Proximal Associations of Alcohol Use with Suicidal Ideation and Behaviors in College Students

Despite the high levels of alcohol use among college students, the proximal role it plays in the development of suicide risk is not well understood. A theory-guided understanding of the connection between alcohol use and suicide risk, such as that afforded by the interpersonal-psychological theory of suicide and alcohol myopia model, will advance efforts to prevent this leading cause of death in college students. The present dissertation is the first to test an integration of these theories. Using a repeated measures design, daily data on alcohol use and suicidal ideation and behaviors (aborted, interrupted, and actual attempts) were collected from 206 (150 women, 53 men, 3 “Other”) college students over 90 days. Participants completed 7,342 (39.6%) of the 18,540 surveys sent. Hypotheses were generally not supported. Alcohol use (drinking day, binge drinking day, number of drinks) was negatively associated with suicidal ideation, and the hypothesized three-way interaction among perceived burdensomeness, thwarted belongingness, and alcohol was not significant. Drinking occurring on a given day was positively associated with daily acquired capability; however, such capability did not mediate the relation between drinking day and suicidal behavior. Finally, suicidal ideation and drinking day positively associated with suicidal behavior; however, the hypothesized interaction between acquired capability and suicidal ideation was not associated with suicidal behavior. These results provide no evidence that alcohol use amplifies the effects of unmet interpersonal needs on suicidal ideation, but alcohol use is associated with increased acquired capability and suicidal behavior. Furthermore, the tenets of the interpersonal psychological theory were not replicated in this study. These findings may be sample-specific given that the participants were young and in college. Additional tests of this model in different samples are needed.