The relationship between alcohol and cannabis use with nonsuicidal self-injury among adolescent inpatients: Examining the 90 days prior to psychiatric hospitalization

Christina M Sellers; Antonia Díaz-Valdés; Michelle M Oliver; Kevin M Simon; Kimberly H McManama O'Brien

doi:10.1016/j.addbeh.2020.106759

The relationship between alcohol and cannabis use with nonsuicidal self-injury among adolescent inpatients: Examining the 90 days prior to psychiatric hospitalization

Addict Behav. 2021 Mar:114:106759. doi: 10.1016/j.addbeh.2020.106759. Epub 2020 Dec 2.

Authors

Christina M Sellers¹, Antonia Díaz-Valdés², Michelle M Oliver³, Kevin M Simon⁴, Kimberly H McManama O'Brien⁵

Affiliations

¹ Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; School of Social Work, College of Social Science, Policy, and Practice, Simmons University, Boston, MA 02115, USA. Electronic address: Christina.Sellers@simmons.edu.
² Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Badajoz 130, Oficina 1306, Las Condes, Santiago 750000, Chile. Electronic address: Antonia.Diazvaldes@umayor.cl.
³ Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; School of Social Work, College of Social Science, Policy, and Practice, Simmons University, Boston, MA 02115, USA. Electronic address: Michelle.Oliver@simmons.edu.
⁴ Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, Department of Psychiatry, Boston, MA 02115, USA; Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA. Electronic address: Kevin.Simon@childrens.harvard.edu.
⁵ Department of Psychiatry, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, Department of Psychiatry, Boston, MA 02115, USA. Electronic address: KimberlyH.M.OBrien@childrens.harvard.edu.

Abstract

Background: This study examined the trajectories of alcohol use, cannabis use, suicide planning (SP), and nonsuicidal self-injury (NSSI) prior to hospitalization and examined the role of alcohol and cannabis use, independently and jointly, in predicting NSSI on a daily level and over time.

Methods: Participants included 71 adolescents hospitalized for suicide risk (75% female; 25% male; M_age = 15.79). All participants drank alcohol at least once in the prior 90-days. We conducted mixed effect models to assess the trajectories of alcohol use, cannabis use, and NSSI over the 90-days prior hospitalization. To test the effect of SP, alcohol use, and cannabis use on NSSI, we conducted logistic random effect models, while controlling for demographics.

Results: SP (OR = 4.47, p < 0.001) and suicide ideation (SI) (OR = 10.09, p < 0.001) significantly increased the odds of engaging in NSSI. Neither cannabis nor alcohol use independently predicted the odds of engaging in NSSI, however, the co-occurrence of alcohol and cannabis use increased the odds of engaging in NSSI on a given day (OR = 30.5, p < 0.05).

Conclusions: Study findings extend current knowledge about the longitudinal and day-to-day relationships between alcohol and cannabis use and NSSI. Results underscore the importance of developing interventions that address polysubstance use among suicidal adolescents engaging in NSSI.

Keywords: Adolescents; Alcohol; Cannabis; Nonsuicidal self-injury; Suicide attempts.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cannabis*
Female
Hospitalization
Humans
Inpatients
Male
Risk Factors
Self-Injurious Behavior* / epidemiology
Suicidal Ideation
Suicide, Attempted

Grants and funding

R34 AA025763/AA/NIAAA NIH HHS/United States