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Suicidal ideation and substance use among adolescents and young adults: a bidirectional relation?

ABSTRACT: To examine reciprocal associations between substance use (cigarette smoking, use of alcohol, marijuana, and other illegal drugs) and suicidal ideation among adolescents and young adults (aged 11-21 at wave 1; aged 24-32 at wave 4).Four waves public-use Add Health data were used in the analysis (N=3342). Respondents were surveyed in 1995, 1996, 2001-2002, and 2008-2009. Current regular smoking, past-year alcohol use, past-year marijuana use, and ever use of other illegal drugs as well as past-year suicidal ideation were measured at the four waves (1995, 1996, 2001-2002, and 2008-2009). Fixed effects models with lagged dependent variables were modeled to test unidirectional associations between substance use and suicidal ideation, and nonrecursive models with feedback loops combining correlated fixed factors were conducted to examine reciprocal relations between each substance use and suicidal ideation, respectively.After adjusting for the latent time-invariant effects and lagged effects of dependent variables, the unidirectional associations from substance use to suicidal ideation were consistently significant, and vice versa. Nonrecursive model results showed that use of cigarette or alcohol increased risk of suicidal ideation, while suicidal ideation was not associated with cigarette or alcohol use. Reversely, drug use (marijuana and other drugs) did not increase risk of suicidal ideation, but suicidal ideation increased risk of illicit drug use.The results suggest that relations between substance use and suicidal ideation are unidirectional, with cigarette or alcohol use increasing risk of suicidal ideation and suicidal ideation increasing risk of illicit drug use.

SUBMITTER: Zhang X

PROVIDER: S-EPMC4129651 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Suicidal ideation and substance use among adolescents and young adults: a bidirectional relation?

Zhang Xiaoyun X Wu Li-Tzy LT

Drug and alcohol dependence 20140612

<h4>Objective</h4>To examine reciprocal associations between substance use (cigarette smoking, use of alcohol, marijuana, and other illegal drugs) and suicidal ideation among adolescents and young adults (aged 11-21 at wave 1; aged 24-32 at wave 4).<h4>Methods</h4>Four waves public-use Add Health data were used in the analysis (N=3342). Respondents were surveyed in 1995, 1996, 2001-2002, and 2008-2009. Current regular smoking, past-year alcohol use, past-year marijuana use, and ever use of other ...[more]

PMID: 24969957

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Project description:OBJECTIVE::To examine sex differences in the association between cyberbullying victimization and mental health (psychological distress and delinquency), substance use-related outcomes (drug and tobacco use, binge drinking), and suicide ideation among adolescents. METHOD::Data were obtained from the Ontario Student Drug Use and Health Survey (OSDUHS; 2013, N=10,272, grade 7 to 12). The sample for analysis included 4,940 students with a mean age of 15.1 years (43.3% male). A series of multi-level, binary, logistic regression models were conducted separately for female and male adolescents to quantify the strength of associations between cyberbullying victimization and study outcomes, after accounting for traditional forms of bullying and demographic covariates. RESULTS::Female adolescents reported significantly higher prevalence of cyberbullying victimization (once, 9.4%; twice or more, 13.3%) as compared with male adolescents (once, 8.3%, twice or more, 7.8%). Exposure to cyberbullying victimization was associated with an increased odds for psychological distress, suicide ideation, and delinquency among both female and male adolescents (adjusted odds ratios ranged from 1.76 to 4.63); although, the effects were more pronounced in females. Among females, but not males, the odds of reporting psychological distress, suicide ideation, and delinquency increased (in a step-wise fashion) with more frequent exposure to cyberbullying victimization. Cyberbullying victimization was associated with an increased odds of adolescent substance use only among females. CONCLUSION::Adolescents exposed to cyberbullying victimization demonstrate an increased odds of poorer mental health, substance use outcomes, and suicide ideation. The current study reveals increased risk among female adolescents as compared with male adolescents. These findings lend support for the need to develop and evaluate targeted preventative interventions specifically tailored for female and male adolescents.

Project description:BackgroundIdentifying proximal risk factors for suicidal ideation that are modifiable and relevant for adolescents and young adults is critical for suicide prevention. This study used an intensive monitoring approach to examine whether objectively- and subjectively- measured sleep characteristics predict next-day suicidal ideation occurrence and intensity through affective reactivity to interpersonal events in young people at high risk for suicide.MethodsParticipants included 59 (13-23 years; 76% White; 75% female) adolescents and young adults undergoing intensive outpatient program treatment for depression and suicidality. Participants completed daily ratings of suicidal ideation, sleep quality, and affective reactivity to positive and negative interpersonal events for up to 3 months (M = 56 days, SD = 24.13). Actigraphy captured behavioral sleep duration and timing. Multilevel modeling was used to evaluate within-person fluctuations in sleep and affective reactivity as predictors of suicidal ideation, and multilevel mediation tested the indirect effects of sleep on suicidal ideation via affective reactivity to interpersonal events.ResultsResults indicate significant indirect effects of objectively measured sleep duration and subjective sleep quality on next-day suicidal ideation via affective reactivity to negative and positive interpersonal events, respectively. Shorter-than-usual sleep predicted the presence and intensity of next-day suicidal ideation via heightened affective reactivity to negative interpersonal events. Worse sleep quality than usual predicted next-day suicidal ideation via reduced affective reactivity to positive interpersonal events.ConclusionsAffectivity reactivity is a proximal mechanism through which sleep indices may influence risk for suicidal thinking on a daily basis. Findings highlight the utility of targeting sleep and emotion regulation in suicide prevention among adolescents and young adults at high-risk for suicide.

Dataset Information

Suicidal ideation and substance use among adolescents and young adults: a bidirectional relation?

Publications

Suicidal ideation and substance use among adolescents and young adults: a bidirectional relation?

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