COMORBID MENTAL DISORDERS AMONG THE POVERTY POPULATION

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This dissertation research aims to examine prevalence rates for singular and comorbid mental disabilities and substance dependence among America's adult poor. Secondly, it identifies social, behavioral, and environmental stressors and social resources mediating the expression of singular and comorbid diagnosable mental disabilities. Diagnosable major depressive episode, generalized anxiety disorder, and substance dependence serve as the examined mental disabilities. Drawing from the Social Stress paradigm, this study will contribute to the empirical knowledge base about poverty and mental health by examining the complex relationship between multiple levels of stressors (individual, social, and environmental), social resources (individual, familial, environmental, and social programs), and mental health outcomes. Existing research on poverty documents the prevalence of mental disabilities in general without focused efforts on identifying the stressors or social resources used by the poor. Identifying the critical stressors and social resources directly affecting mental health outcomes may be important to the public social programs interested in treatment modalities to better assist poor people with gaining economically. The proposed study will use combined cross-sectional 1994b, 1995, and 1996 waves of the National Household Survey on Drug Abuse (NHSDA). To document trends and global effects, the datasets will be analyzed both separately and combined. The sub-sample selected for analysis totaled 38,501. The research provides information important for understanding the patterns of singular and comorbid mental health problems, including substance dependence among the poor for use in targeted interventions. Since much of poverty policy attention returned toward the employable poor, there is an increased need to inform efforts to keep the employable poor working and to assist the unemployed poor into the work force. Along with the renewed interest in improving the poors' work-readiness, the provision of social services again becomes conditioned on the population characteristics. By examining the relationships between stressors and use of social resources, the study uniquely documents the need for services among those experiencing comorbid illnesses. Once modifiable stressors and social resources are determined, the results can aid in the development of relevant social services, interventions, and generate new research investigations.