Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Bill Buhrow, PsyD

Second Advisor

Rodger Bufford, PhD

Third Advisor

Jory Smith, PsyD

Abstract

Clinicians have attempted to understand substance abuse for years, and theories attempting to explain substance abuse have evolved. Theories have ranged from viewing the issue as a moral failure to interpreting it through a disease-oriented viewpoint. The self-medication hypothesis has been used to understand substance abuse and describes the issue as deriving from individuals seeking relief from psychological distress (e.g., emotional dysregulation, behavioral impairment, painful memories). Substance abuse has been linked to the experience of depression, anxiety, exposure to adverse experiences in childhood and adulthood, and trauma-related clinical diagnoses. The role of positive coping has been considered a function that impacts substanceabuse outcomes and psychological functioning. In this study, I aim to investigate how age, level of living comfort, exposure to adverse childhood experiences, psychological functioning, the use of positive coping skills, and substance use relate to one another. Data was obtained from a sample of adults within the United States (n = 535) who completed an online survey via Qualtrics. A hierarchal regression showed that trauma symptoms were the strongest predictor of substance use (beta = 0.387, p < .001); positive coping was minimally and positively predictive of substance use (beta = 0.095, p = .008); and as participants got older, they reported less substance use (beta = -0.14, p < .001). These data support the hypothesis that substance use may be a form of self-medication for coping with the effects of adversity; in this sample, a coping measure added little incremental predictive validity.

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