Suicidal ideation in adolescence: Depression,substance use,and other risk factors

The interrelationships of depression and suicide with adolescent drug use, delinquency, eating disorders, and the risk factors for these different problems were investigated among 597 9th and 11th graders in an urban high school. There is a strong association of drug use with suicidal ideation among girls, and a stronger relationship with attempts among girls and boys. Suicidal youths are ill-adjusted and display a lack of attachment and commitment to family and school. Causal models indicate that poor interpersonal interactions with parents, absence of peer interactions, and life events lead to depression, which in turn leads to suicidal ideation. Depressive symptoms are the strongest predictors of suicidal ideation. Among females, depression predicts drug involvement, and in turn, drug use increases suicidal ideation. Drug use is only one class of problem behaviors that constitutes a risk factor for suicidal behavior in adolescence. Delinquency and eating disorders also have direct effects on suicidal ideation beyond those of depressive affect. As for drug involvement, these problem behaviors are more predictive of suicidal behavior among girls than boys. Similarity and specificity of the predictors for problem behaviors within and between the sexes are discussed. Although young women use drugs to handle feelings of depression, drug use appears ineffective in the long run in relieving these depressive feelings. Understanding the dynamics of suicidal ideation in adolescence has important public health implications, since ideation is a strong predictor of attempts, especially among females.Revised version of a presentation at the Workshop on Adolescent Depression, Princeton, NJ, June 3, 1987.Work on this research has been partially supported by Research Grants DA00064, DA01097, DA03196, and DA02867, and by Research Scientist Award DA00081 from the National Institute on Drug Abuse; and awards from the John D. and Catherine MacArthur Foundation and the Research Foundation for Mental Hygiene, New York State Psychiatric Institute. Partial support for computer costs was provided by Mental Health Clinical Research Center Grant MH30906-07 from NIMH to the New York State Psychiatric Institute.Received Ph.D. in Sociology from Columbia University. Research interests include adolescent psychosocial development, epidemiology and risk factors for drug use, and interpersonal networks.Work on this research was carried out while a Research Associate at the School of Public Health, Columbia University. Received Ph.D. in Sociology from Columbia University. Research interests include personal networks and social support systems in chronic illness, societal factors in mental health, psychosocial consequences of drug use and abuse, panel mortality, and survey methodology.Received M.P.H. from Columbia University. Research interests include reliability and child psychiatry.