Document Type


Date of Degree

Spring 2011

Degree Name

PhD (Doctor of Philosophy)

Degree In

Social Work

First Advisor

Carol Coohey


Purpose. The purpose of this study was to evaluate whether severe victimization experiences, and psychological and social resources were shared risk factors for internalizing only, externalizing only, and co-occurring internalizing and externalizing disorders among victimized substance-using adolescents.

Method. Data for this cross-sectional study were obtained from a multisite research project. Adolescents, ages 11-18, participated in a comprehensive screening program for substance abuse at 106 Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT)-funded grantee sites throughout the United States.

Results. Longer duration/frequent victimization, more than one type of victimization, recent victimization, low self-efficacy beliefs and available sources of emotional support were related to co-occurring internalizing and externalizing disorders. Victimization by a trusted person, however, was only related to internalizing disorders.

Conclusion. The findings show that some indicators of severe victimization experiences, psychological and social resources are shared risk factors for internalizing, for externalizing, and for co-occurring internalizing and externalizing problems, thus providing support for the common factors model of co-morbidity. These findings suggest that practitioners in substance abuse treatment must thoroughly assess for severe victimization experiences among adolescents presenting with co-occurring mental health issues. Treatment planning and interventions may focus on helping adolescents cope effectively with their victimization experiences and addressing their MH needs. Particular emphasis may be placed on enhancing self-efficacy and social skills, so that adolescents may benefit from their available sources of support.


Adolescents, Co-occurring Disorders, Externalizing, Internalizing, Severity of Victimization, Substance Use


viii, 173 pages


Includes bibliographical references (pages 152-173).


Copyright 2011 Bushra Sabri