Adolescent Alcohol Use, Suicidal Ideation, and Suicide Attempts
Received 25 March 2008; accepted 7 August 2008. published online 29 October 2008.
Abstract
Purpose
To examine the association between self-reported alcohol use and suicide attempts among adolescents who did and did not report suicidal ideation during the past year.
Methods
Screening data from 31,953 students attending schools in the United States that implemented the Signs of Suicide (SOS) program in 2001–2002 were used in this analysis. Two types of alcohol use were investigated: heavy episodic drinking, and drinking while down. Self-reported suicide attempts were regressed on suicidal ideation and both measures of alcohol use, controlling for participants’ levels of depressive symptoms, and demographic characteristics.
Results
Logistic regression analyses indicated that both drinking while down and heavy episodic drinking were significantly associated with self-reported suicide attempts. Analyses examining the conditional association of alcohol use and suicidal ideation with self-reported suicide attempts revealed that drinking while down was associated with significantly greater risk of suicide attempt among those not reporting suicidal ideation in the past year. Heavy episodic drinking was associated with increased risk of suicide attempt equally among those who did and did not report suicidal ideation.
Conclusions
This study identified the use of alcohol while sad or depressed as a marker for suicidal behavior in adolescents who did not report ideating prior to an attempt, and hence, may not be detected by current strategies for assessing suicide risk. Findings from this study should provide further impetus for alcohol screening among clinicians beyond that motivated by concerns about alcohol and substance use.
aDivision of Behavioral Sciences and Community Health, University of Connecticut Health Center, Farmington, Connecticut
bInstitute for Public Health Research, University of Connecticut Health Center, East Hartford, Connecticut
cDepartment of Statistics, University of Connecticut, Storrs, Connecticut
dScreening for Mental Health, Inc., and Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
Address correspondence to: Elizabeth A. Schilling, Ph.D. or Robert H. Aseltine, Jr., Ph.D., Institute for Public Health Research, University of Connecticut Health Center, 99 Ash Street, MC 7160, East Hartford, CT 06108.
ABSTRACT