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This meta-analysis supports an association between sleep disturbance and suicidal thoughts and behaviors. Sleep disturbances in general, as well as insomnia and nightmares individually, appear to represent a risk factor for suicidal thoughts and behavior. This proposition is further bolstered by the result that depression did not show risk moderation.

The relationships of depression with alcohol and drug use and impairment were examined. Additional analyses were conducted to examine moderators of these associations. Empirical reports on adults with alcohol abuse or dependence published in English in peer-reviewed journals since 1986 that contained data on depression and substance use variable(s) were obtained using a systematic search. The search yielded 74 studies including 58 reports from clinical venues, 10 that were community-based, and 6 with subjects from both settings. As hypothesized, the analyses showed that depression is associated with concurrent alcohol use and impairment and drug use and impairment. Effect sizes were small. Depression was also related to future alcohol use and impairment, an earlier age of onset of an AUD, and higher treatment participation. Age moderated the association between depression and alcohol use and impairment such that the association was stronger in older samples.

Few studies have examined the role of culturally relevant factors in suicidal behavior among Asian Americans. Using the National Latino and Asian American Study (NLAAS) (Alegria et al., 2004;Heeringa et al., 2004), the current study examined the role of culturally related variables (family conflict, perceived discrimination, and ethnic identity) on suicidal ideation and suicide attempts in a nationally representative sample of 2,095 Asian Americans. Important covariates were sociodemographic characteristics (gender, age, marital status, years of education, household poverty, and nativity status), depressive and anxiety disorders, and number of chronic conditions. Gender related correlates were also explored. The lifetime prevalence of suicidal ideation and attempts was 8.8% and 2.5%, respectively. Female gender, family conflict, perceived discrimination, and the presence of lifetime depressive or anxiety disorders were positively correlated with suicidal ideation and attempts. A high level of identification with one's ethnic group was associated with lower rates of suicide attempts. Among Asian men, but not women, the presence of chronic medical conditions was associated with suicidal ideation. Findings highlight the contributions to suicide risk of cultural factors and gender differences in Asian Americans. Keywordssuicide; family conflict; discrimination; ethnic identity; Asian Americans Understanding risk factors for suicide is the first step in developing suicide prevention and intervention strategies for Asian Americans. Although Asian Americans are one of the most Correspondence concerning this article should be addressed to Janice Ka Yan Cheng, Department of Psychology, University of California, Davis, One Shields Avenue, Davis, CA 95616. jancheng@ucdavis.edu. NIH Public Access Author ManuscriptAsian Am J Psychol. Author manuscript; available in PMC 2010 October 13. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript rapidly growing ethnic groups in the United States, few empirical studies on suicide have been conducted on this population. It has been argued that Western theories and findings of suicide may not be generalizable to ethnic minorities in general and Asian Americans in particular. Leenaars (2008) and Lester (2008) highlighted the need for understanding suicide beyond the factors at the individual level. In recent years, researchers have proposed the use of the ecological model for understanding suicide, which emphasizes that behaviors are influenced by the interplay of individual, interpersonal, social, and cultural levels (Bronfrenbrenner, 1979). The model was first applied to understand child abuse, and most recently, it has been effectively applied to the study of suicide in Latina youths and African American adults (Kaslow et al., 2005;Zayas, Lester, Cabassa, & Fortuna, 2005). Demographic characteristics and psychopathology may contribute to suicidal behavior, but behaviors can also be influenced by interpersonal relationships in specific settings (e.g., fam...

Background While there are reviews reporting on the prevalence of acute use of alcohol (AUA) prior to suicide attempts, no review has used a meta-analytic approach to estimate common odds ratios (OR) of the effect of AUA on suicide attempts. We aim to report the results of the first meta-analysis of controlled epidemiological studies on acute alcohol use and suicide attempt. Methods The English language literature on Medline, PsychInfo, Google Scholar, and public-use databases was searched for original articles and critical review reports on acute alcohol use and suicide attempt for the period ranging from 1996–2015. Studies had to report an OR estimate for this association. Common odds ratios and 95% Confidence Intervals (95%CI) from random effects in meta-analyses for any acute alcohol use and 2 levels of alcohol use on suicide attempt were calculated. Results We gathered 7 studies that provided OR estimates for the likelihood of suicide attempt by acute alcohol use, compared to those who did not drink alcohol. Studies used case-control (3) and case-crossover design (4). All studies found increased ORs for acute alcohol use on suicide attempt. Meta-analysis revealed a common OR of 6.97 (95%CI=4.77, 10.17) for any acute alcohol use. Evidence from 4 studies suggests that «low levels of acute drinking» resulted in an OR of 2.71 (95%CI=1.56, 4.71) and «high levels» had much greater odds of suicide attempt, OR of 37.18 (95%CI=17.38, 79.53). Conclusions Acute use of alcohol is associated with increased likelihood of a suicide attempt, particularly at high doses. Such data should be incorporated into estimates of the burden of disease associated with alcohol use, which are currently limited by a consideration of only alcohol’s chronic effects. Future research should focus on the mechanisms through which acute use of alcohol confers risk for attempt.

Interventions to decrease the likelihood of financial stress and to help families manage discord and severe physical illness may effectively reduce suicides among middle-aged and older adults.

The association between family and social/community indicators of poor social integration and suicide is robust and largely independent of the presence of mental disorders. Findings could be used to enhance screening instruments and identify problem behaviors, such as low levels of social interaction, which could be targeted for intervention.

Alcohol dependence is a potent risk factor for suicide. Accordingly, alcoholics should be targeted in suicide prevention efforts. This article reviews the literature on suicide among alcoholics and provides a model that may inform research, clinical work, and prevention efforts. In this model, we propose that aggression/impulsivity, severe alcoholism, negative affect, and hopelessness are key predisposing factors for suicide among alcoholics. We propose that major depressive episodes and stressful life events, particularly interpersonal difficulties, are key precipitating factors. We also integrate these constructs in a model that proposes that many acts of suicide among alcoholics may be viewed as acts of reactive aggression executed in the midst of distress over a lost or threatened relationship. Empirical evidence for the model is discussed along with its limitations. The next generation of research on alcoholism and suicide should include a focus on the interpersonal anlage of suicide in this population.