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De Leon AN, Peterson R, Leary AV, Burr EK, Cora JL, Dvorak RD. Protective behavioral strategies as a protective factor against suicidal ideation among college student drinkers. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:947-956. [PMID: 35427457 DOI: 10.1080/07448481.2022.2063023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 03/08/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Ardhys N De Leon
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Roselyn Peterson
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Angelina V Leary
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Emily K Burr
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Jessica L Cora
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Robert D Dvorak
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
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Coryell W, Horwitz A, Albucher R, Zheng K, Pistorello J, Eisenberg D, Favorite T, King C. Alcohol intake in relation to suicidal ideation and behavior among university students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1680-1684. [PMID: 34398708 DOI: 10.1080/07448481.2021.1950160] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/23/2021] [Accepted: 03/21/2021] [Indexed: 06/13/2023]
Abstract
ObjectiveHeavy alcohol use has been clearly linked to risk for suicidal behaviors and is also prevalent on many American college campuses. This report uses a large sample of college students to explore relationships between alcohol use, depressive symptoms, and suicidality. Methods: A brief suicide screen was completed by 40,335 university students at four pariticipating sites. Assessments quantified recent depressive symptoms, alcohol use, suicidal ideation, and suicide attempts. Results: Problems from alcohol use were consistently associated with suicidal thoughts and attempts in the previous month, and in the previous year, but the quantity of alcohol used was not. Alcohol related problems exerted effects on the likelihood of both suicide ideation and attempts beyond those explained by their relationship with depressive symptoms. Conclusions: Screens for individuals at increased risk for suicidal ideation and behavior should emphasize alcohol-related problems over quantification of alcohol intake.
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Affiliation(s)
- William Coryell
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Adam Horwitz
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronald Albucher
- Department of Psychiatry, Stanford University, Stanford, California, USA
| | - Kai Zheng
- University of California, Irvine, Irvine, California, USA
| | | | - Daniel Eisenberg
- Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USA
| | - Todd Favorite
- Department of Psychiatry, University of Michigan Psychological Clinic, Ann Arbor, Michigan, USA
| | - Cheryl King
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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Coryell W, Horwitz A, Albucher R, Zheng K, Pistorello J, Eisenberg D, Favorite T, King C. Suicidality and Alcohol Use as Predictors of Future Suicidal Behavior in College Students. Alcohol Alcohol 2022; 57:643-647. [PMID: 36055977 PMCID: PMC9651983 DOI: 10.1093/alcalc/agac037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS There has been a marked increase in suicide fatalities among college-age students in recent years. Moreover, heavy alcohol use, a well-known risk factor for suicide, is present on most campuses. Yet, no prospective studies have examined alcohol use patterns among college students as predictors of suicidal behaviors. METHODS Online of 40,335 students at four universities took place at the beginning of four academic years, 2015-2018. Of these, 2296 met criteria for an increased risk of suicidal behavior and completed 1- and/or 6-month follow-up evaluation(s). Baseline assessments included the Alcohol Use Disorders Identification Test to quantify alcohol consumption and resulting problems, and measures of depression, suicidal ideation and suicidal behavior. RESULTS Suicide attempts during follow-up were reported by 35 (1.5%) of high-risk students. Regression analyses indicated that baseline severity of alcohol use consequences, but not amount of alcohol consumption, was associated with greater odds of a follow-up suicide attempt after controlling for baseline suicidal ideation, functional impairment and history of suicide attempts. CONCLUSIONS Among college students at elevated risk for suicide, the severity of alcohol-related consequences was a significant predictor of future suicide attempts. Alcohol consumption was not a significant predictor, suggesting that the amount students drink is less of a concern for suicidal behavior than are the problems (e.g. failing to meet expectations, experiencing blackouts) associated with drinking.
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Affiliation(s)
- William Coryell
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52240, USA
| | - Adam Horwitz
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ronald Albucher
- Department of Psychiatry, Stanford University, Stanford, CA 94305, USA
| | - Kai Zheng
- Departments of Health Informatics and Emergency Medicine, University of California, Irvine, CA 92697, USA
| | | | - Daniel Eisenberg
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI 48109, USA
| | - Todd Favorite
- Department of Psychiatry, University of Michigan Psychological Clinic, Ann Arbor, MI 48109, USA
| | - Cheryl King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Collados-Ros A, Torres-Sánchez C, Pérez-Cárceles MD, Luna A, Legaz I. Suicidal Behavior and Its Relationship with Postmortem Forensic Toxicological Findings. TOXICS 2022; 10:319. [PMID: 35736927 PMCID: PMC9229491 DOI: 10.3390/toxics10060319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Suicide affects all sociodemographic levels, age groups, and populations worldwide. The factors that can increase the risk of suicidal tendencies are widely studied. The aim of this study was to analyze the types and combinations of toxics found in fatal suicide victims with different suicide mechanisms. A total of 355 autopsies were retrospectively studied, and 26 toxics were determined and related to mechanisms of suicide. Hanging (55%), drug overdose (22.7%), and jumping from a height (17.8%) were most represented suicide mechanisms with positive toxicology. Hanging was the most represented in men (50.3%; p = 0.019), while jumping from a height was more represented in women (29.7%, p = 0.028). Drugs of abuse were the most frequent toxics found in men (55.5%; p < 0.001), while medicines were the most frequent type found in women (70.3%, p < 0.001). Alcohol, nordiazepam, cocaine, and venlafaxine were the most consumed toxics. Benzodiazepines and venlafaxine were found in suicides involving drug overdose, hanging, and jumping from a height. In conclusion, most suicides were associated with drug abuse in men. Hanging was more represented in men and jumping from a height in women. Alcohol was present in combination with other toxics and medicines. The toxicological analysis is fundamental to understanding consumption patterns and establishing strategies and protocols for detecting and preventing suicide.
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Affiliation(s)
- Aurelia Collados-Ros
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Carmen Torres-Sánchez
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
- Pathology Service, Institute of Legal Medicine and Forensic Sciences, 30100 Murcia, Spain
| | - María Dolores Pérez-Cárceles
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Aurelio Luna
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Isabel Legaz
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
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Suicidal ideation, plans, and attempts and the use of psychoactive substances by adolescents. CURRENT PROBLEMS OF PSYCHIATRY 2022. [DOI: 10.2478/cpp-2021-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: Suicidal behavior and substance abuse constitute a serious public health problem.
Aim: The study was to analyze the relationships between suicidal behaviors (ideation, plans, attempts) and substance abuse in adolescents. The authors also took into account the respondents’ motivation to attempt suicide and use psychoactive substances, as well as some demographic variables.
Participants: The study involved 3493 secondary school students aged 16-17 years. The group included 69.41% girls and 30.59% boys.
Methods: The participants were surveyed with a self-report questionnaire designed by one of the authors.
Results: Statistically significant relationships were found between the respondents’ suicidal behaviors and the risky use of alcohol, cannabis, amphetamine, and designer drugs.
Conclusions: 1. The use of psychoactive substances increases the risk of suicidal ideation and plans, as well as suicidal attempts in adolescents and young adults.
2. Significantly more respondents who report suicidal ideation, plans and attempts, in comparison to those who do not report such thoughts and behaviours, abuse alcohol and consumer cannabis, amphetamine and designer drugs to cope with problems and olster self-confidence.
3. In the group of respondents who report suicidal behaviour, psychoactive substances are consumed by significantly more men than women and by significantly more city inhabitants than people living in the country.
4. Young people, who report suicidal thoughts, plans, and attempts, are initiated into alcohol consumption at an earlier age than their non-suicidal peers.
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Marraccini ME, Brick LA, O'Neill JC, Weyandt LL, Buchanan AL. Self-Injurious Thoughts and Behaviors Among College Students: A Latent Class Analysis. Arch Suicide Res 2021; 25:731-750. [PMID: 32233913 PMCID: PMC7529881 DOI: 10.1080/13811118.2020.1746942] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study explored emerging typologies of self-injurious thoughts and behaviors and how they relate to known psychological and cognitive correlates. Latent class analysis was employed to identify subgroups of college students (n = 626, mean age = 20, 73% female, and 83% White) based on history of self-injurious thoughts and behaviors. Differences among classes were tested to examine their associations with suicidal ideation, fearlessness of death, depression/hopelessness, thwarted belongingness, problems with alcohol or drugs, behavioral inhibition, and emotional control. Results of the latent class analysis supported a 3-class solution, with students classified as being likely to have (1) no history of any self-injurious thoughts and behaviors (78%); (2) a history of all self-injurious thoughts and behaviors (8%); or (3) a history of suicidal ideation, plan, and non-suicidal self-injurious thoughts and behaviors, but not suicide attempt (13%). Findings examining correlates of self-injurious thoughts and behaviors highlight the importance of fearlessness of death for distinguishing suicide attempters from non-attempters. Attention to mental health and suicide prevention initiatives should remain a critical priority across college campuses.
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Le TM, Wang W, Zhornitsky S, Dhingra I, Chen Y, Zhang S, Li CSR. The Neural Processes Interlinking Social Isolation, Social Support, and Problem Alcohol Use. Int J Neuropsychopharmacol 2020; 24:333-343. [PMID: 33211853 PMCID: PMC8059487 DOI: 10.1093/ijnp/pyaa086] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/19/2020] [Accepted: 11/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Subjective feeling of social isolation, as can be measured by perceived burdensomeness (PB), is a major risk factor for alcohol misuse. Heightened PB is associated with elevated stress response and diminished cognitive control, both of which contribute to problem drinking. Here, we sought to identify the neural substrates underlying the relationship between PB and alcohol misuse. METHODS We employed resting-state functional magnetic resonance imaging data collected from 61 problem drinkers to characterize the functional connectivity of the hypothalamus and ventral striatum (VS) in relation to PB. We specifically examined whether the connectivities of the hypothalamus and VS were differentially influenced by PB to produce contrasting effects on alcohol use. Finally, we evaluated how individual differences in social support modulate the inter-relationships of social isolation, neural connectivity, and the severity of problem drinking. RESULTS Whole-brain multiple regressions show a positive relationship between PB and hypothalamic connectivity with the hippocampus and an inverse pattern for VS connectivity with the middle frontal gyrus. Difference in strength between the 2 connectivities predicted the severity of problem drinking, suggesting an imbalance involving elevated hypothalamic and diminished prefrontal cortical modulation in socially isolated problem drinkers. A path analysis further revealed that the lack of social support was associated with a bias toward low prefrontal connectivity, which in turn increased PB and facilitated problem drinking. CONCLUSIONS Altered hypothalamus and VS connectivity may underlie problem drinking induced by social isolation. The current findings also highlight the important role of social support as a potential protective factor against alcohol misuse.
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Affiliation(s)
- Thang M Le
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA,Correspondence: Thang M. Le, PhD, Connecticut Mental Health Center, S105, 34 Park Street, New Haven, CT 06519-1109, USA ()
| | - Wuyi Wang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Isha Dhingra
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yu Chen
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sheng Zhang
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Chiang-Shan R Li
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA,Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, Connecticut, USA
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Paulus DJ, Capron DW, Zvolensky MJ. Understanding hazardous drinking and suicidal ideation and suicide risk among college students: anxiety sensitivity as an explanatory factor. Cogn Behav Ther 2020; 50:378-394. [DOI: 10.1080/16506073.2020.1840622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Daniel J. Paulus
- Department of Neuroscience, Medical University of South Carolina, Charlestion, SC, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Daniel W. Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Health Institute, University of Houston, Houston, TX, USA
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