Adolescent alcohol involvement and suicide attempts: toward the development of a conceptual framework.
The present article provides a conceptual framework of the relation between alcohol involvement (A) and suicide attempts (S). This framework can be broadly construed to reflect two dimensions: directionality (direction of causality; A-->S, S-->A, or a spurious relation) and temporality (distinguishing between proximal and distal effects of both behaviors). We review and evaluate the evidence on the association between A and S among adolescents using this conceptual framework as a guide. The extant data suggest that this relation is complex and not fully understood. Further, it seems unlikely that a single approach will be found to determine direction of causality, and the specification and validation of hypothesized mechanisms will involve a variety of different types of evidence. Suggestions for additional research using informative designs are discussed.
Bagge
Courtney L
CL
Department of Psychological Sciences, Midwest Alcohol Research Center, University of Missouri-Columbia, Columbia, MO 65211-0001, United States. CLBF34@mizzou.edu
Sher
Kenneth J
KJ
D000293:Adolescent; D000435:Alcoholic Intoxication / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D015984:Causality; D003430:Cross-Sectional Studies; D006801:Humans; D007389:Internal-External Control; D008016:Life Change Events; D011446:Prospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data