First Advisor

George C. Landaris

Term of Graduation

Spring 2007

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Systems Science: Psychology


Systems Science: Psychology




Abused elderly, Attitude (Psychology), Medication abuse, Psychological abuse, Psychological child abuse



Physical Description

1 online resource (2, x, 192 pages)


Studies consistently indicate a general lack of support for use of medications in the treatment of substance abuse disorders by clinicians, patients, and other stakeholders involved in treatment. Both individual and organizational factors have been shown to influence attitudes towards medications, but the relative contribution of each of these factors remains unclear. Whereas previous studies, by their very design, have generated multilevel data structures, they nevertheless have employed analytic strategies that ignore the multilevel dependencies inherent in such data sets.

To address these limitations, this study took a multilevel approach to investigate the influence of individual and organizational factors on treatment staff. Organizational survey data from the National Drug Abuse Treatment Clinical Trials Network workforce surveys, including 1,421 workforce staff nested within 237 treatment units, were analyzed using hierarchical linear modeling.

Results of the present study suggest that attitudes towards addiction medications are influenced by both individual and organizational factors simultaneously, albeit the more significant determinants reside at the individual level. In addition, this study found evidence that a unique blend of factors (individual and organizational) exists for each medication, although two variables proved to be robust predictors across all medications. Higher levels of academic education and support for psychiatric medications were associated with more positive attitudes towards addiction medications. Evidence was also found that staff attitudes towards addiction medications varied significantly between treatment units.

The overall design of the present study was informed and guided by a systems methodological framework, and in this setting, implications for increasing support for addiction medications in practice were also considered and are discussed.


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