Category: Suicide and Self-Injury
Problem: Alcohol dependence and suicide are major public health problems (Kochanek, et al., 2016). The relationship between alcohol dependence and suicidal ideation is partially mediated by emotional impulsivity (Norwood et al., 2016). The goal of the current study was to investigate other factors that might explain the relationship between alcohol dependence and suicide. Research suggests that socially avoidant individuals tend to drink to cope with negative emotions (Stewart et al., 2006) and that social avoidance is a risk factor for suicide (Joiner & Van Orden, 2008). In addition, research suggests that depression is positively related to alcohol use (Pierce et al., 2000) and puts someone at risk for suicide (Brown et al. 2000). There is also evidence that affect intensity influences drinking habits (Veilleux et al., 2014) and predicts suicide (Hendin et al., 2010). We hypothesized that affect intensity, social avoidance, and the fear of depression would help explain the relationship between alcohol dependence and suicidal ideation.
Method: Data were analyzed from 232 undergraduate students from a Midwestern university who filled out questionnaires including The Suicidal Behaviors Questionnaire (SBQ; Linehan, & Nielsen, 1981), the alcohol dependence subscale of the Alcohol Use Disorders Identification Test (AUDIT; Saunders et al., 1993), the social avoidance subscale of the Inventory of Interpersonal Problems (IIP; Alden et al., 1990), the negative reactivity and negative intensity subscales of the Affect Intensity Measure (AIM; Larsen & Diener, 1987), and the fear of depression subscale of the Affective Control Scale (ACS; Berg et al., 1998).
Results: The bootstrapping method developed by Preacher & Hayes (2008) was used to test our hypothesis. We found that the social avoidance and fear of depression subscales were significant mediators of the relationship between alcohol dependence and suicidal ideation, B=0.08, CI=0.013 to 0.26 and B=0.49, CI= 0.25 to 0.89, respectively. The negative intensity and negative reactivity subscales of the AIM were not significant mediators of the relationship, B=0.01, CI= -0.03 to 0.10 and B=0.04, CI= -0.03 to 0.19, respectively.
Discussion: Our results indicate that social avoidance and the fear of losing control when depressed partially explain the relationship between alcohol dependence and suicidal ideation. The fear of depression may lead individuals to avoid symptoms through both alcohol abuse and engaging in suicidal ideation. Further, social avoidance may also be an important variable in the relationship between alcohol dependence and suicidal ideation, as individuals may look to both as isolated ways to cope with potentially challenging affective states such as depression.