Suicide Ideation Among US College Students Associations With Other Injury Risk Behaviors

Abstract

Suicide, the endpoint of a continuum that begins with suicide ideation, is the third leading cause of death among the US college-aged population. The first and second leading causes of death among this age group, unintentional injury and homicide, may also be linked to suicide ideation. We used data from the National College Health Risk Behavior Survey to examine the association between suicide ideation and injury-related behaviors among 18- to 24-year-old college students. Students who reported suicide ideation were significantly more likely than students who did not report considering suicide to carry a weapon, engage in a physical fight, boat or swim after drinking alcohol, ride with a driver who had been drinking alcohol, drive after drinking alcohol, and rarely or never used seat belts. Given this clustering of injury-related risk behaviors, college prevention programs should aim to reduce risks for injuries comprehensively, rather than addressing each risk behavior separately.     

The personal protective behaviors of college student drinkers: evidence of indigenous protective norms

Given the prevalence of alcohol consumption and the relative infrequency of harm among college students, the authors sought to determine how most college students protect themselves from alcohol-related harm. An analysis of the aggregate National College Health Assessment data identified a cluster of personal protective behaviors that correlated with reduced risk when drinking. Further analysis revealed that nearly three-quarters of student drinkers regularly employ at least 1 protective behavior, and well over half of the students who use protective behaviors routinely employ 2 or more. In addition, the data reveal that student drinkers employ situational abstinence, with nearly 7 out of 10 students reporting that they sometimes or usually refrain from drinking alcohol when they socialize. The use of these protective behaviors is a strong predictor of safety and harm for college-student drinkers.     

Prevalence and predictors of suicidal ideation,plan, and attempts,in first-year college students with ADHD

Abstract

Objective. The present study evaluated the prevalence of past suicidal ideation (SI), plan, and attempt in college students with ADHD (N?=?102) compared to a matched control (N?=?102). Predictors of SI, plan, and attempts, were examined. Participants. Study participants were first year college students at a large Southeastern university who completed measures during August or September of 2014 or January of 2015. Methods. Measures were completed by first year students via an online survey. Results. Prevalence rates for SI and related behaviors were higher among the ADHD group than the matched control, with suicide attempts rates four times higher in the ADHD group (13.7% vs. 2.9%). Results showed that ADHD predicted rates of SI and suicide attempt accounting for depression and key demographic variables. Conclusions. Findings have implications for suicide risk assessments conducted with college students with ADHD.     

Validation of a measure of college students' intoxicated behaviors: associations with alcohol outcome expectancies, drinking motives, and personality

OBJECTIVE: The authors aimed to develop a measure of college students' intoxicated behaviors and to validate the measure using scales assessing alcohol outcome expectancies, motives for drinking, and personality traits. PARTICIPANTS AND METHOD SUMMARY: The authors administered these measures and an inventory describing 50 intoxicated behaviors to 198 college students and conducted factor analysis on intoxicated behaviors. Logistic regression models examined relationships between intoxicated behavior dimensions and expectances, motives, and personality traits. RESULTS: Self-reported behaviors during intoxication episodes were reducible to 3 basic dimensions that formed reliable and valid scales: social, antisocial, and emotionally labile intoxication. CONCLUSIONS: Researchers can use the Intoxicated Behaviors Inventory to evaluate the effectiveness of interventions targeting drinking or to identify college students at risk for problematic consequences of alcohol use. In addition, results point to the need for community efforts to encourage more moderate drinking among college students.     

Suicide Ideation Among College Students Evidencing Subclinical Depression

Abstract

Identifying elevated suicide ideation in college students is a critical step in preventing suicide attempts and deaths by suicide on college campuses. Although suicide ideation may be most prominent in students with severe depression, this should not suggest that only students with severe depression experience significant risk factors for suicide. Objective: The purpose of these 3 studies was to explore the relation between suicide ideation and severity of depressive symptoms in college students. Participants: In each study a sample of college students were recruited for participation. Methods: Participants completed self-report assessments of depressive symptoms and suicide ideation. Results: The results of these studies suggest that although the greatest elevation in suicide ideation occurs at the highest depressive symptoms, significant suicide ideation is also experienced by college students with mild and moderate depressive symptoms. Conclusions: The implications of these findings for the assessment of suicide ideation are discussed.     

Use of Drinking Protective Behavioral Strategies and Sexual Perceptions and Behaviors in U.S. College Students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.     

Sexual risk behaviors and alcohol: Higher base rates revealed using the unmatched‐count technique

HIV/AIDS is a disease whose only known prevention is behavioral. Risky sex is one of the ways in which people become infected with HIV, as well as other STDS. Estimating the base rates of risky sex and risky sex after drinking proves difficult. This study uses the unmatched‐count technique (UCT) to estimate base rates for sexual risk behaviors and sexual risk behaviors after drinking and compares the findings with those estimates found using conventional methods. UCT does not require the participant to directly answer sensitive questions, and, thus, may provide more accurate reporting than other methods. In a population of college students, the UCT revealed higher estimates of base rates for having had sex, having had sex without a condom, and having had sex without a condom after drinking than an anonymous self‐report survey. These higher estimates provide a better feel for the level of these risk behaviors, may help understand the relationship between alcohol and risky sex, and point to the need to target more interventions for condom use and condom use in the presence of drinking among college students.     

Spiritual Well-Being and Suicidal Ideation Among College Students

Objective: This study explored whether specific dimensions of spiritual well-being (religious well-being and existential well-being) relate to reduced suicidal ideation, and whether associations persisted after controlling for religiosity and psychosocial variables associated with suicide. Participants: Participants were 457 college students who completed measures that assessed spiritual well-being, religiosity, hopelessness, depression, social support, and suicidal ideation. Methods: The authors used linear regression modeling to assess religious and spiritual correlates of suicidal ideation. Results: After controlling for demographic variables and psychosocial factors, neither involvement in organized religion nor religious well-being significantly contributed to suicidal ideation. However, even after controlling for significant correlates, existential well-being remained a significant predictor of suicidal ideation. Conclusions: This investigation highlighted existential well-being as an important factor associated with lower levels of suicidal ideation among college students. Findings from this study focusing on the association between spiritual well-being and suicidality may prove especially beneficial to suicide prevention efforts.     

Correction of normative misperceptions: an alcohol abuse prevention program.

Normative misperception refers to the tendency of college students to misperceive campus drinking norms to be more liberal than they actually are. Initial investigations have demonstrated the effectiveness of normative education on reduction of alcohol use in primary and secondary education settings. This study examined the utility of a group program designed to challenge seventy-one male college students' misperceptions of college drinking norms. Participants were enrolled into either a normative education group or a control group representing traditional alcohol education efforts. Participants in the normative education groups demonstrated more accurate perceptions of campus drinking norms and a significant reduction in consequences of alcohol use while those in the control group did not. Changes in normative perceptions were among the strongest contributors to a function discriminating between those who decreased their drinking and those who did not. Results suggest that normative education may be an effective approach to modifying drinking behaviors.     

Increased risk of alcohol abuse among college students living on the US-Mexico border: implications for prevention

Alcohol abuse is a serious problem for students on college campuses. The authors conducted a cross-sectional study to (1) compare measures of alcohol-risk behaviors among college students attending a university on the US-Mexico border with other students and (2) identify factors associated with risk behaviors among border students. They used a self-administered survey to collect data from 286 freshman and sophomore students. Rates of binge drinking were higher among study respondents than among respondents in a national survey of freshman and sophomore college students (46% vs 42% to 45%, respectively). Drinking in high school and drinking in Mexico were significantly associated with all outcomes (binge drinking, drinking and driving, and riding with a drinker). The findings underscore the need for targeted prevention programs among this high-risk population.     

The Role of Monthly Spending Money in College Student Drinking Behaviors and Their Consequences

Objective: Alcohol use among college students is pervasive and affected by economic factors such as personal income and alcohol price. The authors examined the relationship among students' spending money, drinking rate, and alcohol-related consequences.

Participants: In 2005, the authors conducted a Web-based survey among a random sample of 3,634 undergraduate students from 2 large universities.

Methods: The authors used multiple logistic regression to model drinking behaviors and multiple linear regression to model alcohol-related consequences.

Results: The lowest reported levels of average monthly spending money were associated with reduced levels of drinking and getting drunk. Spending money was independently associated with experiencing alcohol-related consequences caused by a student's own drinking, even after the authors controlled for personal drinking behaviors. The effects for consequences caused by others' drinking were significant for students who had gotten drunk.

Conclusions: These findings have implications for alcohol price and marketing, particularly around colleges, and suggest actions for parents to consider.     

The effects of familial acculturative stress and hopelessness on suicidal ideation by immigration status among college students

Objectives: Based on acculturative family distancing theory, we examined whether familial acculturative stress interacted with hopelessness to predict suicidal ideation differentially among emerging adult immigrant versus nonimmigrant college students. Participants: We recruited 152 generationally and racially/ethnically diverse college students (42 immigrants) from 2012 to 2013. Methods: Participants completed measures of hopelessness, depressive symptoms, ethnic identity, familial acculturative stress, and suicidal ideation. Results: Immigrant status interacted with hopelessness and familial acculturative stress. Hopelessness was associated with less suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score below the 11th percentile, but greater suicidal ideation among immigrants than among nonimmigrants at a familial acculturative stress score above the 72nd percentile. Conclusions: Familial acculturative stress may exacerbate the effect of hopelessness on suicidal ideation among immigrant college students, and should be monitored during suicide risk assessment and treatment.     

Suicidality among homeless people: Testing the mediating effects of self-efficacy and depression

ABSTRACT

This cross-sectional study examined the mediating effect of PTSD on suicide ideation and suicide attempt through two mediators, self-efficacy and depression, among homeless adults. We recruited a non-random, purposive sample of 156 homeless adults from seven homeless people shelters in Kansas. SEM results suggest that self-efficacy and depression were significant mediators between PTSD and suicide ideation, but not between PTSD and suicide attempt. This study’s findings can be used to identify risk factors associated with suicidal behaviors that can be used to design service programs aimed at preventing suicidal ideation and attempt among people who are homeless.     

Heavy alcohol use compared to alcohol and marijuana use: do college students experience a difference in substance use problems?

This study examines the risk for alcohol and other drug (AOD) problems resulting from alcohol plus marijuana use compared to alcohol-only use. Data are from telephone interviews with 1113 randomly selected college students attending two large urban universities in the southwestern United States. Alcohol and marijuana users (dual users) were more likely to be younger and report a higher mean number of drinks per occasion and experiencing all AOD problems studied compared to alcohol-only users. Multivariate logistic regression analysis findings reveal the relationship between dual-substance use and increased risk for AOD problems remained after controlling for demographics and alcohol use behaviors. Such problems include greater odds of legal problems and riding with or being an intoxicated driver. College students using alcohol and marijuana are at much higher risk for AOD problems than are students who use alcohol only, even when heavy drinking is taken into account.     

Positive Social Support,Negative Social Exchanges,and Suicidal Behavior in College Students

Abstract

Objective: Risk for suicide is often higher among college students, compared to same-age noncollegiate peers, and may be exacerbated by quality of social support and interactions. The authors examined the independent contributions of positive social support and negative social exchanges to suicide ideation and attempts in college students. Participants: Participants were 439 volunteer undergraduate students, who were primarily female (71%). Methods: Cross-sectional, survey design. Participants completed measures assessing positive social support, including emotional, informational, and tangible support; negative social exchanges; and suicidal behavior, including ideation and attempts. Results: Positive social support, particularly tangible support, and negative social exchanges were significantly predictive of greater suicidal behavior. Conclusions: Practical manifestations of support may buffer against suicide risk for college students, whereas conflict-based interactions may contribute to increased risk. At the institutional, parental, and peer levels, promotion of supportive relationships may be an important suicide prevention strategy.     

Knowledge of Suicide Risk Factors,But Not Suicide Ideation Severity,Is Greater Among College Students Who Viewed 13 Reasons Why

Abstract

Objective: To test associations between viewing 13 Reasons Why, Season 1 and past week suicide ideation severity, behavior risk, stigma, and knowledge in college students. To explore whether personal exposure to suicide and depressive symptom severity moderated these associations. Participants: Eight-hundred and eighteen college students, 64% (n?=?522) of whom watched 13 Reasons Why. Methods: Students completed surveys online. Multivariate negative binomial regressions were used to test associations between watching 13 Reasons Why and suicide-related variables, and interaction terms. Results: Suicide ideation severity and suicide behavior risk were not significantly associated with viewing 13 Reasons Why; however, there was limited statistical power to detect associations. The association between watching 13 Reasons Why and greater suicide knowledge was stronger among those who did not have personal exposure to suicide. Conclusions: 13 Reasons Why may be a platform for psychoeducation on suicide, particularly among those who do not have personal exposure.     

Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

Factors associated with emotional distress and suicide ideation among international college students

Abstract

Objective: To identify risk and protective factors associated with greater emotional distress and suicide ideation among international college students. Participants: International students (n?=?435) from two Midwestern and two Southeastern universities in the US. Methods: Online surveys were administered that measured emotional distress, past-year suicide ideation, entrapment, cultural stress, family conflict, perfectionism, ethnic discrimination, interpersonal needs, ethnic identity, and cultural sanctions against suicide. Results: In final linear regression analyses, higher levels of entrapment, unmet interpersonal needs, and ethnic discrimination were significantly associated with increased emotional distress. Only unmet interpersonal needs remained significantly associated with greater past-year suicide ideation in a multivariate regression analysis. Conclusions: Clinicians working with international students and prevention programmers targeting this population should address students’ perceptions of entrapment, ethnic discrimination, and especially unmet interpersonal needs in efforts to decrease or prevent students’ feelings of emotional distress and suicide ideation.     

Date fighting experiences among college students: are they associated with other health-risk behaviors?

OBJECTIVE: The authors examined the clustering of health-risk behaviors among college students who reported date fight involvement. PARTICIPANTS AND METHODS: The authors administered a Web-based survey to a stratified random sample of 3,920 college students from 10 universities in North Carolina. RESULTS: Among men, 5.6% reported date fight victimization, and 1% reported date fight perpetration. Victimization among men was associated with (1) first drink at age 15 years or younger, (2) a recent threat of violence by someone who had been drinking, (3) smoking, (4) amphetamine use, and (5) older age. Among women, 6.7% reported date fight victimization, which was associated with (1) older age, (2) assault from a student who had been drinking, (3) sex with 2 or more persons, (4) consumption of alcohol in high school, (5) illegal drug use, (6) nonsexual assault requiring medical treatment, and (7) living off campus. Of the women, 4.2% reported date fight perpetration, which was associated with (1) minority race/ethnicity, (2) older age, (3) frequency of sexual intercourse, and (4) alcohol and marijuana use. CONCLUSIONS: Date fight experiences were associated with multiple health-risk behaviors among this sample of college students.     

The Co-Occurrence of Alcohol Use and Gambling Activities in First-Year College Students

Objective: Both alcohol use and gambling are behaviors that can be problematic for many college students; however, it is not clear whether the relationship between the 2 exists for students who have recently entered college.

Participants: The sample included 908 first-year college students who were surveyed in fall 2005, approximately 1 month after entering college.

Methods: Participants completed Web-based surveys on alcohol use and gambling behaviors.

Results: Alcohol use and alcohol-related risks were significantly related to both gambling frequency and peak gambling loss.

Conclusions: These findings have implications for researchers and clinicians working in the area of addictive behaviors among college students, suggesting that those presenting with problems in 1 domain may also be at risk for problems in the other.