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Kelly L, Meeker E, Zajac K, Bryan R, O’Connor B. Interactive effect of adverse child experiences and suicidal thoughts and behaviors on adolescent alcohol and cannabis use frequency. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:1019-1029. [PMID: 37439752 PMCID: PMC10787036 DOI: 10.1037/adb0000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Adolescents with adverse childhood experiences (ACEs) and suicidality may engage in high levels of substance use to alleviate distress. Most studies of associations among ACEs, suicidality, and substance use rely on retrospective reports by adults. Comparatively less is known about concurrent relationships between ACEs, suicide risk, and substance use in adolescents, which is important for prevention. This study tested if the associations between ACEs and drinking and between ACEs and cannabis use would be even stronger among youth with suicidal ideation or attempt, relative to youth without suicidal ideation or attempt. METHOD High schoolers (N = 1,625; 50.8% male; 47.1% female; 2% nonbinary) from western New York completed the Youth Risk Behavior Survey. Ordinal regressions tested main effects and interactions of the number of ACEs and suicidal ideation/behavior (i.e., none, ideation/plan, attempt) on categories of past-month drinking and cannabis days of use, controlling for age, gender, and race/ethnicity. RESULTS Significant ACEs by suicide interactions on adolescent drinking indicate that the association between ACEs and drinking was stronger for adolescents with suicide attempt adjusted odds ratio (AOR = 2.63) compared to youth with no ideation or attempt (AOR = 1.56) and suicidal ideation/planning only (AOR = 1.58). Main effects of ACEs (AORs = 1.95-2.08) and suicide attempt (vs. no suicidal ideation/attempt [AOR = 2.11] and suicidal ideation/plan [AOR = 2.11]) were associated with greater cannabis use; interactions were not significant. CONCLUSIONS Associations between ACEs and drinking were particularly strong for adolescents with suicide attempt. Conversely, ACEs and suicide attempt were independently associated with cannabis use. Mitigating against ACEs may reduce both adolescent alcohol and cannabis use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Lourah Kelly
- University of Connecticut School of Medicine, Farmington, CT
- Rochester Institute of Technology College of Health Sciences, Rochester, NY
| | - Elizabeth Meeker
- Coordinated Care Services Inc., Rochester, NY
- Rochester Institute of Technology College of Health Sciences, Rochester, NY
| | - Kristyn Zajac
- University of Connecticut School of Medicine, Farmington, CT
| | | | - Briannon O’Connor
- Coordinated Care Services Inc., Rochester, NY
- Rochester Institute of Technology College of Health Sciences, Rochester, NY
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2
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Hernández-Vásquez A, Vargas-Fernández R, Bendezu-Quispe G. Binge drinking and suicidal ideation in Peruvian adolescents: Evidence from a pooled cross-sectional survey. J Affect Disord 2023; 340:321-326. [PMID: 37567347 DOI: 10.1016/j.jad.2023.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Binge drinking and suicidal ideation are public health problems that have consequences on the well-being of Peruvian adolescents. This study aimed to evaluate the relationship between binge drinking and suicidal ideation in Peruvian adolescents. METHODS A secondary data analysis of the health questionnaire of the Demographic and Family Health Surveys from 2013 to 2019 was performed. The outcome variable was suicidal ideation in the last 14 days, assessed with one of the Patient Health Questionnaire (PHQ-9) questions, while the independent variable was binge drinking in the last 30 days. Generalized linear models of the Poisson family with logarithmic link (crude and adjusted) were used to assess the association of interest. RESULTS Data from a total of 11,609 participants were analyzed. The pooled prevalence of suicidal ideation was 8.5 % (95 % confidence interval [CI]: 7.8-9.2), and that of binge drinking was 5.8 % (95 % CI: 5.2-6.5). An association was found between binge drinking and suicidal ideation in the adjusted analysis (adjusted prevalence ratio: 2.95; 95 % CI: 1.69-3.09). LIMITATIONS The cross-sectional design of the study does not allow for establishing a causal relationship. CONCLUSIONS Between 2013 and 2019, nine out of every 100 Peruvian adolescents had suicidal ideation, and six out of every 100 adolescents had binge drinking. An association was found between both risk behaviors in Peruvian adolescents.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
| | | | - Guido Bendezu-Quispe
- Vicerrectorado de Investigación, Universidad Privada Norbert Wiener, Lima, Peru.
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3
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Essadek A, Musso M, Assous A, Widart F, Mathieu J, Robin M, Shadili G. Alcohol and psychoactive substance use in a cohort of children followed by child protection in France. Front Psychiatry 2023; 14:1180292. [PMID: 37953931 PMCID: PMC10634220 DOI: 10.3389/fpsyt.2023.1180292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background and aim Many studies have investigated the association between maltreatment and substance use in adulthood.In this study, we sought to explore the association between substance use during adolescence, diverse forms of child maltreatment, and psychological symptoms within a cohort of individuals under the purview of child protection services in France. Method The dataset was culled from a retrospective, population-based study encompassing minors and young adults aged 0 to 21, who were under the care of child protection services. Specifically, we conducted a comparative analysis between minors exhibiting substance use (N = 72) and those without such use (N = 776). Result The odds ratios predominantly illuminated a significant correlation between Substance Use and the manifestation of self-destructive behavior (OR = 4.35; CI 2.02-9.59), as well as aggressive behavior (OR = 5.75; CI 2.87-11.84). Univariate analysis also hinted at an association between SUD and suicidal ideation (OR = 3.52; CI 2.1-5.90). Conclusion Children in France who are in the care of child protection services and who use psychoactive substances are at greater risk of dropping out of school and of having other psychological symptoms. It is important that the public authorities take account of these results in order to adjust the care given to these minors, who often do not receive psychological support.
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Affiliation(s)
| | - Maeva Musso
- Department of Psychiatry, Hopital Saint-Maurice, Paris, France
| | | | - Frédéric Widart
- Department of Psychology, University of Liège, Liège, Belgium
| | - Joris Mathieu
- Université de Lorraine, INTERPSY, Nancy, France
- Centre Spécialisé de l’Obésité (CSO) et Service d’Endocrinologie, Diabétologie et Nutrition (EDN), CHRU-Nancy, Vandoeuvre-lès-Nancy, France
| | - Marion Robin
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- INSERM U1178, Team PsyDev, Villejuif, Paris, France
| | - Gérard Shadili
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
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Kim YJ, Burlaka V, Yoon S. Sex Differences in Suicidal Ideation: Mediating Effects of Alcohol Abuse/Dependence on Suicidal Ideation through Psychological Distress and Hopelessness. HEALTH & SOCIAL WORK 2023; 48:179-187. [PMID: 37279367 DOI: 10.1093/hsw/hlad012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/03/2022] [Accepted: 07/07/2022] [Indexed: 06/08/2023]
Abstract
This article aims to investigate the impact of psychological distress and hopelessness as mediators in the relationship between alcohol use disorder (AUD) and suicidal ideation among young adults. The study employed data from the 2019 National Survey on Drug Use and Health, focusing on participants aged 18 to 25. The PROCESS macro was used to conduct a moderated mediation analysis. The findings revealed that AUD, psychological distress, and hopelessness were all significant risk factors for suicidal ideation among young adults. Furthermore, psychological distress and hopelessness served as significant mediators in the relationship between AUD and suicidal ideation. The study highlights the need for interventions and treatments that address co-occurring alcohol use and psychological distress/hopelessness in both sexes, for young adults at risk of suicide. In summary, the study underscores the importance of recognizing the underlying factors that contribute to suicidal ideation among young adults, especially those with AUD, psychological distress, and hopelessness.
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Affiliation(s)
- Yi Jin Kim
- Department of Social Work, University of Mississippi, Garland Hall 205, P.O. Box 1848, University, MS 38677-1848, USA
| | - Viktor Burlaka
- School of Social Work, Wayne State University, Detroit, MI, USA
| | - Susan Yoon
- College of Social Work, The Ohio State University, Columbus, OH, USA
- Department of Social Welfare, College of Social Sciences, Ewha Womans University, Seoul, Republic of Korea
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Dardiri ME, El-tantawy A, Elmoez KA, Sayed HH, Elbadry H, Ibrahim O. Suicide Risk among Patients with Substance Use Disorders, A Cross Sectional Study In Suez Canal Area Hospitals.. [DOI: 10.21203/rs.3.rs-3076857/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background: Substance Use Disorders are serious health issues that have been linked to numerous clinical correlations and mental health comorbidities. One of the most important health dangers linked to substance addiction was suicide. The current study aims to investigate the phenomena using a bio-psycho-social framework. The aim was to investigate the risk of suicide in a sample of substance use disorders patients. A case control comparison was performed between 190 substance abusers versus 30 controls. Addiction Severity Index, Beck Suicidal Ideation Scale, Arab Religiosity Scale, Socioeconomic Status Scale, as well as multiple historical variables, have been investigated.
Results: Suicidality was prevalent among alcohol and opioids abusers, poly substance abusers, those with a family history of suicide, and those with a history of a previous attempt. Having a positive family history of suicide could predict an 8.3 point rise in Beck Suicidal Ideation Scale score, while having any previous attempt of suicide could predict 9.04 point rise in Beck Suicidal Ideation Scale score. Suicidality scores correlated with Addiction Severity Index scores, and indirectly with socioeconomic status and Religiosity. Combinations of drugs with other mental illness showed a significant predictive effect on suicidality score.
Conclusion: Suicidality is expected among substance abusers, and is affected by multiple bio-psycho-social variables.
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Affiliation(s)
| | | | | | | | - Hytham Elbadry
- General organization of teaching hospital and institutes-Egypt. (GOTHI). Psychiatrist Registrar at KCMH
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Ramezani E, Bougar MR, Khodarahimi S, Forghani MD, Mazraeh N. Men’s opiate-derived drug abuse and psychopathology in their wives: a systematic review and meta-analysis. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04412-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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Lee JS, Kwon H, Park J, Hong HJ, Kweon YS. A Latent Class Analysis of Suicidal Behaviors in Adolescents. Psychiatry Investig 2023; 20:93-100. [PMID: 36891593 PMCID: PMC9996140 DOI: 10.30773/pi.2022.0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 11/16/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE The purpose of the present study was to identify adolescents' suicide subgroups using five indicators (depression, anxiety, suicide ideation, and planned and attempted suicide), and explore the distinctive features of each subgroup. METHODS This study included 2,258 teenagers from four schools. Both adolescents and their parents, who voluntarily agreed to participate in the study, completed a series of self-reported questionnaires on depression, anxiety, suicide, self-harm, self-esteem, impulsivity, childhood maltreatment, and deviant behaviors. The data were analyzed using latent class analysis, a person-centered method. RESULTS Four classes were detected: "high risk for suicide without distress," "high risk for suicide with distress," "low risk for suicide with distress," and "healthy." The "high risk for suicide with distress" class was the most severe on all evaluated psychosocial risk factors, namely, impulsivity, low self-esteem, self-harming behaviours, deviant behaviour problems, and childhood maltreatment, followed by "high risk for suicide without distress." CONCLUSION This study identified two high risk subgroups for adolescent' suicidality, "high risk for suicide with or without distress." Both high risk subgroups for suicide showed higher scores for all psychosocial risk factors than low risk subgroups for suicide. Our findings suggest that special attention needs to be paid to the latent class "high risk for suicide without distress," as this group's "cry for help" might be relatively difficult to detect. Specific interventions for each group (e.g., distress safety plans for "suicidal potential with or without emotional distress") need to be developed and implemented.
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Affiliation(s)
- Jong-Sun Lee
- Department of Psychology, Kangwon National University, Chuncheon, Republic of Korea
| | - Hoin Kwon
- Department of Counseling Psychology, Jeonju University, Jeonju, Republic of Korea
| | - Jungkyu Park
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Hyun Ju Hong
- Suicide and School Mental Health Institute, Hallym University, Anyang, Republic of Korea.,Department of Psychiatry, Hallym University Sacred Hospital, Hallym University, Anyang, Republic of Korea
| | - Yong-Sil Kweon
- Suicide and School Mental Health Institute, Hallym University, Anyang, Republic of Korea.,Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
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Rosales R, Sellers CM, Lee CS, Santos B, O'Brien K, Colby SM. Examining Racial/Ethnic Differences in the Association of Victimization and Suicidal Thoughts and Behaviors with Alcohol Use Among Sexual Minority Youth. LGBT Health 2023; 10:109-120. [PMID: 36044041 PMCID: PMC9986026 DOI: 10.1089/lgbt.2021.0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose: Integrating Minority Stress Theory and Bagge and Sher's Theoretical Framework of the Alcohol-Suicide Attempt Relation, this study aimed to test whether experiencing both minority stress and suicidal thoughts and behaviors (STBs) had a greater strength of association with Latinx and Black sexual minority youth (SMY)'s alcohol use compared with that of White SMY. Methods: Using data on 2341 non-Latinx Black, Latinx, and non-Latinx White SMY from the 2015 and 2017 Youth Risk Behavior Surveys, we tested the prevalence of STBs, victimization, and alcohol use for Black and Latinx participants compared with White participants. Multivariate logistic regression analyses tested the main effects of STBs, victimization, and race/ethnicity on alcohol use. Finally, interaction terms assessed the interaction among STBs, victimization, and race/ethnicity on alcohol use. Results: The results supported our hypothesis, based on Minority Stress Theory, that experiencing victimization would be associated with greater alcohol use. Results also supported Bagge and Sher's theoretical framework showing that suicide plan and attempts were associated with greater alcohol use. When taking all of these stressors into account, results showed that Latinx SMY who experienced victimization had greater current prevalence of alcohol use than their White counterparts. However, Latinx SMY who were victimized and experienced suicidal ideation reported lower alcohol use than White SMY. Conclusion: These findings support the double jeopardy and resiliency hypotheses, which suggest that minority stressors have differing associations for each racial/ethnic SMY group's alcohol use. More research is needed that helps to disentangle the protective and risk factors for alcohol use among Black and Latinx SMY.
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Affiliation(s)
- Robert Rosales
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Christina M Sellers
- College of Social, Sciences, Policy, and Practice, School of Social Work, Simmons University, Boston, Massachusetts, USA.,Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Christina S Lee
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Bryan Santos
- Independent Researcher, Worcester, Massachusetts, USA
| | - Kimberly O'Brien
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island, USA
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9
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Melo TQD, Aquino DMFD, Peixoto AMCDL, Lisboa JLD, Ferreira RC, Zarzar PMPDA, Colares V, Laureano FDGBB, Santos CDFBF, Vieira SCM, Menezes VAD. Is Binge Drinking Associated with Suicidal Behaviors among Brazilian Adolescents? Subst Use Misuse 2022; 57:1365-1373. [PMID: 35673802 DOI: 10.1080/10826084.2022.2083169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the association between suicidal behaviors and binge drinking among Brazilian adolescents. METHODS A cross-sectional study was conducted with 2,476 students 14 to 19 years of age from 26 public high schools in the city of Olinda, Brazil. Data collection occurred between March and June 2018 through the self-administered Youth Risk Behavior Survey. Descriptive analysis and Poisson regression (p < 0.05, 95%CI) were performed. RESULTS The prevalence of suicidal ideation, planning and attempt in the previous 12 months was 23.7%, 17.4% and 13.5%, respectively. Suicidal ideation was associated with binge drinking one to two days (PR:1.053, 95%CI:1.011-1.096) and ≥ three days in the previous 30 days (PR:1.069, 95%CI:1.016-1.125), sadness/hopelessness in the previous 12 months (PR:1.313, 95%CI:1.267-1.360), a report of family physical aggression in the previous 12 months (PR:1.111, 95%CI:1.068-1.155), the female sex (PR:1.082, 95%CI:1.049-1.115) and a non-nuclear family (PR:1.037, 95%CI:1.004-1.071). Suicidal planning was associated with sadness/hopelessness in the previous 12 months (PR:1.257, 95%CI:1.214-1.302), report of family physical aggression in the previous 12 months (PR:1.110, 95%CI:1.065-1.156) and the female sex (PR:1.072, 95%CI:1.041-1.104). Suicide attempt was associated with binge drinking ≥ three days in the previous 30 days (PR:1.062, 95%CI:1.008-1.119), sadness/hopelessness in the previous 12 months (PR:1.202, 95%CI:1.161-1.244), report of family physical aggression in the previous 12 months (PR:1.105, 95%CI:1.060-1.153) and the female sex (PR:1.064, 95%CI:1.034-1.095). The Catholic (PR:0.938, 95%CI:0.899-0.979; PR:0.925, 95%CI:0.888-0.9865; PR:0.937, 95%CI:0.899-0.977) and Evangelical (PR:0.956, 95%CI:0.922-0.992; PR:0.954, 95%CI:0.919-0.991) religions acted as a possible protective factor against suicidal behaviors. CONCLUSIONS Suicidal ideation and attempt were associated with binge drinking.
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Affiliation(s)
| | | | | | - Jonathan Lopes de Lisboa
- Department of Child and Adolescent Oral Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Social Preventive Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Viviane Colares
- Department of Pediatric Dentistry, University of Pernambuco, Camaragibe, Brazil.,Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Brazil
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10
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Bloch-Elkouby S, Barzilay S, Gorman BS, Lawrence OC, Rogers ML, Richards J, Cohen LJ, Johnson BN, Galynker I. The revised suicide crisis inventory (SCI-2): Validation and assessment of prospective suicidal outcomes at one month follow-up. J Affect Disord 2021; 295:1280-1291. [PMID: 34706442 DOI: 10.1016/j.jad.2021.08.048] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/10/2021] [Accepted: 08/21/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIM The Suicide Crisis Syndrome (SCS) is an evidence-based pre-suicidal cognitive and affective state predictive of short-term suicide risk. The most recent SCS formulation, proposed as a suicide-specific DSM diagnosis, features a feeling of Entrapment accompanied by four additional symptom clusters: Affective Disturbance; Loss of Cognitive Control; Hyperarousal; and Social Withdrawal. The aim of the present study was to revise the Suicide Crisis Inventory (SCI; Barzilay et al., 2020), a self-report measure assessing the presence of the SCS,in accordance with the current SCS formulation, as well as to assess the psychometric properties and clinical utility of its revised version, the Suicide Crisis Inventory-2 (SCI-2). METHODS The SCI-2, a 61-item self-report questionnaire, was administered to 421 psychiatric inpatients and outpatients at baseline. Prospective suicidal outcomes including suicidal ideation, preparatory acts, and suicidal attempts were assessed after one month. Internal structure and consistency were assessed with confirmatory factor analysis, convergent, discriminant, and current criterion validity. Receiver-operating characteristic (ROC) curves with Area under the Curve (AUC) were used to examine the predictive validity of the SCI-2 to prospective outcomes. Exploratory analyses assessed the predictive validity of the five SCI-2 dimensions. RESULTS The SCI-2 demonstrated excellent internal consistency (Cronbach's α = 0.971), good convergent, discriminant, and current criterion validity. The SCI-2 significantly predicted all three outcomes, and was the only significant predictor of suicidal attempts with AUC = 0.883. DISCUSSION The results of this study indicate that the SCI-2 is a valid and reliable tool to assess the presence and intensity of the Suicide Crisis Syndrome and to predict short-term prospective suicidal behaviors and attempts among psychiatric outpatients and inpatients regardless of patients' readiness to disclose suicidal ideation.
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Affiliation(s)
- Sarah Bloch-Elkouby
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Shira Barzilay
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Bernard S Gorman
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Olivia C Lawrence
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Megan L Rogers
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Jenelle Richards
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Lisa J Cohen
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Benjamin N Johnson
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
| | - Igor Galynker
- Icahn School of Medicine at Mount Sinai 1 Gustave L. Levy Pl, New York, NY 10029, United States
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Lee JW, Kim BJ, Lee CS, Cha B, Lee SJ, Lee D, Seo J, Lee YJ, Lee YJ, Lim E, Choi JW. Association Between Suicide and Drinking Habits in Adolescents. Soa Chongsonyon Chongsin Uihak 2021; 32:161-169. [PMID: 34671189 PMCID: PMC8499040 DOI: 10.5765/jkacap.210024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/01/2022] Open
Abstract
Objectives Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents. Methods Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits—including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness—and suicidal ideation, plans, and attempts. Results Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students. Conclusion This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.
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Affiliation(s)
- Ji Won Lee
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea
| | - Bong-Jo Kim
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea.,Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Korea.,Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea.,Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Korea
| | - So-Jin Lee
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea.,Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Dongyun Lee
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Korea.,Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jiyeong Seo
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Young-Ji Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Youn-Jung Lee
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea
| | - Eunji Lim
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jae-Won Choi
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Korea
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12
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Rioux C, Huet AS, Castellanos-Ryan N, Fortier L, Le Blanc M, Hamaoui S, Geoffroy MC, Renaud J, Séguin JR. Substance use disorders and suicidality in youth: A systematic review and meta-analysis with a focus on the direction of the association. PLoS One 2021; 16:e0255799. [PMID: 34358273 PMCID: PMC8345848 DOI: 10.1371/journal.pone.0255799] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/24/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Reviews and meta-analyses suggest that substance use and suicidality (i.e., suicidal ideations and attempts) are associated in youth, but the direction of this association remains unclear. Theoretically, the secondary psychiatric disorder hypothesis (SPDH) posits that substance use leads to suicidality, while the secondary substance use disorder hypothesis (SSUDH) posits that suicidality leads to substance use. To clarify these associations, this meta-analysis systematically reviewed studies that examined the prospective associations between SUDs and suicidality in youth (age 25 and younger) and compared results according to the direction of the association. METHODS Web of Science, Embase, PsycINFO, PubMed, Medline and ProQuest Dissertations & Theses Global were searched from inception to March 8, 2020, and 55 effect sizes from 23 samples were included and analyzed using a three-level meta-analysis. RESULTS SUDs significantly predicted subsequent suicidality (OR = 2.16, 95%CI 1.57-2.97), suicidality significantly predicted subsequent SUDs (OR = 2.16, 95%CI 1.53-3.04), and these effect sizes did not differ (p = 0.49). CONCLUSIONS Considering that 65% of reviewed studies only examined the SPDH, this review highlights that more attention should be given to the SSUDH, and that studies should examine bidirectional associations between SUDs and suicidality across time. Clinically, because SUDs and suicidality were found to influence each other, results suggest that mental health and SUDs should ideally be detected and treated early, and that co-occurring disorders should be assessed and treated concomitantly.
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Affiliation(s)
- Charlie Rioux
- Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, Texas, United States of America
| | - Anne-Sophie Huet
- Department of Child and Adolescent Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Natalie Castellanos-Ryan
- School of Psychoeducation, Université de Montréal, Montreal, Québec, Canada
- CHU Ste-Justine Research Centre, Montreal, Québec, Canada
| | - Laurianne Fortier
- School of Psychoeducation, Université de Montréal, Montreal, Québec, Canada
| | - Myriam Le Blanc
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Québec, Canada
- Institut national de psychiatrie légale Philippe-Pinel, Montreal, Québec, Canada
| | - Stéphanie Hamaoui
- Department of Psychology, Université du Québec à Montréal, Montreal, Québec, Canada
| | - Marie-Claude Geoffroy
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Johanne Renaud
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Québec, Canada
- Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention, Montreal, Québec, Canada
| | - Jean R. Séguin
- CHU Ste-Justine Research Centre, Montreal, Québec, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Québec, Canada
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13
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Basith SA, Nakaska MM, Sejdiu A, Shakya A, Namdev V, Gupta S, Mathialagan K, Makani R. Substance Use Disorders (SUD) and Suicidal Behaviors in Adolescents: Insights From Cross-Sectional Inpatient Study. Cureus 2021; 13:e15602. [PMID: 34277223 PMCID: PMC8272950 DOI: 10.7759/cureus.15602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives To determine the demographic predictors of suicidal behaviors and measure the association between the spectrum of substance use disorders (SUD) and hospitalization for suicidal behaviors in the adolescent population. Methods We conducted a cross-sectional study using the nationwide inpatient sample and included 466,244 adolescent inpatients with psychiatric illnesses. The study sample was sub-grouped into suicidal (N = 182,454) and non-suicidal (N = 283,790) cohorts. The odds ratio (OR) of association for demographic characteristics and comorbid SUD in the suicidal group was evaluated using a logistic regression model witha P-value < 0.01. Results Our study population included 466,244 adolescent inpatients. Females had higher odds of suicidal behaviors (OR 1.45; 95% CI 1.431-1.470) compared to males. The most prevalent comorbid SUD among suicidal inpatients was cannabis (15.3%) but had a statistically non-significant association with suicidal behaviors (OR 0.98; 95% CI 0.95-0.99). Inpatients with alcohol use disorders had significantly increased odds of association with suicidal behaviors (OR 1.18; CI: 1.142-1.209) compare to other SUD. Among other substances (cannabis and stimulants), there existed a statistically non-significant association with hospitalization for suicidal behaviors. Conclusion Adolescent inpatients with comorbid alcohol use disorders were at 18% higher odds of hospitalization for suicidal behaviors. Our study provides a basis for more research while also suggesting potential avenues for early identification and intervention efforts for comorbid SUD in adolescents requiring psychiatric care to improve their prognosis and quality of life.
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Affiliation(s)
- Sayeda A Basith
- Psychiatry and Behavioral Sciences, Medical University of the Americas, Charlestown, KNA
| | - Miles M Nakaska
- Family Medicine, American University of the Caribbean, Calgary, CAN
| | | | - Aabha Shakya
- Family Medicine, Saint James School of Medicine, Kingstown, VCT
| | | | - Siddharth Gupta
- Internal Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, IND
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14
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Sellers CM, Díaz-Valdés A, Porter AC, Glenn CR, Miller AB, Battalen AW, O'Brien KHM. Nonsuicidal Self-injury, Suicide Planning, and Suicide Attempts Among High-risk Adolescents Prior to Psychiatric Hospitalization. Res Child Adolesc Psychopathol 2021; 49:1503-1511. [PMID: 34059987 DOI: 10.1007/s10802-021-00830-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days prior to inpatient hospitalization, understand the role of NSSI and SP in predicting suicide attempts (SA) on a given day, and to test the interaction between NSSI and SP in predicting same-day SA. Participants included 69 adolescents (77% female, 65% white, 77% Non-Hispanic/Latinx, Mage = 15.77 SDage = 1.00) from an inpatient psychiatric unit. Past 90 day NSSI, SP, and SA were measured using the Columbia Suicide Severity Rating Scale and Timeline Follow Back. First, mixed effect models were conducted to assess trajectories of NSSI and SP leading up to inpatient hospitalization. The odds of NSSI remained relatively stable prior to hospitalization (OR = 1.01, 95% CI [1.00,1.02]). The odds of SP increased in the 90 days prior to hospitalization (OR = 1.04, 95% CI [1.02,1.05]) with each day associated with a 4% increase in the odds of making a SP. Second, random effect models were conducted to predict the odds of same-day SA from NSSI and SP. When adolescents endorsed either NSSI (OR = 2.99, p < .001) or a SP (OR = 77.13, p < .001) there was elevated odds of same-day SA. However, the presence of both NSSI and SP on a given day did not increase risk of SA on that same day. For this high-risk clinical sample of suicidal adolescents who drink alcohol, odds of SP increased in the days leading up to psychiatric hospitalization, but NSSI remained stable. On days when adolescents reported NSSI or SP, they had an increased odds of same-day SA. These results underscore the importance of frequent monitoring of NSSI and SP among high-risk adolescents who drink alcohol to prevent suicide attempts.
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Affiliation(s)
- Christina M Sellers
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, 02115, US. .,School of Social Work, College of Social Science, Policy, and Practice (CSSPP), Simmons University, Boston, MA, 02115, US.
| | - Antonia Díaz-Valdés
- Faculty of Humanities, Society and Health Research Center, Universidad Mayor, 7750000, Santiago, Chile
| | - Andrew C Porter
- Department of Psychology, University of Rochester, Rochester, NY, 14627, US
| | - Catherine R Glenn
- Department of Psychology, University of Rochester, Rochester, NY, 14627, US.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, 14627, US.,Department of Psychology, Old Dominion University, Norfolk, VA, 23529, US
| | - Adam Bryant Miller
- Department of Psychology and Neurosciences, The University of North Carolina At Chapel Hill, Chapel Hill, NC, 27599, Raleigh, US
| | | | - Kimberly H McManama O'Brien
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, 02115, US.,Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, US
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15
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Miloicov Bacean OC, Fira-Mladinescu O, Putnoky S, Tuta Sas I, Cristina P, Bagiu R, Bagiu IC, Suciu O, Fira-Mladinescu C, Vlaicu B. High School Pupils' Relationships with Their Parents, Schoolmates, and Friends, and Health-Related Risk Behaviors. Psychol Res Behav Manag 2021; 14:587-593. [PMID: 34079396 PMCID: PMC8163963 DOI: 10.2147/prbm.s306133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The aims of this study were to evaluate high school pupils’ relationships with their parents, schoolmates, and friends, and the presence of health-related risk behaviors among the family members and friends on the pupils’ smoking and binge drinking status. Materials and Methods The study was a cross-sectional population-based study that involved a questionnaire, and the sample involved 2908 pupils at high schools in Timis county, Romania. In our study, the following factors related to family members and friends and the living environment were identified. First, there were issues with the relationships with parents among some pupils, with 23.2% being neither satisfied nor unsatisfied and 4.9% being unsatisfied. Second, there were also issues regarding some pupils’ satisfaction with the financial situation of their family, with 21.8% being neither satisfied nor unsatisfied and 16.4% being unsatisfied. An odds ratio (OR) is a statistic that quantifies the strength of the association between two events. Results There were 1495 (51.5%) girls and 1407 (48.5%) boys aged 14–20 years, and 79.2% came from organized families. Among the pupils, 71.1% reported that they were satisfied with their relationship with their parents, while 4.9% were unsatisfied. Additionally, 46.2% were satisfied with the financial status of their families, while 16.4% were unsatisfied. Moreover, 59.2% were satisfied with their relationship with their schoolmates and 80.2% were satisfied with their relationship with their friends, while only 1.8% were unsatisfied with their relationship with their friends. The logistic regression model of the pupils’ smoking status identified two moderate predictive factors: this was defined “>1” friends who smoke (odds ratio [OR]=2.875) and smoking status of siblings (OR=2.222). The major predictive factor in the logistic regression model of occasional alcohol consumption in high quantities by pupils was male gender (OR=5.148). Conclusion The predictive model of pupils’ smoking status identified the following moderate predictors: high number of friends who smoke and smoking status of siblings. The major predictor in the model of occasional alcohol consumption in high quantities by pupils was male gender.
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Affiliation(s)
- Oana Codruta Miloicov Bacean
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Ovidiu Fira-Mladinescu
- Pneumology Discipline, Department 13th Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Salomeia Putnoky
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Ioana Tuta Sas
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Petrescu Cristina
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Radu Bagiu
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Iulia Cristina Bagiu
- Discipline of Microbiology, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Oana Suciu
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Corneluta Fira-Mladinescu
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
| | - Brigitha Vlaicu
- Discipline of Hygiene, Department 14 Microbiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Center for Studies in Preventive Medicine, Timisoara, Timis, Romania
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16
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Rizk MM, Herzog S, Dugad S, Stanley B. Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders. CURRENT ADDICTION REPORTS 2021; 8:194-207. [PMID: 33747710 PMCID: PMC7955902 DOI: 10.1007/s40429-021-00361-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 01/05/2023]
Abstract
Purpose of Review Suicide is a major public health concern and a leading cause of death in the US. Alcohol and opioid use disorders (AUD/OUD) significantly increase risk for suicidal ideation, attempts, and death, and are the two most frequently implicated substances in suicide risk. We provide a brief overview of shared risk factors and pathways in the pathogenesis of AUD/OUD and suicidal thoughts and behaviors. We also review clinical recommendations on inpatient care, pharmacotherapy, and psychotherapeutic interventions for people with AUD/OUD and co-occurring suicidal ideation and behavior. Recent Findings Among people with an underlying vulnerability to risk-taking and impulsive behaviors, chronic alcohol intoxication can increase maladaptive coping behaviors and hinder self-regulation, thereby increasing the risk of suicide. Additionally, chronic opioid use can result in neurobiological changes that lead to increases in negative affective states, jointly contributing to suicide risk and continued opioid use. Despite significantly elevated suicide risk in individuals with AUD/OUD, there is a dearth of research on pharmacological and psychosocial interventions for co-occurring AUD/OUD and suicidal ideation and behavior. Summary Further research is needed to understand the effects of alcohol and opioid use on suicide risk, as well as address notable gaps in the literature on psychosocial and pharmacological interventions to lower risk for suicide among individuals with AUD/OUD.
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Affiliation(s)
- Mina M. Rizk
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
- Department of Psychiatry, Faculty of Medicine, Minia University, Egypt, Egypt
| | - Sarah Herzog
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
| | - Sanjana Dugad
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Irving Medical Center, Columbia University, New York, NY USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, 1051 Riverside Dr., Unit 42, New York, NY 10032 USA
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17
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Ahuja M, Awasthi M, Records K, Lamichhane RR. Early Age of Alcohol Initiation and its Association with Suicidal Behaviors. Subst Use Misuse 2021; 56:1332-1338. [PMID: 34057030 DOI: 10.1080/10826084.2021.1922452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The relationship between alcohol use and suicidal behaviors is well-accepted, but less is known about the contribution of its early initiation. This study was designed to test the association of early alcohol initiation versus later initiation with suicidal ideation and attempt in an ethnically diverse sample. METHODS The Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003 (n = 20,013), database was used. A total of 13,867 participants were selected included 56.9% females and 43.1% males. Race and ethnicity were reported as 28.8% non-Hispanic White, 39.1% Black, 20.3% Latino, and 11.9% Asian. Logistic regression analyses tested the associations between early (< =14 years) and later (> =15) age alcohol initiation with suicide ideation and attempts. Alcohol initiation was indexed by self-report of the first time that any alcohol product was consumed. Potential confounders were controlled. RESULTS Early alcohol initiation was associated with higher odds (AOR = 3.64, 95% CI [2.51, 5.28]) of suicide ideation as compared with adults who had initiated > = age 15 (AOR = 2.11, 95% CI [1.46, 3.04]). Early age initiation was also associated with higher odds (AOR = 3.81, 95% CI [2.02, 7.18]) of lifetime suicide attempt versus later age initiators (AOR = 2.03, 95% CI [1.08, 3.79]). Significant differences were found between early and later age of initiation. Conclusion: Early age of alcohol initiation has profoundly increased odds of suicide ideation or attempt. It is critical that effective prevention programs for children and their caregivers be implemented to prevent or delay alcohol initiation and lessen the risk for future suicidal behaviors.
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Affiliation(s)
- Manik Ahuja
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, Tennessee, USA
| | - Manul Awasthi
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, Tennessee, USA
| | - Kathie Records
- School of Nursing, College of Natural and Health Sciences, University of Northern Colorado, Greeley, Colorado, USA
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18
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Bloch-Elkouby S, Gorman B, Lloveras L, Wilkerson T, Schuck A, Barzilay S, Calati R, Schnur D, Galynker I. How do distal and proximal risk factors combine to predict suicidal ideation and behaviors? A prospective study of the narrative crisis model of suicide. J Affect Disord 2020; 277:914-926. [PMID: 33065834 DOI: 10.1016/j.jad.2020.08.088] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 07/17/2020] [Accepted: 08/25/2020] [Indexed: 12/25/2022]
Abstract
AIM The Narrative Crisis Model of suicide posits that when individuals with trait vulnerabilities for suicide face stressful life events, they may develop distorted perceptions of themselves and society that culminate in a sense of no future. Referred to as the suicide narrative, these perceptions makes them more likely to experience the Suicidal Crisis Syndrome, an acute affective condition that increases the risk of engaging in suicidal ideation behaviors. The goal of this study was to assess the stage components of this model. METHODS The stage components of the NCM were assessed among adult psychiatric inpatients (N = 223; listwise N = 85) aged 18-65 years old and admitted for suicidal ideation or attempts. Suicidal outcomes were assessed at one month follow-up. Structural equation modeling (SEM) was used to assess the model and its prediction of prospective suicidal outcomes. RESULTS The model was supported by the SEM and proved to be a good fit for the data. Each temporal stage was significantly predicted by the precedent stage in the model and 13% of the variance in suicidal ideation and behaviors (when assessed conjointly) were explained by the model. When suicidal ideation and attempts were assessed separately, the amount of variance explained was 10.8% for suicidal ideation and 40.7% for suicidal attempts. DISCUSSION The progression from trait vulnerabilities to suicidal outcomes proposed by the NCM was supported by our findings. These findings have clinical implications in the assessment and treatment of suicide risk and will need replication with larger samples.
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Affiliation(s)
| | | | - Lauren Lloveras
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
| | - Timothy Wilkerson
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
| | - Allison Schuck
- Department of Psychiatry and Behavioral Health, Mount Sinai Beth Israel Medical Center, New York City, NY, USA
| | - Shira Barzilay
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | - David Schnur
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Igor Galynker
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Adelphi University, New York City, USA
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19
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Kim EM, Kim H, Park E. How are depression and suicidal ideation associated with multiple health risk behaviours among adolescents? A secondary data analysis using the 2016 Korea Youth Risk Behavior Web-based Survey. J Psychiatr Ment Health Nurs 2020; 27:595-606. [PMID: 31999868 DOI: 10.1111/jpm.12610] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 12/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently. Multiple HRBs might threaten adolescents' future health in adulthood. Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently. Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs. Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs. Population-based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. ABSTRACT: Introduction There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods This cross-sectional study was conducted using the 2016 Korea Youth Risk Behavior Web-based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43-4.47, 95% CI = 1.37-1.49 to 3.23-6.20) and/or who had suicidal ideation (OR = 1.33-3.19, 95% CI = 1.25-1.42 to 2.25-4.51) were more likely to engage in multiple HRBs. Discussion A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self-reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs.
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Affiliation(s)
- Eun-Mi Kim
- Department of Nursing, Sunlin University, Pohang-si, Korea
| | - Heejung Kim
- College of Nursing, Yonsei University, Seoul, Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Eunhee Park
- School of Nursing, University at Buffalo, Buffalo, NY, USA
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20
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Janakiraman R, Gowin JL, Sloan ME, Schwandt ML, Diazgranados N, Ramchandani VA, Kwako LE. History of suicidality and alcohol craving trajectories during inpatient treatment for alcohol use disorder. Drug Alcohol Depend 2020; 209:107918. [PMID: 32092637 DOI: 10.1016/j.drugalcdep.2020.107918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alcohol use is associated with an increased risk of completed suicide, but it is unclear whether past suicidality affects the course of alcohol use disorder (AUD). We examined whether a history of suicidal ideation or attempts is associated with treatment response in individuals with AUD. METHODS 146 participants underwent inpatient detoxification and residential treatment for AUD. Reductions in craving during treatment were used as an index of treatment response. Participants were assessed for history of suicidality using the Columbia-Suicide Severity Rating Scale and divided into three groups: no history of suicidal ideation or attempts (N = 76), history of suicidal ideation without attempts (N = 50), and history of suicide attempts (N = 20). Alcohol craving was measured weekly during treatment using the Penn Alcohol Craving Scale and compared across groups. RESULTS Individuals with a history of suicide attempts showed higher levels of craving throughout treatment compared to those without a history of suicidality. Associations between past suicide attempts and craving remained significant after adjusting for age, sex, alcohol use disorder severity, comorbid psychopathology, and benzodiazepine treatment. Participants in all groups had significant reductions in alcohol craving by the end of treatment. CONCLUSIONS Our findings suggest that a history of suicide attempts is associated with higher levels of craving throughout inpatient treatment for AUD. These results support current guidelines on assessing suicidal ideation in patients with substance use disorders.
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Affiliation(s)
- Roshni Janakiraman
- Psychology Department, Florida State University, 1107 West Call Street, Tallahassee, FL, 32306, USA; Addictions Division, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
| | - Joshua L Gowin
- Department of Radiology, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA; Section on Human Psychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive Room 10-CRC/2-2352: MSC 1540, Bethesda, MD, 20892, USA
| | - Matthew E Sloan
- Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada; Addictions Division, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Room 10-CRC/1-5330: MSC 1108, Bethesda, MD, 20892, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive, Room 10-CRC/1-5330: MSC 1108, Bethesda, MD, 20892, USA
| | - Vijay A Ramchandani
- Section on Human Psychopharmacology, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, 10 Center Drive Room 10-CRC/2-2352: MSC 1540, Bethesda, MD, 20892, USA
| | - Laura E Kwako
- Division of Treatment and Recovery Research, National Institute on Alcohol Abuse and Alcoholism, 6700B Rockledge Drive, Bethesda, MD, 20892, USA.
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22
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Salles J, Tiret B, Gallini A, Gandia P, Arbus C, Mathur A, Bougon E. Suicide Attempts: How Does the Acute Use of Alcohol Affect Suicide Intent? Suicide Life Threat Behav 2020; 50:315-328. [PMID: 31532854 DOI: 10.1111/sltb.12586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 06/17/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Very few studies have specifically addressed the role of the acute use of alcohol (AUA) in suicide attempts. OBJECTIVE Our study compared the suicide intent scores of self-poisoning patients with and without AUA in order to examine the role of alcohol in attempted suicides. METHODS We recruited 516 patients admitted to the emergency department for self-poisoning. We screened blood alcohol concentrations (BACs) to determine whether these were positive or negative in the two groups. We collected data about covariates such as psychiatric disorders and sociodemographic and suicide characteristics. We then compared suicide intent between the groups, adjusted according to the covariates. RESULTS The patients with AUA had lower scores for suicide intent, but this factor only reduced the self-reporting score, with the scores for objective circumstances and risk similar between the groups. There was a correlation between BACs and self-reported suicide intentionality, but this was not significant. CONCLUSION Acute use of alcohol patients presented with lower suicide intent, as particularly explained by the self-report scores, but there were no differences between the groups in terms of risk and/or the objective circumstances. The role of alcohol in the self-reporting of suicide attempts must be addressed in future studies.
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Affiliation(s)
- Juliette Salles
- Université de Toulouse III, Toulouse, France.,Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France.,INSERM U1043, Centre de Physiopathologie de Toulouse Purpan, Université Paul Sabatier, Toulouse, France
| | - Bernard Tiret
- Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
| | - Adeline Gallini
- Université de Toulouse III, Toulouse, France.,Département d'Épidémiologie et de Santé Publique, Institut Fédératif de Biologie, CHU Toulouse, Toulouse, France
| | - Peggy Gandia
- Université de Toulouse III, Toulouse, France.,Service de Pharmacocinétique et Toxicologie, Institut Fédératif de Biologie, CHU Toulouse, Toulouse, France
| | - Christophe Arbus
- Université de Toulouse III, Toulouse, France.,Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
| | - Anjali Mathur
- Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
| | - Emmanuelle Bougon
- Service de Psychiatrie et Psychologie, Psychiatrie Toulouse, CHU Toulouse, Toulouse, France
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Allan NP, Holm-Denoma J, Conner KR, Zuromski KL, Saulnier KG, Stecker T. Profiles of Risk for Suicidal Behavior in Past and Current United States Military Personnel: Latent Profile Analysis of Current Risk Factors. Arch Suicide Res 2020; 24:1-17. [PMID: 30118632 DOI: 10.1080/13811118.2018.1506843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Person-centered approaches are underutilized to identify people with shared risk profiles. In this study, an at-risk sample of 773 past/current military personnel (Mage = 31.3 years, SD = 6.8) with current ideation (90.6%) and/or a prior suicide attempt (43.9%) were assessed using latent profile analysis. Variables included prior suicide attempts, suicidal ideation, alcohol/drug use, insomnia, depression, belongingness, burdensomeness, and post-traumatic stress disorder symptoms. Three classes emerged: Low Symptoms (N = 502), Elevated Suicidality (N = 176), and Elevated Substance Use (N = 95). At 1-month follow-up, the Elevated Suicidality and Elevated Substance Use classes had the highest odds of suicidal behavior. The finding concerning the Elevated Substance Use class suggests it may represent a distinct short-term risk group in military personnel.
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Prevalence of lifetime substances use among students in Ethiopia: a systematic review and meta-analysis. Syst Rev 2019; 8:326. [PMID: 31837700 PMCID: PMC6911280 DOI: 10.1186/s13643-019-1217-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 11/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The use of substances is a growing concern in Ethiopia, and their impacts on younger generation have been a concern of different professionals. Even though students are at high-risk of substance abuse, there is lack of comprehensive evidence for policy decision on substance use among students. Therefore, the aim of this systematic review and meta-analysis was to estimate the prevalence of common substances among students in Ethiopia. METHOD A comprehensive literature searches were done from biomedical databases: PubMed/Medline, African Journal Online, HINARI, Science Direct, and Google Scholar for article published until Dcember 31, 2017, and Addis Ababa Uiversity's electronic library search of unpublished thesis and dissertations. Two authors autonomously selected studies, extracted data, and evaluated quality of studies. The prevalence of lifetime substances use was estimated using the random effects model. Q and I2 statistics were computed to measure the extents of heterogeneity. RESULTS A total 676 study articles were identified from electronic databases, and 28 of them were included in meta-analysis. The analysis revealed that the lifetime prevalence of any substance use was 52.5% (95% CI 42.4-62.4%), khat 24.7% (95% CI 21.8-27.7%), alcohol 46.2% (95% CI 40.3-52.2%), and smoking cigarette 14.7% (95% CI 11.3-18.5%). Significant heterogeneity was observed but there was no significant publication bias. The lifetime prevalence of khat, alcohol, and cigarette smoking among high school vs university students was 22.5% (95% CI 15.2-30.7%) vs 25.1% (95% CI 21.9-28.5%), 41.4% (95% CI 22.1-62.1%) vs 47.8% (95% CI 39.9-55.7%), and 21.5% (95% CI 12.6-32.1%) vs 12.9% (95% CI 10.1-16.0%), respectively. CONCLUSION This meta-analysis highlighted the extent of lifetime prevalence of any substance, khat, alcohol, and cigarettes smoking among students in Ethiopia. Significant percent of high school students have exposed to substances. Policy makers should devise and implement strictly binding regulation to curb widespread of substances around educational institution premises at national level. Priority should be given to intervention strategies that help delay first use of substance to prevent problems later in life. Besides, the problem warrants regular national-level educational institutions based studies focusing on the magnitude, trajectory, and consequences of substance use among students. Systematic review registration: PROSPERO CRD42018082635.
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Abstract
Unhealthy alcohol and drug use are common among adolescents. A range of evidence-based interventions are available, but are rarely accessed by adolescents because of barriers such as cost, limited dissemination, lack of motivation to change, and logistical obstacles such as lack of transportation. Technology-delivered approaches may facilitate receipt of treatment in this vulnerable population. The limited number of controlled trials in this area present a mixed picture in terms of efficacy. Although sufficient to merit close attention and expanded research, the current literature points to a strong need for larger samples and greater use of rigorous and replicable methods.
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26
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Melson AJ, O’Connor RC. Differentiating adults who think about self-harm from those who engage in self-harm: the role of volitional alcohol factors. BMC Psychiatry 2019; 19:319. [PMID: 31660913 PMCID: PMC6816185 DOI: 10.1186/s12888-019-2292-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/16/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Self-harm, an act of self-poisoning or self-injury irrespective of motivation, is a major public health concern. Use of alcohol prior to or alongside acts of self-harm is common but little is known about the alcohol-related mechanisms of self-harm enaction. We utilised an ideation-to-action approach to clarify the extent to which volitional alcohol factors differentiated those who have thoughts of self-harm but do not act on them (self-harm ideation) and those who engage in self-harm (self-harm enaction). METHODS Cross-sectional analyses of the baseline phase of the Health Lifestyle and Wellbeing study: 1546 adults (1079 female; Mean age = 34 y; 92% White) resident in Scotland completed measures of demographics, lifetime self-harm, volitional alcohol factors and psychosocial factors. Multinomial logistic regression compared those with a history of self-harm thoughts ('ideation', n = 297), self-harm acts ('enaction', n = 346) and 'controls' (n = 897) to identify volitional alcohol factors associated with self-harm enaction. RESULTS Volitional alcohol factors differentiated those with a history of self-harm enaction from those with a history of self-harm ideation (as well as those with no history) in initial models adjusted for demographics and depressive symptoms: the self-harm enaction group reported stronger alcohol-related negative urgency (OR = 1.74, 95% CI 1.41-2.16, p < .001), more frequent heavy drinking (OR = 1.46, 95% CI 1.24-1.72, p < .001) and stronger expectancies that drinking alcohol leads to negative self-perceptions (OR = 1.33, 95% CI 1.03-1.72, p = 0.03) and markers of self-harm risk (OR = 1.64, 95% CI 1.18-2.30, p = 0.004). Alcohol-related negative urgency and heavy-drinking frequency continued to differentiate those in the self-harm enaction group from those in ideation group in multivariate models. Consistent with theoretical models positing phase-specific moderators of self-harm ideation and enaction, psychosocial factors (perceived stress, support, negative mood regulation expectancies) differentiated those with a history of self-harm ideation from those without but not those in the ideation and enaction groups. CONCLUSIONS Management of self-harm risk requires better understanding of alcohol-related mechanisms of self-harm enaction. Volitional alcohol factors may play a role in governing the translation of self-harm thoughts into self-harm acts.
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Affiliation(s)
- Ambrose J. Melson
- 0000 0001 2193 314Xgrid.8756.cSuicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Rory C. O’Connor
- 0000 0001 2193 314Xgrid.8756.cSuicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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Fulton E, Baines D, Bartle N. Underage drinking as a natural part of growing up: a UK study of parental beliefs. DRUGS AND ALCOHOL TODAY 2019. [DOI: 10.1108/dat-11-2017-0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose
Parental beliefs about underage drinking are known to influence the drinking behaviours of their children. The purpose of this paper is to explore parental beliefs about their own child drinking alcohol and young people in general, in order to ascertain whether there is a need to target such beliefs in the design of public health interventions.
Design/methodology/approach
Parents of 11–18 year olds attending one of nine schools in the Midlands of England, UK were invited to take part. Participants completed a newly designed 40-item questionnaire measuring parental beliefs about the impact and causes of underage drinking; talking to their child about alcohol; and how much and how often they thought their child consumed alcohol.
Findings
In total, 185 parents took part in the study, reporting on their eldest child aged 18 or under. The majority of parents agreed that underage drinking is detrimental to child health and wellbeing. However, over 60 per cent believed that alcohol consumption is a “natural part of growing up”, and stronger agreement with this belief was associated with higher parental reports of alcohol consumption in their children.
Social implications
The majority of parents recognised the risks and negative effects of alcohol; however, many also believe it is a natural part of growing up. Parents may hold conflicting beliefs about underage drinking, which could impact on the drinking beliefs and behaviours of their children.
Originality/value
Public health interventions may need to counter the common parental belief that underage drinking is a normal part of growing up and therefore to be expected. Clear messages about the impact parent beliefs and behaviour have on young people drinking, to ensure parents recognise that messages are aimed at themselves, and not just “other parents” are imperative.
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Substance use and suicidal ideation among child welfare involved adolescents: A longitudinal examination. Addict Behav 2019; 93:39-45. [PMID: 30684820 DOI: 10.1016/j.addbeh.2019.01.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/27/2018] [Accepted: 01/14/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the longitudinal predictors of alcohol use, marijuana use, and suicidal ideation among maltreated adolescents. METHODS Longitudinal data from this study come from three waves of the National Survey of Child and Adolescent Wellbeing II (NSCAW II). Participants included 1050 adolescents (Mage = 14.13) who were subjects of child abuse or neglect investigations. Items from the Health Risk Behavior Questionnaire were used to measure alcohol and marijuana use. Suicidal ideation was measured using an item from the Childhood Depression Inventory. Data on deviant peer affiliation, caregiver health, maltreatment type, age, race, and gender were also collected. RESULTS Marijuana use, suicidal ideation, caregiver drug abuse, deviant peer affiliation, age, and race were predictive of alcohol use. Alcohol use, deviant peer affiliation, age, and time were predictive of marijuana use. Alcohol use, deviant peer affiliation, age, and gender predicted suicidal ideation. CONCLUSIONS Longitudinal evidence indicated that individual, family, and peer factors played an important role in predicting alcohol use, marijuana use, and suicidal ideation among child welfare involved adolescents. In addition, this study provides evidence of a potentially reciprocal relationship between alcohol use and suicidal ideation among this population. Intervention efforts for reducing the public health problems of substance use and suicide among child welfare involved adolescents should focus on the importance of peers in influencing thoughts and behaviors, as well as the functional relationship between alcohol use and suicidal ideation.
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29
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Sellers CM, Iriarte ADV, Battalen AW, O’Brien KHM. Alcohol and marijuana use as daily predictors of suicide ideation and attempts among adolescents prior to psychiatric hospitalization. Psychiatry Res 2019; 273:672-677. [PMID: 31207851 PMCID: PMC9262037 DOI: 10.1016/j.psychres.2019.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/01/2019] [Accepted: 02/02/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Little research has been conducted on alcohol use, marijuana use, and suicide ideation and attempts on a daily level, and specifically among adolescents prior to inpatient hospitalization. The purpose of this study was to examine the within (over time) and between (between adolescents) effects of alcohol use and marijuana use on suicide ideation and attempts. METHODS Participants included 50 adolescents (80% female; Mage = 15.8). All participants reported drinking alcohol in the prior three months and were receiving treatment in an inpatient psychiatric hospital. Random and mixed-effect models were used to test study hypotheses. RESULTS Results from the random effect model indicated that alcohol use, marijuana use, hospitalization and sexual orientation were significant predictors of suicide attempts. Results from the mixed-effect model indicated that marijuana use, hospitalization, and sexual orientation were significant predictors of suicide ideation. CONCLUSIONS Study findings extend current knowledge about the longitudinal and day-to-day relationship between alcohol and marijuana use and suicide ideation and attempts. Results underscore the importance of addressing alcohol and marijuana use in interventions with suicidal adolescents, recognizing that sexual minority youth may be at elevated risk for suicide ideation.
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Affiliation(s)
- Christina M. Sellers
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA,Corresponding author at: Boston Children’s Hospital, 300 Longwood Ave, Boston, MA, USA. (C.M. Sellers)
| | - Antonia Diaz-Valdes Iriarte
- Boston College, School of Social Work, 140 Commonwealth Ave Chestnut Hill, MA 02467, USA,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Oficina 1305, Las Condes, Santiago 750000 Chile
| | - Adeline Wyman Battalen
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA
| | - Kimberly H. McManama O’Brien
- Boston Children’s Hospital, Department of Psychiatry, 300 Longwood Ave Boston, MA 02115, USA,Education Development Center, Department of Innovation in Practice and Technology, 43 Foundry Ave Waltham, MA 02453, USA,Harvard Medical School, Department of Psychiatry, 25 Shattuck St Boston, MA 02115, USA
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30
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McManama O'Brien KH, Battalen AW, Sellers CM, Spirito A, Yen S, Maneta E, Ryan CA, Braciszeweski JM. An mHealth approach to extend a brief intervention for adolescent alcohol use and suicidal behavior: Qualitative analyses of adolescent and parent feedback. JOURNAL OF TECHNOLOGY IN HUMAN SERVICES 2019; 37:255-285. [PMID: 31814806 PMCID: PMC6897385 DOI: 10.1080/15228835.2018.1561347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/24/2018] [Accepted: 12/18/2018] [Indexed: 06/10/2023]
Abstract
Mobile health (mHealth) tools that supplement inpatient psychiatric care can maintain and enhance intervention effects following hospitalization. Adolescents hospitalized following a suicidal event represent a vulnerable population who could greatly benefit from such an mHealth intervention. In specific, suicidal adolescents who drink alcohol are in need of robust interventions that address the bidirectional relationship between alcohol use and suicidal thoughts and behaviors, because it puts them at especially high risk for suicide upon discharge. The purpose of this study was to conduct qualitative interviews to gather feedback to improve a brief alcohol intervention provided to suicidal adolescents during psychiatric hospitalization, and to develop a mHealth tool to extend care after discharge. Participants, eight adolescents and their parents, identified the need for a smartphone application to deliver intervention content to adolescents and parents during the post-hospitalization period. Adolescents sought support in meeting alcohol- and mood-related goals, while parents desired general resources as well as tips for conversations with their adolescent about mood and alcohol use.
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Affiliation(s)
- Kimberly H McManama O'Brien
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Education Development Center, Department of Innovation in Practice and Technology, Waltham, MA, 02453, US
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, US
| | - Adeline Wyman Battalen
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Boston College School of Social Work, Chestnut Hill, MA, 02467, US
| | - Christina M Sellers
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Boston College School of Social Work, Chestnut Hill, MA, 02467, US
| | - Anthony Spirito
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, 02912, US
| | - Shirley Yen
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, 02912, US
| | - Eleni Maneta
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, US
| | - Colleen A Ryan
- Boston Children's Hospital, Department of Psychiatry, Boston, MA, 02115, US
- Harvard Medical School, Department of Psychiatry, Boston, MA, 02115, US
- Children's Specialized Hospital, Department of Medicine, 200 Somerset St., New Brunswick, NJ, 08901, US
| | - Jordan M Braciszeweski
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, 48202, US
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Borruso LD, Buckley NA, Kirby KA, Carter G, Pilgrim JL, Chitty KM. Acute Alcohol Co-Ingestion and Hospital-Treated Deliberate Self-Poisoning: Is There an Effect on Subsequent Self-Harm? Suicide Life Threat Behav 2019; 49:293-302. [PMID: 29498087 DOI: 10.1111/sltb.12443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 09/13/2017] [Indexed: 11/29/2022]
Abstract
The aim of this study was to determine the relationship between alcohol co-ingestion in an index deliberate self-poisoning (DSP) episode with repeated DSP and subsequent suicide. A retrospective cohort study was conducted involving 5,669 consecutive index presentations to a toxicology service following DSP between January 1, 1996, and October 31, 2010. Records were probabilistically matched to National Coronial Information System data to identify subsequent suicide. Index DSPs were categorized on co-ingestion of alcohol, and primary outcomes analyzed were repetition of any DSP, rates of repeated DSP, time to first repeat DSP, and subsequent suicide. Co-ingestion of alcohol occurred in 35.9% of index admissions. There was no difference between those who co-ingested alcohol (ALC+) and those who did not co-ingest alcohol (ALC-) in terms of proportion of repeat DSP, number of DSP events, or time to first repeat DSP event. Forty-one (1.0%) cases were probabilistically matched to a suicide death; there was no difference in the proportion of suicide between ALC+ and ALC- at 1 or 3 years. There was no significant relationship between the co-ingestion of alcohol in an index DSP and subsequent repeated DSP or suicide. Clinically, this highlights the importance of mental health assessment of patients that present after DSP, irrespective of alcohol co-ingestion at the time of event.
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Affiliation(s)
- Luca D Borruso
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Pharmacology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Nicholas A Buckley
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Pharmacology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Katharine A Kirby
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Pharmacology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Gregory Carter
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, NSW, Australia
| | - Jennifer L Pilgrim
- Drug Harm Prevention Unit, Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Monash University, Southbank, Vic, Australia
| | - Kate M Chitty
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Pharmacology, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Lee J, Chang SJ, Kim H, Kim MH, Ahn JS, Park KC, Moon JS, Min S. Prolonged Risk of Suicide Reattempts in Patients with Alcohol Use Disorder and Acute Alcohol Use: A Register-Based Follow-Up Study (2010-2015). Psychiatry Investig 2019; 16:145-153. [PMID: 30808121 PMCID: PMC6393750 DOI: 10.30773/pi.2018.11.22] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 11/22/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE This study aimed to clarify the role of acute alcohol use and alcohol use disorder in individuals exhibiting suicidal behaviors, including repetition of suicide attempt. METHODS Data pertaining to 691 suicide attempters who had visited an emergency center and had been followed-up from 2010 to 2015 were gathered. Participants were categorized into following three groups according to alcohol use pattern at the time of the suicide attempt: 1) suicide attempters with neither alcohol use disorder nor acute alcohol consumption (NAU), 2) suicide attempters who had used alcohol during the suicide attempt but did not have alcohol use disorder (AAU), and 3) suicide attempters with alcohol use disorder (AUD). Group comparisons and multivariate Cox proportional models for suicidal behavior were used for statistical analysis. RESULTS AUD have been shown to have lower lethality of suicide attempt but higher risk of suicide reattempts in the future. Furthermore, positive relationships between suicide reattempts and AUD persisted throughout the longer period than other groups. CONCLUSION Suicide attempters with AUD should be considered a high-risk group for suicide reattempts in future, and this group should be followed-up for a longer period with specialized care program.
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Affiliation(s)
- Jinhee Lee
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sei Jin Chang
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Joung-Sook Ahn
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Ki-Chang Park
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Jin Sil Moon
- Center of Biomedical Data Science (CBDS), Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Seongho Min
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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McManama O'Brien KH, Sellers CM, Battalen AW, Ryan CA, Maneta EK, Aguinaldo LD, White E, Spirito A. Feasibility, acceptability, and preliminary effects of a brief alcohol intervention for suicidal adolescents in inpatient psychiatric treatment. J Subst Abuse Treat 2018; 94:105-112. [PMID: 30243410 DOI: 10.1016/j.jsat.2018.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/23/2018] [Accepted: 08/29/2018] [Indexed: 11/25/2022]
Abstract
Alcohol use, both short-term intoxication and longer-term use, is a notable risk factor for suicide. Despite the strong relationship between alcohol use and suicidal thoughts and behaviors, providers typically treat these two problems independently. In particular, acute psychiatric care hospitalizations for adolescents are typically brief, and many only cursorily address alcohol use. Integrating a brief motivational enhancement intervention for alcohol use into an inpatient psychiatric hospitalization treatment protocol has the potential to enhance motivation to stop or reduce drinking if adolescents can more fully understand how it increases risk for suicidal behavior. This study tested the feasibility, acceptability, and preliminary effects of the Alcohol and Suicide Intervention for Suicidal Teens (ASIST), a brief motivational enhancement intervention targeting alcohol use and suicidal thoughts and behaviors for suicidal adolescents receiving inpatient psychiatric treatment. Results from a randomized pilot trial of ASIST (N = 50) revealed that the intervention was both feasible and acceptable, with 92% of those in the ASIST condition reporting that the intervention helped them to understand how their alcohol use is related to their suicidal thoughts and behaviors. Study findings suggest a larger randomized controlled trial may be warranted to test the effectiveness of ASIST with psychiatrically hospitalized adolescents.
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Affiliation(s)
- Kimberly H McManama O'Brien
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Harvard Medical School, Department of Psychiatry, 25 Shattuck St., Boston, MA 02115, United States of America; Education Development Center, Department of Innovation in Practice and Technology, 43 Foundry Ave, Waltham, MA 02453, United States of America.
| | - Christina M Sellers
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Adeline Wyman Battalen
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America.
| | - Colleen A Ryan
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Children's Specialized Hospital, Department of Medicine, 200 Somerset St., New Brunswick, NJ 08901, United States of America.
| | - Eleni K Maneta
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Harvard Medical School, Department of Psychiatry, 25 Shattuck St., Boston, MA 02115, United States of America.
| | - Laika D Aguinaldo
- Brown University, Department of Psychiatry and Human Behavior, 121 South Main St., Providence, RI 02912, United States of America.
| | - Erina White
- Boston Children's Hospital, Department of Psychiatry, 300 Longwood Ave, Boston, MA 02115, United States of America; Harvard Medical School, Department of Psychiatry, 25 Shattuck St., Boston, MA 02115, United States of America; Mightier, Boston, 200 Portland St., MA 02114, United States of America.
| | - Anthony Spirito
- Brown University, Department of Psychiatry and Human Behavior, 121 South Main St., Providence, RI 02912, United States of America.
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34
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Todeshkchuei GG, Molaeinezhad M, Ghasemi Todeshkchuei S. Psychosocial Factors Associated with Suicidal Behavior among Iranian Women: A Meta-analysis. Adv Biomed Res 2018; 7:86. [PMID: 29930926 PMCID: PMC5991272 DOI: 10.4103/abr.abr_47_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Suicide is one of the public health problems worldwide, but it lacks regular relevant reporting system. This issue is more important among women who play an influential role in the family and society. Therefore, the assessment of recent relevant studies is important to detect suicide-related factors and to help make the decisions about public health. The aim of the current study was to determine socioeconomic and psychological factors of suicide attempts in Iranian women using a descriptive meta-analysis method. All domestic scientific databases were searched using "suicide" keyword. A search was also done using keywords of corresponding to Medical Subject Headings including "Iran," "suicide," "psychosocial determinants," "behavior," "suicide commitment," "suicide thoughts," and "women." Overall, 3061 articles were retrieved through the initial search. Finally, 69 studies from nine provinces were included for the analysis. All statistical analyses were performed using R software version 3.2.6 with Metafor package version 1.9-9. Using nine selected studies, frequency of urban family (prevalence = 85%, 95% confidence interval [CI] = 0.68-1.00), nonacademic education (prevalence = 53%, 95% CI = 0.45-0.61), and family problems (prevalence = 34%, 95% CI = 0.19-0.49) was identified as the most important related factor of suicide compared to any other related factors. According to the results, family problems and lower education are associated with suicide attempts. Thus, providing training programs and family consultant services are recommended to reduce the incidence of suicide attempts.
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Affiliation(s)
| | - Mitra Molaeinezhad
- Department of Sexual and Reproductive Health, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Depressive symptoms, alcohol use and coping drinking motives: Examining various pathways to suicide attempts among young men. J Affect Disord 2018; 232:243-251. [PMID: 29499507 DOI: 10.1016/j.jad.2018.02.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 01/29/2018] [Accepted: 02/16/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Research has identified several correlates of suicidal behaviors including depressive symptoms, alcohol use and coping drinking motives. However, their associations and their role as possible causal mechanisms in the prediction of suicide attempt are not well understood. This study examined, both cross-sectionally and longitudinally, the potential pathways from alcohol use, drinking coping motives, and depression to suicide attempts. METHODS Participants (N = 4617) were young Swiss men (mean age = 19.95) participating in the Cohort Study on Substance Use Risk Factors. Measures of depressive symptoms, alcohol use (total drinks per week, heavy episode drinking) and coping drinking motives were used from the baseline and/or 15-month follow-up assessments to predict follow-up suicide attempt. RESULTS Main findings showed indirect associations through depressive symptoms, such that coping drinking motives were positively associated with depressive symptoms, which were in turn positively related to suicide attempts over time (for total drinks per week models, cross-sectional model: B = 0.130, SE = 0.035, 95% CI = 0.072, 0.207; longitudinal model: B = 0.039, SE = 0.013, 95% CI = 0.019, 0.069). Alcohol use was not significantly related to suicide attempt. LIMITATIONS Main limitation includes a low prevalence rate for suicide attempt potentially reducing power effects in the analyses and our focus on distal-yet not proximal, role of alcohol use on suicide attempt. CONCLUSIONS Findings of this study suggest that young men with depressive symptoms and/or those who use alcohol to cope with negative affect may benefit from programs targeting suicidal behaviors.
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McManama O’Brien KH, Aguinaldo LD, White E, Sellers CM, Spirito A. A Brief Alcohol Intervention During Inpatient Psychiatric Hospitalization for Suicidal Adolescents. COGNITIVE AND BEHAVIORAL PRACTICE 2018. [DOI: 10.1016/j.cbpra.2017.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Rehm J, Probst C. Decreases of Life Expectancy Despite Decreases in Non-Communicable Disease Mortality: The Role of Substance Use and Socioeconomic Status. Eur Addict Res 2018; 24:53-59. [PMID: 29627831 DOI: 10.1159/000488328] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/09/2018] [Indexed: 01/05/2023]
Abstract
With the epidemiological transition, causes of death shifted from communicable to non-communicable diseases (NCDs) and life expectancy increased, as these NCD deaths occurred later in life. However, in the United States, over the past years, life expectancy has been stagnating or decreasing despite decreasing NCD mortality rates. Analyses of the most important underlying causes of death with increasing premature mortality reveal that psychoactive substance use played a crucial role for these increases. Furthermore, it can be shown, that a high proportion of the increased premature mortality and decreased life expectancies happened in lower socio-economic strata. Substance use policies should thus focus on lowering the gap between substance-attributable mortality in higher versus lower socioeconomic strata.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
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Larkin C, Griffin E, Corcoran P, McAuliffe C, Perry IJ, Arensman E. Alcohol Involvement in Suicide and Self-Harm. CRISIS 2017; 38:413-422. [DOI: 10.1027/0227-5910/a000488] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract. Background: Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior. Aims: This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations. Method: Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide Support and Information System. Emergency department presentations of self-harm in the years 2007–2013 were obtained from the National Self-Harm Registry Ireland. Results: Alcohol consumption was detected in the toxicology of 44% out of 307 suicide cases. Only younger age was significantly associated with having consumed alcohol among suicides. Alcohol consumption was noted in the case notes in 21% out of 8,145 self-harm presentations. Logistic regression analyses indicated that variables associated with having consumed alcohol in a self-harm presentation included male gender, older age, overdose as a method, not being admitted to a psychiatric ward, and presenting out-of-hours. Limitations: Data was limited to routinely collected variables by the two different monitoring systems. Conclusion: Alcohol consumption commonly precedes suicidal behavior, and several factors differentiated alcohol-related suicidal acts. Self-harm cases, in particular, differ in profile when alcohol is consumed and may require a tailored clinical approach to minimize risk of further nonfatal or fatal self-harm.
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Affiliation(s)
| | - Eve Griffin
- National Suicide Research Foundation, Cork, Ireland
| | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Ireland
| | | | - Ivan J. Perry
- School of Public Health, University College Cork, Ireland
| | - Ella Arensman
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Ireland
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Agrawal A, Tillman R, Grucza RA, Nelson EC, McCutcheon VV, Few L, Conner KR, Lynskey MT, Dick DM, Edenberg HJ, Hesselbrock VM, Kramer JR, Kuperman S, Nurnberger JI, Schuckit MA, Porjesz B, Bucholz KK. Reciprocal relationships between substance use and disorders and suicidal ideation and suicide attempts in the Collaborative Study of the Genetics of Alcoholism. J Affect Disord 2017; 213:96-104. [PMID: 28213124 PMCID: PMC5434702 DOI: 10.1016/j.jad.2016.12.060] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/22/2016] [Accepted: 12/21/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Substance use and misuse and suicidal thoughts and behaviors tend to co-occur. The purpose of this study was to examine whether (a) suicidal ideation and attempt are related to onset of alcohol, nicotine and cannabis use and dependence; (b) early use of alcohol, nicotine and cannabis is associated with onset of suicidal ideation and attempt; and (c) whether these associations persist while controlling for covariates, such as family history of alcohol problems, major depression and other internalizing and externalizing disorders. METHODS The prospective cohort of the Collaborative Study of the Genetics of Alcoholism (COGA; N=3277) was used. Cross-sectional and discrete time logistic regression (i.e. survival) analyses examined associations between suicidal ideation and attempt and onset of alcohol, nicotine and cannabis use and dependence. Survival models also examined whether individual early substance use was related to onset of ideation and attempt. RESULTS Ideation was related to 0.71-0.77 odds of onset of subsequent alcohol, nicotine and cannabis use. Attempt was associated with 1.44-1.61 odds of later alcohol, nicotine and cannabis dependence, even after accounting for covariates. Evidence for early substance use being related to subsequent onset of ideation or attempt was limited. Several sex and race differences emerged. LIMITATIONS The sample was ascertained for family history of alcoholism; not all participants had been followed up allowing for censored observations; reporting bias. CONCLUSION Suicide attempts are associated with increased likelihood of onset of substance dependence.
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Affiliation(s)
- Arpana Agrawal
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA.
| | - Rebecca Tillman
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Richard A Grucza
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Elliot C Nelson
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Vivia V McCutcheon
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Lauren Few
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Kenneth R Conner
- University of Rochester Medical Center, Dept. of Emergency Medicine, Rochester, NY, USA
| | - Michael T Lynskey
- Kings College, Institute of Psychiatry, Dept. of Addiction, London, UK
| | - Danielle M Dick
- Virginia Commonwealth University, Dept. of African-American Studies, Richmond, VA, USA
| | - Howard J Edenberg
- Indiana University, Dept. of Biochemistry and Molecular Biology, Indianapolis, IN, USA
| | | | - John R Kramer
- University of Iowa Carver College of Medicine, Dept. of Psychiatry - Div. of Psychology, Iowa City, IA, USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Depts. of Psychiatry and Pediatrics, Iowa City, IA, USA
| | - John I Nurnberger
- Indiana University School of Medicine, Dept. of Psychiatry, Indianapolis, IN, USA
| | - Marc A Schuckit
- University of California San Diego, Dept. of Psychiatry, San Diego, CA, USA
| | - Bernice Porjesz
- SUNY Downstate Medical Center, Dept. of Psychiatry, Brooklyn, NY, USA
| | - Kathleen K Bucholz
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
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Borges G, Bagge C, Cherpitel CJ, Conner K, Orozco R, Rossow I. A meta-analysis of acute use of alcohol and the risk of suicide attempt. Psychol Med 2017; 47:949-957. [PMID: 27928972 PMCID: PMC5340592 DOI: 10.1017/s0033291716002841] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND No review has used a meta-analytic approach to estimate common odds ratios (ORs) for the effect of acute use of alcohol (AUA) on suicide attempts. We aim to report the results of the first meta-analysis of controlled epidemiological studies on AUA and suicide attempt. METHOD The English-language literature on Medline, PsycINFO and Google Scholar was searched for original articles and critical review on AUA and suicide attempt (period 1996-2015). Studies had to report an OR estimate for this association. Common ORs and 95% confidence intervals (CIs) from random effects in meta-analyses for any AUA and two levels of alcohol use on suicide attempt were calculated. RESULTS In all, seven studies provided OR estimates for the likelihood of suicide attempt by AUA, compared with those who did not drink alcohol. Studies used case-control (n 3) and case-crossover designs (n 4). Meta-analysis revealed a common OR of 6.97 (95% CI 4.77-10.17) for any AUA. Using four studies, 'low levels of acute drinking' resulted in an OR of 2.71 (95% CI 1.56-4.71) and 'high levels' had an OR of 37.18 (95% CI 17.38-79.53). CONCLUSIONS AUA is associated with increased likelihood of a suicide attempt, particularly at high doses. Such data should be incorporated into estimates of the burden of disease associated with alcohol use, which are currently limited by a consideration of only alcohol's chronic effects. Future research should focus on the mechanisms through which AUA confers risk for attempt.
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Affiliation(s)
| | - Courtney Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Mississippi
| | | | | | | | - Ingeborg Rossow
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo
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Norström T, Rossow I. Alcohol Consumption as a Risk Factor for Suicidal Behavior: A Systematic Review of Associations at the Individual and at the Population Level. Arch Suicide Res 2016; 20:489-506. [PMID: 26953621 DOI: 10.1080/13811118.2016.1158678] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The objective of this study was to provide an updated review of the magnitude of the relationship between alcohol use and suicidal behaviour at the individual and the population level. Systematic literature searches retrieved 14 reviews of individual level studies and 16 primary population level studies. Alcohol abuse and alcohol intoxication are often present in suicidal behaviour; risk of suicide is elevated in alcohol abusers and increasing population drinking tends to be associated with increase in suicide rates. Estimated magnitude of the relationship differs for men and women and it varies at the population level across cultures with different drinking pattern. These variations probably reflect gender differences and cultural variation in drinking behavior generally. Empirical evidence for a causal relationship is still urgently needed.
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Abstract
Despite advances in theory and the development and implementation of evidence-based treatments, the United States suicide rate has been rising continuously for over a decade. Although this does not indicate that traditional treatment approaches should be abandoned, it does highlight the need to supplement such approaches with alternatives. One seemingly highly valuable option is means safety, defined as the reduced access to and/or increased safe storage of potentially lethal methods for suicide. This paper provides a review of the current literature on the prevalence of six methods for suicide and preventative efforts aimed to reduce suicide rates. The majority of means safety interventions seem promising given that these methods are common and highly lethal. However, cultural and practical barriers will need to be taken into consideration when implementing these plans. Overall, means safety efforts and preventative measures seem to be promising ways to reduce the national suicide rate if implemented.
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Affiliation(s)
- Hyejin M Jin
- Department of Psychology, University of Southern Mississippi, 118 College Drive, Box #5025, Hattiesburg, MS, 39406, USA
| | - Lauren R Khazem
- Department of Psychology, University of Southern Mississippi, 118 College Drive, Box #5025, Hattiesburg, MS, 39406, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, 118 College Drive, Box #5025, Hattiesburg, MS, 39406, USA.
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Xuan Z, Naimi TS, Kaplan MS, Bagge CL, Few LR, Maisto S, Saitz R, Freeman R. Alcohol Policies and Suicide: A Review of the Literature. Alcohol Clin Exp Res 2016; 40:2043-2055. [PMID: 27618526 DOI: 10.1111/acer.13203] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 07/25/2016] [Indexed: 11/28/2022]
Abstract
Both intoxication and chronic heavy alcohol use are associated with suicide. There is extensive population-level evidence linking per capita alcohol consumption with suicide. While alcohol policies can reduce excessive alcohol consumption, the relationship between alcohol policies and suicide warrants a critical review of the literature. This review summarizes the associations between various types of alcohol policies and suicide, both in the United States and internationally, as presented in English-language literature published between 1999 and 2014. Study designs, methodological challenges, and limitations in ascertaining the associations are discussed. Because of the substantial between-states variation in alcohol policies, U.S.-based studies contributed substantially to the literature. Repeated cross-sectional designs at both the ecological level and decedent level were common among U.S.-based studies. Non-U.S. studies often used time series data to evaluate pre-post comparisons of a hybrid set of policy changes. Although inconsistency remained, the published literature in general supported the protective effect of restrictive alcohol policies on reducing suicide as well as the decreased level of alcohol involvement among suicide decedents. Common limitations included measurement and selection bias and a focus on effects of a limited number of alcohol policies without accounting for other alcohol policies. This review summarizes a number of studies that suggest restrictive alcohol policies may contribute to suicide prevention on a general population level and to a reduction of alcohol involvement among suicide deaths.
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Affiliation(s)
- Ziming Xuan
- Department of Community Health Sciences , Boston University School of Public Health, Boston, Massachusetts.
| | - Timothy S Naimi
- Section of General Internal Medicine , Boston Medical Center, Boston, Massachusetts
| | - Mark S Kaplan
- Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, California
| | - Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Lauren R Few
- Department of Psychiatry , Washington University School of Medicine, Saint Louis, Missouri
| | - Stephen Maisto
- Department of Psychology , Syracuse University, Syracuse, New York
| | - Richard Saitz
- Department of Community Health Sciences , Boston University School of Public Health, Boston, Massachusetts
| | - Robert Freeman
- National Institute on Alcohol Abuse and Alcoholism , NIH, Bethesda, Maryland
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Borges G, Bagge CL, Orozco R. A literature review and meta-analyses of cannabis use and suicidality. J Affect Disord 2016; 195:63-74. [PMID: 26872332 DOI: 10.1016/j.jad.2016.02.007] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/31/2015] [Accepted: 02/03/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND We lack a review of the epidemiological literature on cannabis use (acute use and chronic-usual quantity/frequency and heavy use) and suicidality (suicide death, suicide ideation, suicide attempt). METHODS The English language literature on Medline, PsychInfo, Google Scholar, and public-use databases was searched for original articles, critical review reports, and public use data on cannabis use and suicide for the period ranging from 1990-2015 (February). Odds ratios (OR) from random effects in meta-analyses for any cannabis use and heavy cannabis use were calculated. RESULTS The acute cannabis-suicidality literature mostly includes descriptive toxicology reports. In terms of death by suicide, the average positive cannabis rate was 9.50% for studies sampling from all suicides, with higher cannabis detection rates amongst suicide decedents by non-overdose methods. We found only 4 studies providing estimates for any chronic cannabis use and death by suicide (OR=2.56 (1.25-5.27)). After deleting duplicates we found 6 studies on any cannabis use and suicide ideation (OR=1.43 (1.13-1.83)), 5 studies on heavy cannabis use and suicide ideation (OR=2.53 (1.00-6.39)), 6 studies on any cannabis use and suicide attempt (OR=2.23 (1.24-4.00)) and 6 studies on heavy cannabis use and suicide attempt (OR=3.20 (1.72-5.94)). CONCLUSIONS We currently lack evidence that acute cannabis use increases imminent risk for suicidality. The evidence tends to support that chronic cannabis use can predict suicidality, but the lack of homogeneity in the measurement of cannabis exposure and, in some instances, the lack of systematic control for known risk factors tempered this finding.
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Affiliation(s)
- Guilherme Borges
- Senior Researcher and Professor, National Institute of Psychiatry and Metropolitan Autonomous University, Mexico City, Mexico.
| | - Courtney L Bagge
- Associate Professor, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Mississippi, USA
| | - Ricardo Orozco
- Researcher, National Institute of Psychiatry, Mexico City, Mexico
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Bagge CL, Conner KR, Reed L, Dawkins M, Murray K. Alcohol use to facilitate a suicide attempt: an event-based examination. J Stud Alcohol Drugs 2016; 76:474-81. [PMID: 25978835 DOI: 10.15288/jsad.2015.76.474] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The current study is based on the hypothesis that alcohol-involved suicide attempts are characterized by lower premeditation and intent, but only when the use of alcohol is not motivated by the desire to facilitate the attempt. Test of this idea was conducted by comparing proximal suicide premeditation and intent of suicide attempts among three groups: individuals who (a) drank to facilitate the attempt (e.g., to "numb fears" about attempting), (b) drank for nonfacilitative motives, and (c) did not use alcohol before the attempt. METHOD Participants included 324 (62% female) recent suicide attempters presenting to a Level 1 trauma hospital. The Timeline Followback Interview for Suicide Attempts and a novel Suicide Facilitative Drinking Motives Scale were used to assess facilitative motives for drinking and characteristics of the attempt. RESULTS One third of participants drank before the attempt, and most (73%) who used alcohol did not do so to facilitate the attempt. As hypothesized, attempts carried out by this group had shorter proximal suicide premeditation and lower suicide intent compared with the other study groups; in contrast, individuals who drank to facilitate the attempt were similar to non-alcohol users on these indices. CONCLUSIONS Alcohol-involved suicide attempts are heterogeneous. Motives for drinking are a key source of heterogeneity insofar as fundamental characteristics of attempts (proximal premeditation, intent) differ as a function of drinking motivation. Clinical implications include that individuals making suicide attempts with facilitative motives for drinking cannot be assumed to be at lowered risk upon a drop in blood alcohol level.
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Affiliation(s)
- Courtney L Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kenneth R Conner
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York.,VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York
| | - Louren Reed
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Milton Dawkins
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kevin Murray
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
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Kanamüller J, Riipinen P, Riala K, Paloneva E, Hakko H. Hanging suicides in northern Finland: A descriptive epidemiological study. DEATH STUDIES 2015; 40:205-210. [PMID: 26681439 DOI: 10.1080/07481187.2015.1117537] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors examined all hanging-suicides during 1988-2013 (N = 851) in the province of Oulu, northern Finland. Using death-certificate data and ICD-diagnoses from the Finnish Hospital Discharge Register, we focused on gender differences in suicide, mental health, and somatic health. Male victims were more likely to have intoxication or problematic alcohol use; female victims were more likely to have somatic or mental hospitalization. Previous physical or mental hospitalization was related with absence of intoxication at the time of suicide. Suicide prevention should focus on acute alcohol abuse in the presence of acute stressors, suicidal thoughts and mental illness.
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Affiliation(s)
- Juha Kanamüller
- a Department of Psychiatry , Oulu University Hospital , Oulu , Finland
| | - Pirkko Riipinen
- b Department of Psychiatry , University of Oulu , Oulu , Finland
| | - Kaisa Riala
- a Department of Psychiatry , Oulu University Hospital , Oulu , Finland
- c Department of Adolescent Psychiatry , Helsinki University Central Hospital , Helsinki , Finland
| | - Eero Paloneva
- a Department of Psychiatry , Oulu University Hospital , Oulu , Finland
| | - Helinä Hakko
- a Department of Psychiatry , Oulu University Hospital , Oulu , Finland
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Heerde JA, Toumbourou JW, Hemphill SA, Herrenkohl TI, Patton GC, Catalano RF. Incidence and Course of Adolescent Deliberate Self-Harm in Victoria, Australia, and Washington State. J Adolesc Health 2015; 57:537-44. [PMID: 26499859 PMCID: PMC4621461 DOI: 10.1016/j.jadohealth.2015.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 07/22/2015] [Accepted: 07/23/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE There have been few longitudinal studies of deliberate self-harm (DSH) in adolescents. This cross-national longitudinal study outlines risk and protective factors for DSH incidence and persistence. METHODS Seventh and ninth grade students (average ages 13 and 15 years) were recruited as state-representative cohorts, surveyed, and then followed up 12 months later (N = 3,876), using the same methods in Washington State and Victoria, Australia. The retention rate was 99% in both states at follow-up. A range of risk and protective factors for DSH were examined using multivariate analyses. RESULTS The prevalence of DSH in the past year was 1.53% in Grade 7 and .91% in Grade 9 for males and 4.12% and 1.34% for Grade 7 and Grade 9 females, respectively, with similar rates across states. In multivariate analyses, incident DSH was lower in Washington State (odds ratio [OR] = .67; 95% confidence interval [CI] = .45-1.00) relative to Victoria 12 months later. Risk factors for incident DSH included being female (OR = 1.93; CI = 1.35-2.76), high depressive symptoms (OR = 3.52; CI = 2.37-5.21), antisocial behavior (OR = 2.42; CI = 1.46-4.00), and lifetime (OR = 1.85; CI = 1.11-3.08) and past month (OR = 2.70; CI = 1.57-4.64) alcohol use relative to never using alcohol. CONCLUSIONS Much self-harm in adolescents resolves over the course of 12 months. Young people who self-harm have high rates of other health risk behaviors associated with family and peer risks that may all be targets for preventive intervention.
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Affiliation(s)
- Jessica A. Heerde
- Post-doctoral Research Associate, Learning Sciences Institute Australia, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria 3065; School of Psychology, Deakin University, Geelong Waterfront Campus, Geelong, Victoria 3217, Australia
| | - John W. Toumbourou
- Professor and Chair in Health Psychology, Prevention Sciences, School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Geelong Waterfront Campus, Geelong, Victoria 3217, Australia and Centre for Adolescent Health; Murdoch Childrens Research Institute, Flemington, 3031, Australia
| | - Sheryl A. Hemphill
- Program Director, Learning Sciences Institute Australia and Professor, School of Psychology, Australian Catholic University; 115 Victoria Parade, Fitzroy, Victoria 3065; Centre for Adolescent Health; Murdoch Childrens Research Institute; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, and School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Todd I. Herrenkohl
- Professor, Co-Director, 3DL Partnership and Professor, University of Washington School of Social Work, 9725 3rd Avenue NE, Suite 401, Seattle, WA 98115
| | - George C. Patton
- Professor, Centre for Adolescent Health, Murdoch Childrens Research Institute, Department of Paediatrics, The University of Melbourne, Flemington, 3031, Australia
| | - Richard F. Catalano
- Bartley Dobb Professor for the Study and Prevention of Violence, and Director, Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Avenue NE, Suite 401, Seattle, WA 98115
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Few LR, Werner KB, Sartor CE, Grant JD, Trull TJ, Nock MK, Bucholz KK, Deitz SK, Glowinski AL, Martin NG, Nelson EC, Statham DJ, Madden PAF, Heath AC, Lynskey MT, Agrawal A. Early onset alcohol use and self-harm: a discordant twin analysis. Alcohol Clin Exp Res 2015; 39:2134-42. [PMID: 26463647 DOI: 10.1111/acer.12889] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/26/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Self-harm has considerable societal and economic costs and has been extensively studied in relation to alcohol involvement. Although early onset alcohol use (EAU) has been causally linked to maladaptive clinical outcomes, its association with self-harm is less well characterized. This study aimed to further examine the link between EAU and both nonsuicidal self-injury (NSSI) and suicide attempt (SA), and elucidate shared familial and causal/individual-specific pathways that explain this co-occurrence. METHODS Using data from 6,082 Australian same-sex twin pairs (1,732 monozygotic [MZ] and 1,309 dizygotic [DZ]), ages 23 to 40, we examined prevalence rates of NSSI and SA among twin pairs concordant and discordant for EAU. Conditional logistic regression, controlling for early clinical covariates and the influence of zygosity on EAU, was used to examine the odds ratio (OR) of self-harm within twin pairs discordant for EAU. RESULTS Prevalence rates of both NSSI and SA were highest among twin pairs concordant for EAU and for twins who reported EAU within discordant twin pairs. Results from discordant twin analyses revealed nearly 4-fold increased odds of SA for the twin who endorsed EAU, and this OR was equal across MZ and DZ twins. EAU also was associated with elevated odds of NSSI (OR = 7.62), although this was only the case for DZ twins in discordant pairs. CONCLUSIONS The equivalent increase in odds of SA for both MZ and DZ twins suggests that causal or individual-specific influences explain the link between EAU and SA. For NSSI, elevated odds for DZ twins and nonsignificant findings for MZ twins implicate correlated genetic factors in the association between EAU and NSSI. Future studies should test mechanisms through which EAU may causally influence SA, as well as examine whether genetic risk for third variables (e.g., negative urgency, stress reactivity) may explain the genetic overlap between EAU and NSSI.
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Affiliation(s)
- Lauren R Few
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Kimberly B Werner
- George Warren Brown School of Social Work, Washington University, Saint Louis, Missouri
| | - Carolyn E Sartor
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri.,Department of Psychiatry, Yale University School of Medicine, West Haven, Connecticut
| | - Julia D Grant
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Sarah K Deitz
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Anne L Glowinski
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | | | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Dixie J Statham
- School of Social Sciences, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
| | - Michael T Lynskey
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri
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Posporelis S, Paspali A, Takayanagi Y, Sawa A, Banerjea P, Kyriakopoulos M. Demographic and clinical correlates of suicidality in adolescents attending a specialist community mental health service: a naturalistic study. J Ment Health 2015. [PMID: 26203534 DOI: 10.3109/09638237.2015.1022249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Adolescents comprise a unique and often challenging group of patients with diverse presentations to the Mental Health Services; suicidal behavior being one of them. AIMS The main aim of this naturalistic project was to investigate demographic and clinical correlates of adolescent suicidal and self-harm events, which may be of value to decision-making in clinical practice. METHOD All adolescents (n = 149) registered and actively managed by a specialist community mental health service in South London were included in the study. Clinical information from their files was used to determine suicidality/self-harm events. The Columbia Classification Algorithm of Suicide Assessment (C-CASA) was utilised for classification purposes. Logistic regression was used to explore the effects of age, sex, diagnosis, medication, substance use (alcohol and/or cannabis) and ethnicity on suicidality/self-harming behaviors. RESULTS Age, sex and use of psychotropic medication were identified to play a significant role in determining the risk of engaging in self-harming behavior. The risk was higher with increasing age and female sex. Medication seemed to have a protective effect. Reporting a 20% prevalence of non-suicidal self-injury (NSSI) in our population, we highlight the importance of NSSI as a distinct diagnostic category. CONCLUSIONS Our findings have implications for risk assessment and appropriate decision-making in clinical settings. Results are translatable and relevant to other metropolitan areas.
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Affiliation(s)
- Sotirios Posporelis
- a Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA .,b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK
| | - Aspasia Paspali
- b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK
| | - Yoichiro Takayanagi
- c Department of Mental Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA
| | - Akira Sawa
- a Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Partha Banerjea
- b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK
| | - Marinos Kyriakopoulos
- b Child and Adolescent Mental Health Services Clinical Academic Group , South London and Maudsley NHS Foundation Trust , London , UK .,d Institute of Psychiatry, Psychology and Neuroscience King's College London , London , UK , and.,e Department of Psychiatry , Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Giancola PR, Josephs RA, Parrott DJ, Duke AA. Alcohol Myopia Revisited: Clarifying Aggression and Other Acts of Disinhibition Through a Distorted Lens. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 5:265-78. [PMID: 26162159 DOI: 10.1177/1745691610369467] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The alcohol myopia model (AMM; Steele & Josephs, 1990) is reviewed in light of its unique ability to account for a variety of alcohol and nonalcohol-related disinhibited behaviors, particularly aggression. The AMM posits that alcohol has a narrowing, or a "myopic," effect on one's ability to attend to competing instigatory and inhibitory cues. Disinhibited behavior is presumed to occur when attention is directed toward salient provocative or instigatory cues rather than inhibitory cues. AMM research is reviewed with regard to stress and anxiety, risky sexual behavior, drinking and driving, suicide, disinhibited eating, smoking, and alcohol-related aggression. The AMM is also expanded by proposing five key mechanisms (i.e., negative affect, angry affect, hostile cognitive rumination, self-awareness, and empathy) that are likely to explain how the model is specifically involved in the alcohol-aggression relation. Finally, a number of public health interventions, extrapolated from the AMM, are proposed to stimulate future research directed at reducing the prevalence of alcohol-related violence.
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Affiliation(s)
| | | | | | - Aaron A Duke
- Department of Psychology, University of Kentucky, Lexington
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