Date of Award

Fall 12-1-2022

Document Type

Open Access Thesis

Degree Name

Doctor of Psychology (PsyD)



First Advisor

Dr. J. Leverone

Second Advisor

Dr. A. Hughes-Scalise

Third Advisor

Dr. M. Bennett


Alcohol use disorder (AUD) is one of the leading causes of death and disability among individuals in the United States (Bergmann et al., 2013; Jung, 2019; Sliedrecht et al., 2019; Witkiewitz, 2019). A number of individuals reporting an AUD diagnosis also report difficulties related to numerous physical, social, and mental health consequences, most notably, major depression. Major depressive disorder (MDD) and AUD co-occur at high rates, and researchers have been investigating the negative consequences and outcomes related to these co-occurring illnesses (McHugh & Weiss, 2019; Tolliver & Anton, 2022). Using a large nationally representative sample of 18–36-year-olds, treatment completion within various treatment modalities (i.e., hospital settings; mental health settings; and family and community support settings) were examined among those diagnosed with a co-occurring AUD and a lifetime Major Depressive Episode (MDE), and with a single alcohol use diagnosis. Logistic regression analyses revealed individuals with a co-occurring AUD and MDE were six times more likely to drop out of treatment prematurely compared to individuals with a single AUD diagnosis. This study also revealed that men and women do not differ in treatment completion in general. However, a significant finding was observed among women receiving treatment in hospital and primary care settings: women with a single AUD diagnosis were more likely to leave treatment in these settings prematurely compared to men. The findings may be accounted for by the increased complexity and challenges associated with a co-occurring AUD and MDE and highlights the need for targeted mental health care within substance use treatment centers (Archie et al., 2012; Bazargan-Hejazi et al., 2016; Holma et al., 2020; McHugh & Weiss, 2019; Pavkovic et al., 2018).


SC 11.PsyD.2022.Madler.S