Depression, Addictive Behaviors, and Suicidal Ideation Among Korean College Students: Examining the Moderating Roles of Alcohol Use and Gambling

Background and Purpose: The prevalence of suicide in South Korea is staggeringly high as it ranks number one among OECD (Organization for Economic Co-operation and Development) countries in suicide rate. This is South Korea’s most severe social problem and has become the leading cause of death among twenty year olds. Suicidal ideation among college students has been associated with poor mental health, academic pressure, and employment seeking stress, which demonstrate Korea’s hypercompetitive socio-cultural context. Furthermore, permissive alcohol policies on college campuses, high internet accessibility, and a revitalized gambling industry have led to uniquely high rates of addictive behaviors such as alcohol abuse and gambling among Korean college students. Research indicates that depression is an important predictor for suicidal ideation. Studies have also found that depression, addictive behaviors, and suicidal ideations are highly associated with each other. This study examines the association between depression and suicidal ideation among Korean college students and the moderating roles of addictive behaviors (i.e., alcohol use, gambling).   

Methods: We collected data from full-time students (n = 870) enrolled at nine Universities throughout South Korea. More than half of the total sample (52.3%, n = 450) experienced either alcohol use or gambling. We used a stratified sampling strategy selecting two Universities with similar sizes from each of the five geographically representative areas (except one from Kang-Won area). The survey was conducted on each campus using in-person methods by trained assistants after attaining participant consent. We measured depression using seven items selected from the DASS-21 (Depression, Anxiety and Stress Scale, α=.845). Suicidal ideation was measured by five items selected from the YRBSS (Youth Risk Behavior Surveillance System, α=.882). Alcohol use and gambling were assessed by the 10- item AUDIT (Alcohol Use Disorder Identification Test, α=.852) and 9-item PGSI (Problem Gambling Severity Index, α=.933) respectively. We employed hierarchical multiple regression analyses with interaction terms to examine the association between depression and suicidal ideation, and the moderating roles of alcohol use and gambling.    

Results: Findings reveal that depression, alcohol use, and gambling are associated with suicidal ideation among Korean college students. We found a significant moderating effect of alcohol use on the relationship between depression and suicidal ideation (ß = .015, p< .001). The influence of depression on suicidal ideation is greater for Korean college students who use high levels of alcohol (respondents with +1 standard deviation greater than the mean score) compared to those who use low levels of alcohol, presenting the moderating role of alcohol use. Gambling did not moderate the relationship between depression and suicidal ideation.  

Conclusions and Implications: These findings support existing knowledge on the moderating roles of addictive behaviors, alcohol use in particular, on the relationship between depression and suicidal ideation among college students in South Korea. The results suggest that alcohol use is an important modifiable factor for suicidal ideation when specifically related with depression. It is crucial that policy makers and practitioners working on college campuses recognize the need for efforts that reduce alcohol use and potentially prevent suicide among college students.