Psychology ETDs

Publication Date

Spring 2-22-2023


American Indian (AI) communities endorse high rates of abstinence from alcohol and substance use, yet experience disparate rates of alcohol and substance-related consequences. Alcohol and substance use is conceptualized as interwoven with unique AI contextual factors, which are often not incorporated into examination of related constructs. Current knowledge gaps exist in study of precision medicine approaches to treatment for reward and relief drinking in AI. This study aimed to understand reward and relief substance use phenotypes in AI. We described a contextually-informed model of relief assessment and to compare this assessment to the original reward and relief models using latent profile analysis. We expected 4 profile solutions to be best fit to the data for both models, and that the contextually-informed would be better than the original at distinguishing profiles. Our sample consisted of n=79 AI people seeking treatment at an outpatient Southwest Tribal SUD treatment facility. Our results indicated that a two-profile solution best fit the data for both the original (LMR (p)=0.195, entropy=0.884) and CI models (LMR (p)=0.003, entropy=0.908), and in contrast to our hypotheses both models fit approximately equally well. Due to theoretical fit, the culturally informed model was selected. We conducted a Monte Carlo simulation study to examine the effects of our small sample size on our profile solutions, which indicated that a four-profile solution that more closely resembled hypothesized phenotypes may have been best fit to the data had the sample size approached 1,000. These findings indicate that in AI people, incorporating context improves understanding of these constructs, and might help inform precision medicine approaches to behavioral and medication treatments for alcohol use disorder.

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First Committee Member (Chair)

Kamilla Venner, Ph.D.

Second Committee Member

Katie Witkiewitz, Ph.D.

Third Committee Member

Margo Hurlocker, Ph.D.




alcohol use disorder, substance use disorder, American Indian, reward drinking, relief drinking

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