Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.



Degree Program

Nursing, PhD

Committee Chair

Hall, Lynne

Committee Co-Chair (if applicable)

Crawford, Timothy

Committee Member

Crawford, Timothy

Committee Member

Staten, Ruth

Committee Member

Hall, Martin

Author's Keywords

mental health; substance use disorders; treatment receipt; trends; population; pregnant women


The purposes of this dissertation were to examine trends from 2008 to 2014 in mental health and substance use disorders and treatment receipt, and explore factors associated with treatment receipt in pregnant women aged 18-44 years in the United States. A systematic review showed that illicit drug use disorder increased in pregnant women over the past decade. Despite the increase in treatment admissions for these disorders from 1992 to 2012, the overall treatment admission rate for pregnant women remained relatively stable (4%). In a trend study, compared mental health and substance use disorders and treatment receipt across Matched groups of pregnant (n = 5,520) and non-pregnant women (n = 11,040) who participated in the 2008-2014 National Survey on Drug Use and Health (NSDUH) did not differ on mental health and substance use disorders and treatment receipt. Past-year anxiety disorder, past-month psychological distress, and illicit drug use disorder increased in the total sample from 2008 to 2014, whereas trends in treatment receipt did not change over time. Secondary analysis of data from the same survey was conducted with data from pregnant women (1,106 with mental health problems and 521 with substance use disorders). Predictors of mental health treatment receipt included: mental health problems, college education, health insurance, and White ethnicity. Predictors of substance use treatment receipt were: illicit drug abuse/dependence, alcohol dependence, comorbid anxiety/depression, White ethnicity, and urban residency. Compared to Whites, nonWhite pregnant women with mental health and/or substance use disorders had lower odds of receiving mental health treatment.