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Effectiveness of intensive case management for substance-dependent women receiving temporary assistance for needy families. American Journal of Public Health, 96 11 , Children of substance abusing women on federal welfare: Implications for child well-being and TANF policy. Journal of Human Behavior in the Social Environment, 12 , Coombs Ed.

Dealing effectively with substance use problems among mothers on welfare. Connection, Academy Health, Barriers to employability among substance dependent and non-substance-affected women on federal welfare: Implications for program design. Journal of Studies on Alcohol, 64 2 , A new treatment model for substance-abusing parenting women on welfare.

Evaluation Review, 27 6 , Examining mechanisms of action in step community outpatient treatment. Drug and Alcohol Dependence, 72 3 , James, S. The violent matrix: A study of structural, interpersonal, and intrapersonal violence among a sample of poor women. American Journal of Community Psychology, 31 , Motivated closed mindedness and the emergence of culture.

Crandall Eds. Mahwah, NJ: Earlbaum. McLellan, A. Examining mechanisms of action in step treatment: The role of step cognitions. Journal of Studies on Alcohol, 63 6 , Cultural and familial influences that maintain the negative meaning of alcohol. Journal of Studies on Alcohol, 13 Suppl. Woolis, D.

Learning our way through welfare reform. Policy and Practice of Public Human Services, 59 2 , Substance abuse is responsible for child abuse. Journal of Psychoactive Drugs, 31 3 , Delivering comprehensive services to high-risk African American males. Davis Ed. Working with African American males: A guide to practice Family works: Substance abuse treatment and welfare reform. Public Welfare, 56 1 , Kraus, S. Should compulsive sexual behavior be considered an addiction? Addiction, , Seo, D.

Gender-related differences in neural correlates of stress-induced anxiety. Journal of Neuroscience Research, 95 , Anticipatory reward processing among cocaine-dependent individuals with and without concurrent methadone-maintenance treatment: Relationship to treatment response. Karaka, S. International Journal of Mental Health and Addiction. Wilkinson, S. Marijuana legalization: Impact on physicians and public health. Annual Review of Medicine, 67 , Neurobiology of compulsive sexual behavior: Emerging science. Neuropsychopharmacology, 41 , Kim, S. Annals of the New York Academy of Sciences.

Balodis, I. Neurofunctional reward processing changes in cocaine dependence during recovery. Neuropsychopharmacology, 41 8 , Banz, B. Behavioral addictions in addiction medicine: From mechanisms to practical considerations. Progress in Brain Research, , Thompson, A. Does learning about race prevent substance abuse? Racial discrimination, racial socialization and substance use among African Americans.

Mei, S. Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China. Addictive Behaviors, 61 , Dong, G. Risk-taking and risky decision-making in Internet gaming disorder: Implications regarding online gaming in the setting of adverse consequences. Journal of Psychiatric Research, 73 , Morie, K. Current Addiction Reports,3 2 , Short-term Internet-search practicing modulates brain activity during recollection. Neuroscience, , Addict Behav. Garrison, K. Functional connectivity during exposure to favorite-food, stress, and neutral-relaxing imagery differs between smokers and non-smokers.

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Drug and Alcohol Dependence. Prenatal cocaine exposure, illicit substance use, and stress and craving processes during adolescence: Relationship to treatment response. Rutherford, H. Investigating maternal brain structure and its relationship to substance use and motivational systems.

Importance of sex differences in impulse control and addictions. Frontiers in Psychiatry. Hartman, S. Impact of baseline BMI upon the success of Latina participants enrolled in a 6-month physical activity intervention. Journal of Obesity , doi: Epub Nov Prescription medication abuse and illegitimate internet-based pharmacies. Annals of Internal Medicine, 12 , When technology fails: Getting back to nature. Clinical Psychology, 17 1 , Pekmezi, D. A culturally adapted physical activity intervention for Latinas: A randomized controlled trial. American Journal of Preventive Medicine, 37 6 , Leisure-time physical activity disparities among Hispanic subgroups in the United States.

American Journal of Public Health, 98 8 , — Clark, M. Strategies and cost of recruitment of middle-aged and older unmarried women in a cancer screening study. Cancer Epidemiology, Biomarkers and Prevention, 16 12 , Medical Care, 45 7 , Democracy and political corruption: A cross-national comparison. Crime, Law and Social Change, 41 2 , State failure, economic failure, and predatory organized crime: A comparative analysis.

Journal of Research in Crime and Delinquency, 41 2 , Wainberg, M. Science and the Nuremburg Code: A question of ethics and harm commentary on Spitzer, Archives of Sexual Behavior, 32 5 , Fairer sex or fairer system? Gender and corruption revisited. Social Forces, 82 2 , Understanding how optimism works: An examination of optimists' adaptive moderation of belief and behavior.

In Edward C. Chang Ed. J ournal of Gender, Culture and Health, 4 3 , Johnson, H. Glassman, M. Journal of Gender, Culture and Health, 4 1 , The moderating effects of gender and ethnicity on the relationship between effect expectancies and alcohol problems. J ournal of Studies on Alcohol, 60 1 , The wrong way to stay slim. New England Journal of Medicine , 18 , This information will be used to better customize your experience and help inform future tools and features on our website. What is Risky Substance Use? Reports Journals Books.

Search keyword. Items per page 5 10 20 40 Families and Children. Fisher, J. Desrosiers A. Feinstein, E. Annunziata, D. Samuolis, J. Sung, H. Califano, J. Faw, L. If you would like a copy of this book chapter please contact us at American Journal of Orthopsychiatry, 71 2 , Foster, S. No place to hide: Youth substance abuse in rural America Paradigm, 4 4 , If you would like a copy of this article please contact us at Sprott, J.

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Back to top. Grilo, C. M, Grilo, C. Foote, J. Case of malignant neglect: Substance abuse and America's schools. Union Signal, 78 1 , Winning at any cost: Doping in Olympic sports. Sports Technology, Summer, Tapper, D. Kuerbis, A. The last word: Catching up with the science. International Innovation, Leiferman, J. Diamond, G. Pirkle, E. Raghavan, C. Rosenthal, M. Kleber, H. Levin, F. McDowell, D. MDMA: Its history and pharmacology. Psychiatric Annals , 24 3 , Horowitz, H. Belenko, S.

E Recidivism among high-risk drug felons: A longitudinal analysis following residential treatment. Journal of Offender Rehabilitation, 37 , Young, D. Lang, M. Youth crime in the U. Overcrowded Times, 10 5 , 1, 12— Public policy and spending. Foster, W. Gamkhar, S. Drugs and drug policy in America: A documentary history. Westport, CT: Greenwood Press. Merrill, J. Shwartz, M. Carise, D. Doob, A. Fox, K. Public services.

Nakashian, M. Recovery: An act of work. Policy and Practice of Public Human Services, 58 2 , Muffler, J. W, Lacadie, C. M, Sinha, R. Mitchell, M. Jena, A. Does participation in the world economy reduce political corruption? An empirical inquiry. Aspinwall, L. Newsletter Additional Information Thank you for subscribing This information will be used to better customize your experience and help inform future tools and features on our website.

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I am a parent looking for information about raising drug-free kids I am a parent looking for information about raising drug-free kids. I am a policymaker I am a policymaker. Risk for minor childhood injury: An investigation of parent and child factors. Journal of Pediatric Psychology, 30, Similarities and differences of longitudinal phenotypes across alternate indices of alcohol involvement: A methodologic comparison of trajectory approaches. Psychology of Addictive Behavior, 19, Conjoint developmental trajectories of young adult alcohol and tobacco use.

Alan Marlatt and Katie Witkiewitz Eds. Addictive behaviors: New readings on etiology, prevention, and treatment. Monti, P. Adolescence: Booze, Brains, and Behavior. Alcoholism: Clinical and Experimental Research. Piasecki, T. Hangover frequency and risk for alcohol use disorders: Evidence from a longitudinal high-risk study. Prescription privileges for psychologists. Clinical Science, Towards a cognitive theory of substance use and dependence. Wiers and A.

Stacy Eds. New York: Guilford Press. The development of alcohol problems. Annual Review of Clinical Psychology, 1, Drinking after college: The questions of continuity and consequences. Fearnow-Kenney and and D. Wyrick Ed. Lynchburg, VA: Tanglewood Research. Earleywine Ed. New York: Oxford. A parent's nightmare. Review of Paul Raeburn's, "Acquainted with the night: A parent's quest to understand depression and bipolar disorder in his children. Stepp, S. Borderline personality features prospectively predict alcohol use problems.

Journal of Personality Disorders, 19, Gogineni, A. Female offspring of alcoholics: Recent findings on alcoholism and psychopathology risks. Alcoholism: Clinical and Experimental Research, 30, Experimental and Clinical Psychopharmacology, 14, Personality and substance dependence symptoms: Modeling substance-specific traits. Psychology of Addictive Behavior. Characterizing alcohol dependence: Transitions during young and middle adulthood. Experimental and Clinical Psychopharmacology, 14 , Psychology of Addictive Behavior, 20, Drinking among college students - Consumption and consequences.

Galanter Ed. Larkins, J. Family history of alcoholism and the stability of personality in young adulthood. Park, A. Individual differences in the Greek effect on risky drinking: The role of self-consciousness. Psychology of Addictive Behaviors , 20, Investigation of profiles of risk factors for adolescent psychopathology: A person-centered approach. Journal of Clinical Child and Adolescent Psychology. Schuckit, M. Searching for the full picture: Structural equation modeling in alcohol research. A Genuine Contribution to the Evidence Wars.

Review of John C. Norcross, Larry E. Beutler, and Ronald F. Levant Eds. Goudriaan, A. Decision making and binge drinking: a longitudinal study. Alcoholism: Clinical and Experimental Research, 31, College spring break and alcohol use: Effects of selection and spring break activity. Journal of Studies on Alcohol and Drugs, 68, Martinez, J. Fake ID" ownership and heavy drinking in underage college students: Prospective findings.

Psychology of Addictive Behavior , 21, Frequency of heavy drinking and perceived peer alcohol involvement: Comparison of influence and selection mechanisms from a developmental perspective.

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Addictive Behaviors, 32, Saults, J. Differential effects of alcohol on working memory: Distinguishing multiple processes.

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Experimental and Clinical Psychopharmacology, 15, Review of Carlton K. The road to alcohol dependence: Comment on Sartor et al. Addiction, , Stress-response-dampening effects of alcohol: Attention as a mediator and moderator. Alcohol and affect regulation. Gross Ed.

New York: Guilford. Heavy drinking across the transition to college: Predicting first-semester heavy drinking from precollege variables. Addictive Behavior, 32, Personality disorder symptoms, drinking motives, and alcohol use and consequences: Cross-sectional and prospective mediation. Automatic and controlled processes and the development of addictive behaviors in adolescents: A review and a model. Pharmacology, Biochemistry, and Behavior, 86, College student alcohol consumption, day of the week, and class schedule.

Agrawal, A. Drinking expectancies and motives: A genetic study of young adult Missouri women. American Psychologist, 63, Bagge, C. Adolescent alcohol involvement and suicide attempts: Toward the development of a conceptual framework. Clinical Psychology Review, 28, B rown, S. A developmental perspective on alcohol and youth ages Pediatrics, , SS Curran, P.

Pooling data from multiple longitudinal studies: The role of item response theory in integrative data analysis.


Developmental Psychology, 44, Hussong, A. Characterizing the life stressors of children of alcoholic parents. Journal of Family Psychology, 22, Comparison of longitudinal phenotypes based on alternate heavy drinking cut scores: A systematic Comparison of trajectory approaches III.

Conjoint developmental trajectories of young adult substance use: Alcoholism: Clinical and Experimental Research, 32, Is heavy drinking really associated with attrition from college? Psychology of Addictive Behaviors, 22, New York: Macmillan Reference. Risk factors for substance use, abuse, and dependence: Personality. Tragesser, S. Drinking motives as mediators of the relation between personality disorder symptoms and alcohol use disorder. Journal of Personality Disorders, 22, Journal of Studies on Alcohol and Drugs, 70, Cicero, D.

Are there developmentally-limited forms of bipolar disorder? Relation of caregiver alcohol use to unintentional childhood injury. Journal of Pediatric Psychology, 34 , Epler, A. College student receptiveness to various alcohol treatment options. Journal of American College Health, 58 1 , Reasons for abstaining or limiting drinking: a developmental perspective.

Psychology of Addictive Behavior, 23 , Longitudinal patterns of gambling activities and associated risk factors in college students. Trajectories of tobacco use from adolescence to adulthood: Are the most informative phenotypes tobacco specific? Swan, T. Baker, L. Chassin, D. Conti, C. Lerman, and K. Perkins Eds. Levitt, A.

The Language of intoxication: Preliminary investigations. Alcoholism: Clinical and Experimental Research, 33, Littlefield, A. Is 'maturing out' of problematic alcohol involvement related to personality change? Journal of Abnormal Psychology , , A new minimum legal drinking age MLDA? Addictive Behaviors, 34, Blue-collar scholars? Journal of College Student Development , 50, Selection and socialization of risky drinking during the college transition: The importance of micro-environments associated with specific living units. Psychology of Addictive Behaviors, 23, The future of treatment for substance use: A View from Cohen, F.

Collins, A. Young, D. Leffingwell Eds. New York: Routledge. How can etiological research inform the distinction between normal drinking and disordered drinking? Scheier Ed. Blonigen, D. Course of antisocial behavior during emerging adulthood: Developmental differences in personality. Cain, A. Stability and change in patterns of concerns related to eating, weight, and shape in young adult women: A latent transition analysis. Dick, D. Understanding the construct of impulsivity and its relationship to alcohol use disorders.

Daily patterns of conjoint smoking and drinking in college student smokers. Psychology of Addictive Behavior, 24, Alcohol use disorders in young adulthood. Grant and M. Potenza Eds. New York: Oxford University Press. The multiple, distinct ways that personality contributes to alcohol use disorders. Social and Personality Psychology Compass, 4, Developmental trajectories of impulsivity and their association with alcohol use and related outcomes during emerging and young adulthood I.

Alcoholism: Clinical and Experimental Research, 34, A personality-based description of maturing out of alcohol problems: Extension with a Five-Factor Model and robustness to modeling challenges. Addictive Behaviors, 35, Three or more alcohol dependence symptoms but not clustered in the same 12 months: Diagnostic orphans from a longitudinal perspective. Journal of Studies on Alcohol and Drugs, 71, Methods of "Fake ID' Obtainment and use in underage college students.

Deliberate induction of alcohol tolerance: Empirical introduction to a novel health risk. Addiction, , Alcohol use disorders. Weiner and W. Craighead Eds. New York: Wiley. Consilient research approaches in studying gene x environment interactions in alcohol research. Addiction Biology, 15, Talley, A. Sexual orientation and substance use trajectories in emerging adulthood.

Journal of Personality Disorders, 24, It's the algorithm! Why differential rates of chronicity and comorbidity are not evidence for the validity of the abuse-dependence distinction. A candidate gene association study of alcohol consumption in young women. Journal of Studies on Alcohol and Drugs, 35 , Brister, H. Psychology of Addictive Behaviors, 25, Decision making and response inhibition as predictors of heavy alcohol use: a prospective study.

Alcoholism: Clinical and Experimental Research, 35, Jahng, S. Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity. PMID : Johnson, B. Should the reorganization of addiction-related research across all the National Institutes of Health be structural? Kristjansson, S. Drinking motives in female smokers: Factor structure, alcohol dependence, and genetic influences.

PMID: 2 Cited by. Smoking outcome expectancies in young adult female smokers: Individual differences and associations with nicotine dependence in a genetically-informative sample. Drug and Alcohol Dependence,, Does variance in drinking motives explain the genetic overlap between personality and alcohol use disorder symptoms? A twin study of young women. Interactions between self-reported alcohol outcome expectancies and cognitive functioning in the prediction of alcohol use and associated problems: A further examination. Psychology of Addictive Behaviors, 25 , Martin, C.

Commentary: Hazardous use should not be a diagnostic criterion for substance use disorders in DSM Journal of Studies on Alcohol and Drugs, 72, Psychological Medicine, 41, Interaction between the DRD4 VNTR polymorphism and proximal and distal environments in alcohol dependence during emerging and young adulthood.

The subjective effects of alcohol-tobacco co-use: An ecological momentary assessment investigation. PMID: 21 Alcohol use trajectories and the ubiquitous cat's cradle: Cause for concern? Barlow Ed. Alcohol use and alcohol use disorders. Friedman Ed. April 6, Santora, M. Dowell, and J.

Henningfield Eds. The influence of general identity disturbance in reports of lifetime substance use disorders among sexual minority adults with a history of substance use. Alcohol use and the transition to college. The Addiction Newsletter, 18 3 , White, H.

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  4. In Memoriam: G. Alan Marlatt Cannabinoid receptor CNR1 genotype moderates the effects of childhood physical abuse on anhedonia and depression. Archives of General Psychiatry, 69 , Concerns related to eating, weight, and shape: Typologies and transitions in men during the college years.

    International Journal of Eating Disorders, 45, PMID: 6. Development and Psychopathology, 24 , Cooper, H. Verster, K. Brady, M. Conrod Eds. Totowa, NJ: Humana Press. Grant, J. Age and ethnic differences in the onset, persistence and recurrence of alcohol use disorder in a developmental framework. The relationship between rs in the dopa decarboxylase DDC gene and alcohol consumption is mediated by drinking motives in regular smokers. Alcoholism: Clinical and Experimental Research, 36, Alcohol dependence is related to overall internalizing psychopathology load rather than to particular internalizing disorders.

    Evidence from a national sample. Smoking desistance and personality change in emerging and young adulthood. Nicotine and Tobacco Research, 14, Transactional models between personality and alcohol involvement: A further examination. Low sensitivity to alcohol: Relations with hangover occurrence and susceptibility in an ecological momentary assessment investigation. Responses to alcohol and cigarette use during ecologically assessed drinking episodes. Robertson, B. Validity of the Hangover Symptoms Scale: Evidence from an electronic diary study. Alan Marlatt Obituary.

    American Psychologist, 67, Alcohol: Psychosocial effects. Ramachandran Eds. Oxford: Elsevier. Patterns of alcohol use and consequences among empirically derived sexual minority subgroups. Journal of Studies on Alcohol and Drugs, 73 , Personality Disorders: Theory, Research, and Treatment, 3, Deconstructing the age-prevalence curve of alcohol dependence: Why 'maturing out' is only a small piece of the puzzle. Personality and contextual factors in college students' drinking. White and D. Rabiner Eds. Waldron, M. The interpretability of family history reports of alcoholism in general community samples: Findings in a Midwestern US twin birth cohort.

    Winograd, R. The drunken self:The five-factor model as an organizational framework for characterizing perceptions of one's own drunkenness. Do people who 'mature out' of drinking see themselves as more mature? Cadigan, J. Transitions in and out of athletic involvement and risky drinking. Journal of Studies on Alcohol and Drugs, 74, The developmental psychopathology of alcohol use and alcohol disorders: Research achievements and future directions.

    Development and Psychopathology, 25, Gender differences in natural language factors of subjective intoxication in college students: An experimental vignette study. Alcoholism: Clinical and Experimental Research, 37, Motivational typologies of drinkers: Do enhancement and coping drinkers form two distinct groups? Addictive Behaviors. Oxford Bibliographies in Psychology. DOI: Comprehensive Handbook of Psychology, 2 nd edition. Volume Eight: Clinical Psychology A three category scale was created for each type of substance cigarettes, alcohol, and other drugs to take into account the severity of substance use.

    Cigarettes : 1 did not smoke in the last 6 months, 2 smoked less than one cigarette a day infrequent use , and 3 smoked one cigarette or more a day. In some analyses, groups 2 and 3 for drug use were combined. The validity and reliability of the measures have been reported elsewhere Schwab-Stone et al. A diagnosis was considered to be positive if symptoms reported by either the parent or the child met DSM criteria Shaffer, Fisher et al. Depressive disorders assessed include major depression and dysthymia.

    Anxiety disorders assessed were social phobia, agoraphobia, panic, separation anxiety, overanxious disorder, generalized anxiety, and obsessive compulsive disorder. Disruptive behavior disorders assessed were attention-deficit hyper-activity disorder, oppositional defiant disorder, and conduct disorder. Age of onset of a diagnosis was calculated from both parent and child reports. Youth demographic data included gender, age, and ethnicity. Information about mother's education, public assistance, and family structure living with both biological parents vs.

    In the first set of models, the substance of interest was examined controlling for study site. In the second set of models, sociodemographic factors that were significant in the bivariate analysis were added age, gender, maternal education, living with biological parents, and public assistance as additional controls. In the third set of models, psychiatric disorders depression, anxiety, and disruptive disorders were further controlled for.

    In the analyses of suicide attempt, a fourth model was considered with suicidal ideation included as an additional control variable. It is known that many youth use multiple substances. To further understand what patterns of substance use were related to suicidal behaviors, the Guttman scale of substance use described earlier was introduced into the logistical regression analyses.

    The first category, no current use of any substance, served as the reference group. Analyses were also conducted hierarchically controlling for the confounding variables in the manner previously described. Finally, to better understand the role of substance use in the onset of suicide attempt, we analyzed data of retrospectively reported age of onset of both suicide attempt and substance use with Cox proportional hazards models, adjusting for potential confounding factors such as sociodemographics, onset of depression, and onset of use of other substances.

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    The age at first suicide attempt was the time variable of interest and was censored by age at interview if a child did not report any suicide attempt. The onset of use of a specific substance was treated as a time-varying predictor that was coded as 1 if the onset of using the substance preceded the first suicide attempt and as 0 otherwise.

    Among the 1, youth in the sample, 49 3. Seventy-four 5. Table 1 shows family and individual characteristics by suicidal behaviors. There were more girls Finally, youth with at least one suicide attempt were less likely to live with both biological parents than those without any suicidal behavior. In terms of substance use and abuse, youth with suicidal behaviors were more likely to use and abuse substances than youth without suicidal behavior. The results also show a relationship between types of suicidal behaviors and substance abuse and dependence.

    Youth with suicidal behaviors were more likely to have other psychiatric disorders than youth without such behaviors. Stronger associations were observed for suicide attempt than ideation. For both ideation and attempt, the association between suicidal behaviors and substance use and abuse can be partially explained by family characteristics Model 2 , and by other psychiatric disorders Model 3 , which can be seen by the decrease in the magnitude of Odds Ratios in both models.

    However, after controlling for psychiatric disorders, none of the substance use variables were significantly associated with suicidal ideation. Much stronger associations were found for suicide attempt Table 3. The analyses for each type of substance cigarettes, alcohol, and other drugs were limited because they could not take into account the fact that many youth use multiple substances. The four higher level substance use groups from level V to level VIII were significantly associated with suicide attempt, even after controlling for sociodemographic factors Model 2.

    The results of the Cox proportional hazards regression analysis are reported in Table 5. Models A1—A3 show that, controlling for family sociodemographic factors, the use of each type of substance predicted subsequent onset of suicide attempts. The hazards ratios were 2. Model B included three time-varying variables for three types of substance use.

    The onset of depression was an additional control in the model. The results indicate that onset of depression strongly predicted first suicide attempt. The effect of alcohol was no longer statistically significant independent of the simultaneous effects of smoking, other drugs, and depression. One strength of the study was the use of data from a representative sample of youth in the community, rather than clinical settings.

    Another strength was the assessment of the different psychiatric disorders by the DISC, a standardized psychiatric instrument for children.

    Substance Use, Suicidal Ideation and Attempts in Children and Adolescents

    A third strength was the attempt to evaluate the impact of each specific type of substance or pattern of substance use on suicide ideation and attempt. Many previous studies have examined the impact of one type of substance e. In this study, efforts were made to evaluate the contribution of each type of substance to suicidal behaviors while controlling for the impact of other substances.

    Alcohol abuse and dependence appeared to be strongly associated with suicide attempt. The relationship between alcohol and suicidality may involve the disinhibitory effects of acute alcohol intoxication, the increase in vulnerability for depression resulting from chronic alcohol abuse, as well as possible self-medication for depressive symptoms, including suicidal behaviors.

    Findings from some neurobiological studies suggest that both suicidal behaviors and alcohol abuse are associated with some underlying biological risk factors, such as serotonergic abnormalities. A relationship between low levels of serotonin and suicide attempts was found in biological psychiatry research. Audenaert et al. This may explain why people use alcohol to self-medicate their depressive symptoms.

    However, Weiss and colleagues found that after continuous administration of ethanol over an extended period 3—5 weeks , if the animals are then deprived of ethanol for 8 hours, serotonin levels in the same brain region drop very low. When the animals are then given free access to ethanol, the serotonin levels rise again, but remain lower than those attained in nondependent animals. This may indicate a worsening of depressive symptoms as a result of alcohol dependence, which, at least in humans, may lead to a decision to commit suicide.

    Age differences may explain this difference between the two studies. In previous studies, the impact of cigarette smoking was sometimes assessed with-out controlling for the impact of alcohol or other drugs Miller et al. Nevertheless, using the combined measure of substance use including all the various drugs in the analyses made the estimates of the unique impact of cigarettes or alcohol much more valid and accurate. This might be due to the fact that they represent different levels of suicidal behaviors. This study was limited by its cross-sectional design with retrospective reports of onset of substance use and suicidal behaviors.

    No causal relationship could be determined. The study was also limited by the small number of adolescent drug abusers in the community sample, therefore, no specific analyses could be done to examine the impact of each specific illegal drug. However, the findings of the study highlight the role of substance use in adolescent suicidal behaviors. Cigarettes, on the other hand, were the primary substance used by adolescents to self-medicate.

    Their use was associated with both suicidal ideation and attempt. Therefore, in the prevention of suicide, attention should be paid to youth who are smoking and drinking. On the other hand, in the prevention of smoking or alcohol use, the assessment of suicidal behaviors and other depressive symptoms is also crucial.

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