Gender Differences in Suicide Ideation: Mediating Effects of Alcohol Abuse/Dependence on Suicide Ideation through Psychological Distress and Hopelessness

Background/Purpose:

A number of studies reported direct associations between alcohol use and suicide (AAD). However, there is a need in additional research testing the mediating effects of psychological distress and hopelessness on the relationship between AAD and suicide. Also, there has been a lack of examining gender gaps in suicidal behaviors. Kim and Burlaka (2017) found that higher psychological distress strengthened the association between AAD and suicidal behaviors. The present study aims to further expand this line of research. Specifically, this study used the nationally representative sample of young adults to explore role of gender differences in the multiple mediation effects of psychological distress and hopelessness on association between AAD and suicide ideation.

 

Methods:

Data and samples: The current study used the 2014 NSDUH public use data. Young adults aged 18 to 25 years (M = 21.02, male = 47.9%) old were selected as study samples. Among the current study sample, 47.9% were male and 52.1% were female.  Regarding race, 54.9% were Caucasians, 20.2% were Hispanics, 13.5% were African Americans, 5.0% were Asians, and 6.5% were other races.

Data and samples: To measure suicide ideation one question was asked if the respondent seriously thought about trying to kill self at any time in the past year. AAD was created by using a combination of mutually exclusive alcohol abuse and alcohol dependence variables. Psychological distress was measured using the Kessler Psychological Distress Scale (K6). Hopelessness was measured by asking a question how often did the respondent feel hopeless in the worst month during the past year.

Analyses: A PROCESS (v. 3.0) mediation analysis was conducted.

 

Results:

Two separate mediation analyses (male and female groups) were conducted. Psychological distress mediated the association between AAD and suicide ideation for both male and female groups. Also, hopelessness played a mediating role in the relation between AAD and suicide ideation in both gender groups. In the multiple mediator model, psychological distress and hopelessness were significant mediators between AAD and suicide ideation in both male and female groups.

Conclusion and Implication:

The current study findings suggest that young adults who have AAD problems are at heightened risk for suicide ideation, underscoring the importance of assessing suicide ideation in this high-risk group. Incorporating brief suicide risk screening in AAD treatment programs may be effective in identifying those who are at risk of suicidal behavior and need further assessment and intervention. Our findings also suggest that psychological distress and hopelessness may be important mechanisms for increasing or decreasing suicide ideation associated with AAD, and this was true for both genders. Therefore, hopelessness and psychological distress should be assessed and evaluated thoroughly in male and female young adults who exhibit symptoms of AAD. Finally, potential intervention and treatment target for reducing suicide risk in young adults should include those with co-occurring alcohol use and psychological problems (i.e., psychological distress and hopelessness).