title: Alcohol use and suicidality in firefighters: Associations with depressive symptoms and posttraumatic stress.
abstract: Both suicidality and alcohol use disorders are significant public health concerns among firefighters, and alcohol use is associated with increased suicide risk. In addition, firefighters endorse high rates of symptoms of depression and posttraumatic stress disorder (PTSD). Thus, the current investigation examined associations between alcohol dependence and suicide risk among a large sample of firefighters. Specifically, this study examined the indirect effects of alcohol dependence on suicidality outcomes via both depression and posttraumatic stress, using structural equation modeling. A total of 2883 male firefighters completed a self-report survey, containing measures of alcohol use, suicidality, PTSD, and depressive symptoms. Results indicated good model fit. The latent alcohol dependence variable was directly related to the latent suicide risk variable. However, when depression and posttraumatic stress latent variables were added into the model, alcohol dependence was no longer associated with suicide risk. Furthermore, alcohol dependence was indirectly related to suicide risk via latent depression and posttraumatic stress variables. Indirect effects were established after controlling for relevant covariates. Clinical implications are discussed.
authors.affiliation: University of Houston, Michael E. DeBakey VA Medical Center.
authors.forename: Colleen E
authors.initials: CE
authors.lastname: Martin
authors.affiliation: University of Houston. Electronic address: aavujano@central.uh.edu.
authors.forename: Anka A
authors.initials: AA
authors.lastname: Vujanovic
authors.affiliation: University of Houston.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Paulus
authors.affiliation: University of Houston.
authors.forename: Brooke
authors.initials: B
authors.lastname: Bartlett
authors.affiliation: University of Houston, Texas Institute of Measurement Evaluation and Statistics (TIMES).
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Gallagher
authors.affiliation: Houston Fire Department.
authors.forename: Jana K
authors.initials: JK
authors.lastname: Tran
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D000437:Alcoholism / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000523:psychology*; D061388:Firefighters / Q000523:psychology*; D006801:Humans; D008297:Male; D008960:Models, Psychological; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology*; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult