Theses and Dissertations

Advisor

Nadorff, Danielle

Committee Member

Tompkins, Catherine

Committee Member

McKinney, Cliff

Committee Member

McMillen, Robert

Date of Degree

8-7-2025

Original embargo terms

Immediate Worldwide Access

Document Type

Dissertation - Open Access

Major

Clinical Psychology

Degree Name

Doctor of Philosophy (Ph.D.)

College

College of Arts and Sciences

Department

Department of Psychology

Abstract

Individuals raised in a grandfamily, or family structure in which a grandparent raises their grandchildren, experience higher rates of adverse childhood experiences (ACEs), insecure attachment, and negative mental health outcomes during childhood. Literature on outcomes of these individuals across the lifespan is extremely limited, however, and it is unclear how formative individual and family experiences of being raised by grandparents carry into emerging adulthood (e.g., 18 to 25-years-old). Emerging adulthood is a developmental stage marked by significant instability and unpredictability that is linked with increased vulnerability to mental health concerns and substance use. It has been identified as an important developmental stage for targeted substance use and mental health interventions. The “self-medication” hypothesis of substance use indicates that individuals engage in substance use due to a lack of secure attachment strategies in an attempt to “numb” the negative affect. Given that individuals raised by grandparents are more likely to have insecure attachment and decreased mental health, it is imperative to elucidate intersections between the unique factors of this population and known risk factors of emerging adulthood. A sample of 535 emerging adults from a large southern university completed online questionnaires on childhood factors including their family system and ACEs, as well as current attachment, mental health, and substance use patterns in emerging adulthood. Findings of the study suggest that ACEs are a significant predictor of insecure attachment, substance use and all mental health outcomes. Once history of ACEs was statistically controlled, substance use was no longer an explanatory variable between insecure attachment and mental health outcomes, which does not support the self-medication hypothesis. Further, there were unique group differences for those raised by grandparents which suggest they experience higher rates of mental health symptoms when they have a preoccupied or unresolved attachment pattern. Clinical implications include incorporating an ACEs screen into intake sessions, as well as gaining competency in working with grandfamilies through a trauma informed approach.

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