A preliminary examination of the association between drinking as a typical coping strategy and level of acute alcohol consumption prior to a suicide attempt

Protective behavioral strategies as a protective factor against suicidal ideation among college student drinkers

Objective: Research shows that alcohol use is linked to suicidal ideation (SI), while depression is strongly associated with SI. Protective behavioral strategies (PBS) are safe drinking strategies. PBS are broadly protective across alcohol-related problems; however, it is unclear if these effects extend to those at risk for SI. We hypothesized that alcohol use and depressive symptoms would be risk factors for SI, and that these factors would moderate the effects of PBS. PBS was hypothesized to be protective for individuals with elevated depressive symptoms and alcohol use. Participants: College student drinkers (n = 990; M age = 19.97, SD = 3.75) from a Southeastern University. Methods: Participants completed an online survey inquiring about demographics, depressive symptoms, SI, alcohol use, and PBS use. Results: Depressive symptoms were associated with an increased likelihood of SI; however, alcohol use was not. PBS were most protective for individuals with high levels of alcohol use and/or depressive symptoms. Conclusions: PBS may be protective for heavier drinkers who are at heightened risk for SI.

A qualitative exploration of young adults' perceptions of a new intervention for alcohol use disorder

BACKGROUND

Due to the rising prevalence of alcohol use disorders among young adults, the need for effective and accessible interventions has become increasingly imperative. In acknowledgment of this issue, we developed a novel intervention known as contingency management plus problem solving therapy (CM-PST). The aim of the current study was to gain insight into the perspectives on the effectiveness of the newly developed CM-PST using focus group discussion among young adults who consume alcohol regularly.

MATERIALS AND METHODS

The study employed a qualitative research design, utilizing focus group discussions as the primary data collection method. Participants described their perceptions regarding the newly developed CM-PST. Semi-structured focus group sessions were conducted via Zoom in November 2022. A total of 19 young adults, aged 18-24 years old, participated in five focus group sessions. Data were analyzed using deductive content analysis.

RESULTS

Participants demonstrated overall positive attitudes toward the novel intervention, recognizing the potential benefits, it could offer in terms of alcohol use reduction and emotional well-being. They emphasized the importance of incentives in motivating behavioral changes, as well as the practicality of problem-solving techniques in addressing everyday challenges. Additionally, participants provided valuable insights into potential barriers and implementation challenges, highlighting the need for flexible and personalized approaches to accommodate individual preferences and needs.

CONCLUSIONS

The results of this study contribute to the growing body of literature on innovative intervention approaches for young adults facing alcohol use issues. The findings shed light on the acceptability and perceived effectiveness of the CM-PST intervention from the perspective of the target population.

Longitudinal patterns of alcohol use and psychological symptoms during COVID-19 pandemic and role of alexithymia: A latent transition analysis in the FinnBrain Birth Cohort Study

BACKGROUND

The COVID-19 pandemic has been posing widespread influence on mental well-being. However, research on the dynamic relations between alcohol use and psychological symptoms in the context of the pandemic and the role of alexithymic traits in predicting the development of mental health problems longitudinally remains scarce.

METHODS

Latent profile and transition analyses were conducted to model the longitudinal patterns of transitions in the profiles of alcohol use and psychological symptoms across 10 months during the pandemic (from May 2020 to March 2021) and to investigate the role of alexithymia and its dimensions Difficulty Identifying and Describing Feelings (DIF and DDF), and Externally Oriented Thinking (EOT) in 720 parents from the FinnBrain Birth Cohort Study.

RESULTS

Three profiles, Risky Drinking, Distressed Non-Risky Drinking, and Non-Distressed, Non-Risky Drinking, and their transitions were identified. The role of alexithymia appeared to be stronger in Risky Drinking than Non-Distressed, Non-Risky Drinking. DIF predicted the development of symptoms in Risky Drinking, whereas DDF predicted Risky Drinking remaining stable over time and showed a trend towards psychological distress in Risky Drinking and Non-Distressed, Non-Risky Drinking. EOT was more likely to be a risk factor for Risky Drinking remaining constant and Non-Distressed, Non-Risky Drinking becoming Risky Drinking.

LIMITATIONS

This study was mainly limited by the generalizability of the findings.

CONCLUSIONS

Our findings add deeper insights into the longitudinal development of alcohol use and psychological symptoms as well as evidence on the role of alexithymia in shaping mental health, providing implications for tailoring clinical preventive and therapeutic measures.

Suicidal ideation and sobriety: Should acute alcohol intoxication be taken into account for psychiatric evaluation?

BACKGROUND

When evaluating an emergency department (ED) patient who presents with suicidal ideation, it is a common practice to wait until the patient's ethanol level is known or calculated to be less than 80 mg/dl to evaluate patient safety. We know of no study that establishes an association between the degree of alcohol intoxication based on a blood alcohol level (BAL) and reported suicidal ideation (SI) upon recovery.

METHODS

We conducted a retrospective review of patients evaluated in a Midwestern ED for the calendar year 2017. Cases were selected if they had a psychiatric social work consult and a blood alcohol level drawn while in the ED. Patients were selected on the same 2 days each week throughout the year to meet the sample size requirements of the study, resulting in 1084 cases for review. Chi-square analysis was used to evaluate the relationship between suicidal ideation and alcohol intoxication as defined by a BAL ≥80 mg/dl.

RESULTS

Among patients presenting with suicidal ideation and a concurrent BAL ≥80 mg/dl, 69% no longer reported suicidal ideation when their BAL was <80 mg/dl, compared to 38% for patients without a positive BAL on presentation (chi-square, p = 0.000012).

CONCLUSION

Our data show that patients presenting to the ED with complaints related to suicidal behavior who have a BAL ≥80 mg/dl are more likely to no longer endorse having suicidal ideation once their BAL is < 80 mg/dl than patients with similar presenting complaints and no alcohol intoxication. This finding supports the common ED practice of re-assessing suicidal ideation among individuals who are initially intoxicated once their BAL has decreased below 80 mg/dl.

The conditional association of problematic drinking with suicidal ideation by alcohol expectancies

PURPOSE

Theory has identified alcohol expectancies as a facilitating factor in the association between problematic drinking and suicidal ideation. In the first test of this question, we explored whether the impact of problematic drinking on suicidal ideation depended on alcohol expectancies.

METHODS

We conducted a secondary analysis of cross-sectional, observational, survey data from a convenience sample of 444 individuals court-ordered to domestic violence intervention programs (69.5% non-Hispanic White; 78.6% Male-identified; Mage = 32.53, SDage = 10.10).

RESULTS

Parallel analysis and exploratory factor analysis revealed a three-factor structure of the Effects of Drinking Alcohol Scale, including alcohol expectancies related to 1) disinhibition and negative mood, 2) positive mood, and 3) physical and cognitive effects. Multiple linear regression employing bootstrapping procedures tested the moderating effects of these expectancies on the association between problematic drinking and suicidal ideation, while controlling for gender and depressive symptoms. Problematic drinking was negatively associated with suicidal ideation at low levels of disinhibition and negative mood expectancies, and this association became more positive as these expectancies increased. Problematic drinking was negatively associated with suicidal ideation at high levels of positive mood and became more positive as these expectancies decreased.

DISCUSSION

These preliminary findings suggest that expectancies related to the mood-altering and disinhibiting effects of alcohol may play a role in whether problematic drinking facilitates suicidal thinking. Future intensive longitudinal designs are needed to test whether this moderation is replicated during periods of acute alcohol intoxication and when other psychiatric symptoms are controlled.