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

Introduction: 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.

Other- and Self-Directed Forms of Violence and Their Relationship With Number of Substance Use Disorder Criteria Among Youth Ages 12–17: Results From the National Survey on Drug Use and Health

“…Findings from the present study indicate that alcohol, marijuana, and other DUD criteria and nicotine dependence are significantly related to violence toward others and self. They are consistent with the findings from general population studies of violence toward others (Coid et al, 2006;Corrigan & Watson, 2005;Pulay et al, 2008) and toward self (Borowsky et al, 2001;Harris & Barraclough, 1997;Roy et al, 1990) and, more importantly, expand on the findings from prior studies for combined (Bossarte et al, 2008;Cleary, 2000;Harford et al, 2012;Swahn et al, 2013). Nevertheless, comparisons between the violence categories show that the increased number of marijuana use disorder criteria was no longer a significant predictor to discriminate one form of violence from another.…”

“…Using a similar typology, Swahn et al (2013) found significant associations between combined violence (physical fighting and suicide attempt) and early drinking onset, heavy drinking, and feelings of sadness. Drinking onset before age 13 versus nondrinkers was significantly related to violence but not significantly different among different patterns of violence.…”

“…In addition, a growing body of research particularly on adolescents in the general population has compared associations between suicidality and violence against others with a particular focus on the joint presence of these behaviors (Bossarte et al, 2008;Cleary, 2000;Harford et al, 2012;Swahn et al, 2013). Cleary (2000) examined the association between victimization (i.e., being threatened with a weapon, property damaged, felt unsafe at school) and suicidal and/ or violent behaviors among 1,569 high schools students in New York State, excluding New York City.…”

Incremental and Predictive Validity of the Antisocial Process Screening Device in a Community Sample of Male and Female Ethnic Minority and Caucasian Youth

“…Among high school students, the prevalence of physical fighting can be as high as 31.5% (Swahn, Bossarte, Palmier, & Yao, 2013). As such, including this item may have produced a higher base rate of violent offending compared to some other studies.…”

Early Onset Alcohol Use and Self‐Harm: A Discordant Twin Analysis

“…In general, EAU has been associated with a host of maladaptive outcomes, including alcohol problems and sexual risk-taking (Stueve and O'Donnell 2005), as well as lower education attainment (Grant et al 2012). It has also been linked more specifically to increased risk for SA (Bossarte and Swahn 2011;Swahn et al 2010;Swahn and Bossarte 2007) and comorbid reports of SA and physical fighting among high school students (Swahn et al 2013). Far fewer studies have examined EAU and NSSI.…”