Victimization, Suicidal Ideation, and Alcohol Use From Age 13 to 15 Years: Support for the Self-Medication Model

PURPOSE

Recent years have seen increased coverage of adolescent victimization and suicide. Both adolescent peer victimization and substance use have been associated with suicidal ideation, with evidence suggesting that all three factors are interrelated. There are at least four models which can explain the associations between these factors (i.e., self-medication, secondary mental disorder, bidirectional, and common factor). However, none of them is being empirically supported as the dominant model because few longitudinal studies have explored the association between these factors.

METHODS

The present study compared longitudinal paths of all four models simultaneously using a cross-lagged model. This was done using self-reported measures of peer victimization, suicidal ideation, and alcohol use at age 13, 14, and 15 years in a longitudinal sample of 238 adolescents.

RESULTS

All three variables were moderately stable across time. Significant cross-lagged associations were found, showing that frequent peer victimization at age 13 years was associated with higher odds of having suicidal ideation at age 14 years (odds ratio, 1.82; p < .05). In turn, presence of suicidal ideation at age 14 years was significantly associated with higher alcohol use frequency at age 15 years (β = .13; p < .05).

CONCLUSIONS

Results support previous literature suggesting that peer victimization predates alcohol use and extends it by showing clear directionality between suicidal ideation and alcohol use over 1 year, supporting the self-medication model. Clarifying the empirical basis of these underlying models could allow for earlier prevention strategies, by targeting the risk factor that appears the earliest in the model.

Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample

This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.