Predictive factors associated with driving under the influence among Brazilian drug-using drivers

Adverse Childhood Experiences in Brazilian College Students: Examining Associations with Suicidal Ideation and Risky Behaviors

Background

The association between adverse childhood experiences (ACEs) and poor health outcomes is well-established in high-income countries. However, the evidence is limited for the association of ACEs, mental health, and risky behaviors for low- and middle-income countries. Moreover, studies often overlook prescription drug misuse and risky driving when examining the association of ACEs with risky behaviors. In our study, we examined the associations between ACEs, suicidal ideation, and risky behaviors (binge drinking, prescription drug misuse, and risky driving) among Brazilian college students.

Methods

Participants consisted of a convenience sample of students recruited from undergraduate courses primarily in two states in Southern Brazil (93%). Data were collected via an online survey between December 2020 and August 2021. The analytical sample comprised 503 participants, most were female (71%), and the mean age was 24 years. Survey instrument included questions on ten different ACE types, mental health, and risky behaviors. Statistical analyses included univariate descriptive analysis, binary and multivariable regression models.

Results

Across the ten ACE types assessed, only 14% of participants reported no ACEs, and 29% of participants experienced polyvictimization (i.e., four or more ACES). Multivariable models showed that, compared to those with no ACEs, participants who experienced polyvictimization had significantly increased odds of reporting suicide ideation (AOR = 6.21, p < .001), prescription drug misuse (AOR = 8.78, p < .01), and riding with an impaired driver (AOR = 3.58, p < .01).

Conclusions

Our findings support the need for psychological support and services available for college students with multiple ACEs.

Prediction of attempted suicide in men and women with crack-cocaine use disorder in Brazil

Background

Suicide is a severe health problem, with high rates in individuals with addiction. Considering the lack of studies exploring suicide predictors in this population, we aimed to investigate factors associated with attempted suicide in inpatients diagnosed with cocaine use disorder using two analytical approaches.

Methods

This is a cross-sectional study using a secondary database with 247 men and 442 women hospitalized for cocaine use disorder. Clinical assessment included the Addiction Severity Index, the Childhood Trauma Questionnaire, and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, totalling 58 variables. Descriptive Poisson regression and predictive Random Forest algorithm were used complementarily to estimate prevalence ratios and to build prediction models, respectively. All analyses were stratified by gender.

Results

The prevalence of attempted suicide was 34% for men and 50% for women. In both genders, depression (PR_M = 1.56, PR_W = 1.27) and hallucinations (PR_M = 1.80, PR_W = 1.39) were factors associated with attempted suicide. Other specific factors were found for men and women, such as childhood trauma, aggression, and drug use severity. The men's predictive model had prediction statistics of AUC = 0.68, Acc. = 0.66, Sens. = 0.82, Spec. = 0.50, PPV = 0.47 and NPV = 0.84. This model identified several variables as important predictors, mainly related to drug use severity. The women's model had higher predictive power (AUC = 0.73 and all other statistics were equal to 0.71) and was parsimonious.

Conclusions

Our findings indicate that attempted suicide is associated with depression, hallucinations and childhood trauma in both genders. Also, it suggests that severity of drug use may be a moderator between predictors and suicide among men, while psychiatric issues shown to be more important for women.