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Clin Psychol Rev. 2008 Dec;28(8):1283-96. doi: 10.1016/j.cpr.2008.06.002. Epub 2008 Jun 18.

Adolescent alcohol involvement and suicide attempts: toward the development of a conceptual framework.

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Department of Psychological Sciences, Midwest Alcohol Research Center, University of Missouri-Columbia, Columbia, MO 65211-0001, United States.


The present article provides a conceptual framework of the relation between alcohol involvement (A) and suicide attempts (S). This framework can be broadly construed to reflect two dimensions: directionality (direction of causality; A-->S, S-->A, or a spurious relation) and temporality (distinguishing between proximal and distal effects of both behaviors). We review and evaluate the evidence on the association between A and S among adolescents using this conceptual framework as a guide. The extant data suggest that this relation is complex and not fully understood. Further, it seems unlikely that a single approach will be found to determine direction of causality, and the specification and validation of hypothesized mechanisms will involve a variety of different types of evidence. Suggestions for additional research using informative designs are discussed.

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