Adolescent substance use and suicidal behavior: A review with implications for treatment research
Adolescent substance use and suicidal behavior: A review with implications for treatment research
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DOI：
10.1097/01.alc.0000127417.99752.87
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发表时间：
2004-05-01
影响因子：
3.2
通讯作者：
Spirito, A
中科院分区：
文献类型：
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作者：
Esposito-Smythers, C;Spirito, A
青少年物质使用（酒精和其他药物）和自杀行为单独构成严重的公共健康问题。报告同时发生药物滥用和自杀倾向的青少年是一个特别高风险的群体。在这篇综述中，我们探讨了与药物滥用和自杀青少年群体研究相关的四个领域。首先，我们回顾了与物质使用和自杀行为之间的关联相关的流行病学研究。结果表明，物质使用增加了青少年临床和社区人群自杀行为的统计风险。酒精中毒可能通过其对大脑的精神药理学作用而成为陷入困境的青少年自杀行为的近端危险因素。药物使用也可能通过增加压力和加剧同时发生的精神病理学而成为自杀行为的远端危险因素。其次，我们提出了不同的理论模型，可以解释青少年同时发生的药物使用和自杀行为的高发生率。药物使用可能源于具有主要外化症状的冲动性自杀企图者中潜在的问题行为综合症。相比之下，具有主要内化症状的非冲动自杀企图者可能会使用物质来应对负面情感状态。第三，我们探讨了药物滥用和自杀青少年群体的治疗研究现状。对药物滥用治疗和自杀行为的研究既没有充分评估也没有纳入对其他同时发生的问题的治疗。最后，我们提出了未来研究的建议方向，包括针对患有这些同时出现的问题的青少年制定综合干预措施。
Adolescent substance use (alcohol and other drugs) and suicidal behavior, independently, pose serious public health problems. Youths who report co-occurring substance use and suicidality are a particularly high-risk group. In this review, we explore four areas that are pertinent to research with substance-abusing and suicidal adolescent populations. First, we review epidemiological research that is relevant to the association between substance use and suicidal behavior. Results suggest that substance use heightens statistical risk for suicidal behavior in adolescent clinical and community populations. Alcohol intoxication may serve as a proximal risk factor for suicidal behavior among distressed youths through its psychopharmacological effects on the brain. Substance use may also serve as a distal risk factor for suicidal behavior by increasing stress and exacerbating co-occurring psychopathology. Second, we propose different theoretical models that might explain the high rates of co-occurring substance use and suicidal behavior among adolescents. Substance use may stem from an underlying syndrome of problem behavior among impulsive suicide attempters with predominant externalizing symptoms. In contrast, nonimpulsive suicide attempters with predominant internalizing symptoms may use substances to cope with negative affective states. Third, we explore the status of treatment research with substance abusing and suicidal adolescent populations. Studies of substance abuse treatment and suicidal behavior have neither adequately assessed nor incorporated treatment of the other co-occurring problem. Finally, we conclude with proposed directions for future research, including the development of integrated interventions tailored to adolescents with these co-occurring problems.