Catherine Wilsnack is a doctoral candidate in the Steve Hicks School of Social Work at the University of Texas at Austin (UT Austin). Her 
dissertation is titled, “Psychosocial Health at the Intersection of Oncology and Substance Use.” Her study will help characterize how and why cancer survivors may experience an increased risk of substance use throughout the cancer continuum (diagnosis, treatment, and survivorship).
Since its establishment in 1995, the Harry E. and Bernice M. Moore Fellowship has been awarded to support doctoral students conducting research at UT Austin. Scholarships are awarded to students with a primary research interest in the human experience during crises, including natural or other major disasters or, more broadly, stress and adversity. Fellowship winners receive a one-time, unrestricted award of $20,000.
We spoke to Catherine about her research:
Tell us about yourself. At what point did you decide to pursue this particular line of research, and what influenced that decision?
My dissertation research was inspired by a research participant who I interviewed while working on a different study. This participant stood out to me because her cancer survivorship experience was so different compared to other cancer survivors who did not experience substance use. While interviewing her, I recognized how practitioners and systems of care failed her as she explained how her experience with cancer treatment and survivorship left her more vulnerable to developing a substance use disorder (SUD). At that point, I knew I wanted to change the trajectory of my dissertation research and attempt to fill this gap in research and clinical practice.
Your dissertation is titled “Psychosocial Health at the Intersection of Oncology and Substance Use.” What questions are you trying to answer with this work?
The purpose of my mixed methods dissertation is to investigate the relationship between substance use and psychosocial health among cancer survivors. The quantitative portion will analyze 22 years of data from the public-use National Health Interview Survey-Linked Mortality Files to examine how psychosocial variables (e.g., sociodemographic, clinical, and mental health related variables) predict survival among cancer survivors who engage in problematic substance use vs those who do not. The qualitative portion will describe the lived experiences of cancer survivors who developed a SUD following their cancer diagnosis and characterize their healthcare experience from point of diagnosis through survivorship–identifying barriers and facilitators to population-specific care and ascertaining the risk and protective factors for cancer survivors developing a SUD.
What gap in the literature will be filled by your study? Who stands to benefit from it?
Overall, my research can help reshape the standard of care for this population and provide clearer guidance on how to implement trauma-informed psychosocial care in clinical and research capacities. The findings can also facilitate the development of interventions that identify and minimize risk of SUDs among cancer survivors as they navigate concurrent survivorship and substance use needs.
How do you think your research methods and approach will help you to answer the questions that you’re posing?
Using a mixed-methods approach allows the research topic to be examined from multiple lenses. I will provide a general understanding of the research topic via quantitative findings, which is then elaborated on during the qualitative phase. The qualitative phase will build on and provide more in-depth findings to the research topic, filling in gaps from the quantitative phase. I will also evaluate how quantitative findings may confirm, expand, or disagree with the qualitative findings, producing mixed-methods findings as well. Drawing on principles from participatory research design, I will work on the qualitative design of the study with a community member who has lived experience, ensuring community needs and priorities are addressed.
Are there any suggested readings you can recommend for those who might be interested in learning more about the topic?
- Bulls, H. W., Chu, E., Goodin, B. R., Liebschutz, J. M., Wozniak, A., Schenker, Y., & Merlin, J. S. (2022). Framework for opioid stigma in cancer pain. Pain, 163(2), e182-e189.
- Balachandra, S., Eary, R. L., Lee, R., Wynings, E. M., Sher, D. J., Sura, T., … & Day, A. T. (2022). Substance use and mental health burden in head and neck and other cancer survivors: A National Health Interview Survey analysis. Cancer, 128(1), 112-121.
- Yusufov, M., Braun, I. M., & Pirl, W. F. (2019). A systematic review of substance use and substance use disorders in patients with cancer. General Hospital Psychiatry, 60, 128-136.