Alcohol Misuse and Suicidal Thoughts and Behaviors Among Youth: Proximal Associations and Mechanisms of Risk

About This Grant

PROJECT SUMMARY/ABSTRACT The association between alcohol misuse and suicide risk among youth has been widely established; however, how these two high-risk behaviors relate to one another in the short-term is relatively unexplored. Given that young adulthood is marked by precipitous rise in heavy drinking and STBs, understanding the proximal relationship between alcohol misuse and STBs is critical. Research examining risk for suicide and alcohol misuse has focused largely on long-term risk, with limited empirical investigations of short-term predictors of suicide or alcohol misuse among youth in vulnerable periods or the common mechanisms and contexts that may explain the relationship. Executive functioning (EF) deficits and interpersonal stressors are posited to be related to increased alcohol misuse and STBs among youth; however, no study has examined these constructs in real time as they relate to both alcohol misuse and STBs. Further, interpersonal stress has been found to negatively affect EF capabilities; yet, no research to date has examined whether EF, particularly in the context of interpersonal stress, is related alcohol misuse and STBs among youth. To this end, the proposed career development award seeks to address an important gap in current research by examining EF deficits, interpersonal stress and the relationship between alcohol misuse and STBs in real time. Participants (N = 90) presenting to two Emergency Departments with recent STBs and alcohol misuse will complete an initial assessment followed by a 30-day ecological momentary assessment (EMA) protocol. The proposed training plan closely aligns with the research goals of this project, and includes (1) achieving expertise in alcohol research; (2) acquiring necessary skills in EMA and applying of advanced analytic approaches to intensive longitudinal data; (3) developing proficiency in the administration and interpretation of ambulatory and stress- induced assessment of EF; and (4) progress towards scientific independence. The mentorship team has expertise in research in youth alcohol misuse with translational implications (Dr. David Goldston), EMA data collection among high-risk youth (Drs. Richard Liu and Evan Kleiman), multi-level modeling for intensive longitudinal data (Drs. Evan Kleiman and David Yanez) and stress-induced and ambulatory assessment of executive function (Drs. Laura Germine and Richard Liu). This application has important clinical implications, as findings from this study may identify intervention targets (e.g. stress-sensitive EF capabilities) for reducing risk for both alcohol misuse and STBs, as well as particular short-term contexts in which both high-risk behaviors are imminently likely (e.g. following interpersonal stress). Thus, the proposed study has potential to inform future research studies examining state-sensitive mechanisms underlying alcohol misuse and STB risk among youth.