Co-Occurring Physical Fighting and Suicide Attempts Among U.S. High School Students: Examining Patterns of Early Alcohol Use Initiation and Current Binge Drinking
abstract
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Access this abstract nowIntroduction: A growing body of empirical research documents a significant co-occurrence of suicide attempts and interpersonal violence among youth. However, the potential role of early alcohol use initiation and current heavy alcohol use as correlates of this comorbidity has not been examined in a nationally representative sample of high school students.
Methods: We based our analyses on cross-sectional data from the 2009 Youth Risk Behavior Survey, which includes a nationally representative sample (n=16,410) of high school students in grades 9 through 12 in the United States. Multinomial logistic regression analyses were conducted to test the associations between measures of alcohol use (early alcohol use initiation and heavy drinking) and comorbid suicidal and violent behavior while controlling for potential confounders.
Results: Among high school students, 3.6% reported comorbid physical fighting and suicide attempt in the past year. Early alcohol use (prior to age 13) and heavy drinking (5 or more drinks in a row) were strongly associated with comorbid reports of physical fighting and suicide attempts (Adj. odds ratio [OR]=3.12; 95% confidence interval [CI]:2.49-3.89) and (Adj. OR=3.45; 95%CI:2.63-4.52).
Conclusion: These findings underscore the importance of both early alcohol use initiation and heavy drinking as statistically significant correlates of comorbid fighting and suicide attempts among youth. While future research is needed to determine the temporal ordering between problem drinking and violent or suicidal behaviors, existing prevention programs may benefit from including components aimed at reducing and delaying alcohol use.
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Co-Occurring Physical Fighting and Suicide Attempts Among U.S. High School Students: Examining Patterns of Early Alcohol Use Initiation and Current Binge Drinking
West J Emerg Med 2013 Aug 01;14(4)341-346, MH Swahn, RM Bossarte, JB Palmier, H YaoFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Two recent large studies about binge drinking behaviors in teens have potentially important implications for practice and policy.
Australian teenagers in a large 15-year prospective cohort study were reported to have very high binge drinking rates—half of the males and one-third of the females admitted to past-week binge drinking, and most of the binge drinkers continued this behavior into adulthood. While the numbers themselves may not translate directly to US teenage habits, the persistence of the behavior into adulthood is likely universal, and it is concerning.
Another study, reporting a strong correlation among binge drinking, physical fighting, and suicide attempts among US high school students, also points to the dangers of early initiation of alcohol use.
While it’s unclear whether violent or suicidal behavior precede or result in problem drinking, physicians seeing adolescents need to be especially vigilant about possible binge drinking in teens who are already aggressive or depressed and at suicide risk. Public health efforts to reduce and delay alcohol use may need to be increased to protect at-risk youth.