Suicide attempts among adolescent drug users
A. L. Berman and R. H. Schwartz
Department of Psychology, American University, Washington, DC 20016.
Substance use has been identified as a significant risk factor in nonfatal
and fatal suicides during adolescence. A comprehensive questionnaire on
patterns of alcohol and other drug use, early childhood and nuclear family
psychological and behavioral history, and previous suicidal attempts was
completed by 298 (88%) of 340 outpatient adolescent substance abusers in
three geographic regions east of the Mississippi River. An abbreviated Beck
Depression Inventory was included to ascertain current symptoms of
depressed mood. Adolescents admitting to a previous suicide attempt (30%)
were compared with two age- and sex-matched samples. Substance abusers were
three times as likely as a normative population of non-drug-using age- and
sex-matched peers to make a suicide attempt. Thirty-three percent of
attempts reported occurred prior to high school. Both the wish to hurt
oneself and actual suicide attempts were found to increase significantly
after the initiation of substance use. Forty percent used drugs within 8
hours before the suicide attempt, and 23% of attempters reported that their
families continued to have a firearm with ammunition in the home following
the suicide attempt. Adolescent substance abusers who had attempted suicide
were significantly more likely than a matched group of nonattempters in the
same drug treatment facility to: (1) complain of usually feeling "blue" or
sad (depressed affect) during early childhood, (2) identify important
childhood behavioral problems, (3) identify long-standing self-perceived
impaired self-concept, and (4) identify serious parental problems, such as
chronic depression or alcoholism. Self-perceived chronic loneliness in
childhood appears to be a singularly important initiator of adolescent drug
use and subsequent suicide attempts among drug abusers.
