to be aware of, critique, contribute to, and, where relevant, utilize emerging scholarly literature to inform their intervention strategies. This comprehensive addictions bibliography draws from a wide variety of sources, perspectives, and ideologies to hasten the rate at which academics and practitioners can more meaningfully participate in this rapidly developing field of practice.


Alcohol Screening And Brief Intervention As Standard Practice In Indian Country, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Bonnie Duran, Catherine N. Dulmus Phd, Amy R. Manning Mar 2014

Alcohol Screening And Brief Intervention As Standard Practice In Indian Country, David A. Patterson Silver Wolf (Adelv Unegv Waya) Phd, Bonnie Duran, Catherine N. Dulmus Phd, Amy R. Manning

Brown School Faculty Publications

Alcohol use and the resulting problems associated with high-risk drinking in the American Indian/Native Alaskan (AI/NA) population are well-documented, as alcohol misuse has taken an incredible toll on many AI/NA communities. Presently, both overall health issues and alcohol use occur disproportionately within this population. This article provides an updated overview of the impact of alcohol use in the United States and within AI/NA communities specifically. It also provides recommendations for an alcohol-related screening and brief intervention instrument that social workers can begin using in their practice and can be utilized within the AI/NA community.


An Introduction To Drugs And The Neuroscience Of Behavior, Adam J. Prus Jan 2014

An Introduction To Drugs And The Neuroscience Of Behavior, Adam J. Prus

Books

This up-to-date text provides an introductory overview of the nervous system actions and behavioral effects of the major classes of psychoactive drugs, using pedagogy unique among pharmacology texts to make the topic approachable.


Targeting Tobacco In A Community-Based Addiction Recovery Cohort: Results From A Computerized, Brief, Randomized Intervention Trial, Alison Breland, Lauren Almond, Jennifer Kienzle, Steven J. Ondersma, Alton Hart, Michael Weaver, Pamela Dillon, Dace Svikis Jan 2014

Targeting Tobacco In A Community-Based Addiction Recovery Cohort: Results From A Computerized, Brief, Randomized Intervention Trial, Alison Breland, Lauren Almond, Jennifer Kienzle, Steven J. Ondersma, Alton Hart, Michael Weaver, Pamela Dillon, Dace Svikis

Psychology Publications

Introduction. Nearly 80% of substance dependent individuals also use tobacco, and smoking cessation efforts during treatment for other substance use is associated with similar or even improved outcomes. However, smoking cessation is not routinely addressed during treatment for substance use disorders. The present study tested a computerized brief motivational intervention (C-BMI) for smoking cessation in an understudied population: a cohort recruited from a recovery community organization (RCO) center.

Methods. Following baseline assessment, participants were randomly assigned to either a 30-minute C-BMI plus access to free nicotine replacement therapy (NRT), or an information-only control group plus NRT access. Results. Reductions in …


State Responses To Alcohol Use And Pregnancy: Findings From The Alcohol Policy Information System, Laurie Drabble, Sue Thomas, Lisa O'Connor, Sarah Roberts Jan 2014

State Responses To Alcohol Use And Pregnancy: Findings From The Alcohol Policy Information System, Laurie Drabble, Sue Thomas, Lisa O'Connor, Sarah Roberts

Faculty Publications

This article describes U.S. state policies related to alcohol use during pregnancy, using data from the National Institute on Alcohol Abuse and Alcoholism Alcohol Policy Information System. Specifically, this study examines trends in policies enacted by states over time and types of policies enacted across states in the United States, with a focus on whether laws were supportive or punitive toward women. Findings revealed substantial variability in characteristics of policies (19 primarily supportive, 12 primarily punitive, 12 with a mixed approach, and 8 with no policies). Findings underscore the need to examine possible consequences of policies, especially of punitive policies …