(PS9-A25) Alcohol and Substance Use as Prospective Predictors of Nonsuicidal Self-injury in Adolescents

Problem: Previous studies suggest that 75% of teenagers have experimented with addictive substances, and those who partake in alcohol use before the age of 15 are six times more likely to develop alcohol dependence (Siegel, 2015). Substances pose particularly harmful effects when used by adolescents, as it elevates the risk of suicide and long-term substance-related disorders, while also contributing to a greater likelihood of mental health issues (Siegel, 2015). Existing research suggests that adolescents who use substances frequently have a higher likelihood of reporting lifetime nonsuicidal self-injury (NSSI), but it’s not clear if alcohol or substance risk pose the biggest risk for future NSSI (Giletta et al., 2012). In the present study, we examined both alcohol and substance use at baseline and their association with concurrent lifetime NSSI and NSSI at a 6-month follow-up. It was predicted that lifetime substance use would have a stronger association with NSSI than lifetime alcohol use at both time points.

Procedure: Data were taken from a longitudinal study of high school students from the south-central region of the United States. The sample consisted of 400 adolescents assessed at baseline and a six-month follow-up. The mean age at baseline was 15.7; 63% identified as female, 81% as heterosexual, and 79% white. Data collection occurred at schools and adolescents completed several self-report measures including the Alcohol Use Disorders Identification Test (AUDIT), the Drug Abuse Screen Test (DAST), and the Suicide and Self-Injurious Thoughts and Behaviors Interview (SITBI). The drug and alcohol measures were administered via iPad to provide greater privacy and confidentiality in responding.

Results: Within the sample, 19.7% reported ever using alcohol, and 11.2% reported ever using substances at baseline. Logistic regression was used to examine the association of lifetime alcohol and substance use with lifetime nonsuicidal self-injury (yes/no), all at baseline. The overall model was significant, (χ² (2) = 21.41, p < .001) and accounted for 9% of the overall variance. Lifetime substance use was significantly associated with likelihood of lifetime NSSI (OR=4.82, p< .01), but lifetime alcohol use was not (OR=1.15, p =.66). Logistic regression was also used to examine the association of lifetime alcohol and substance use at baseline and NSSI at 6-month follow-up (yes/no). The overall model was significant (χ² (2) = 12.58, p < .01) and accounted for 5.1% of the overall variance. Lifetime substance use was associated with higher likelihood of NSSI at follow-up (OR=3.33, p< .001), but lifetime alcohol use was not (OR=1.08, p=.81).

Conclusions and implications: Results suggest that substance use is more strongly related to concurrent and future NSSI than alcohol use in adolescents. While this is consistent with previous research,, future could explore which types of substances are more strongly associated with NSSI and other self-harm behavior, as well as how these behaviors progress into adulthood.