Predicting Suicide Ideation for Substance Users: The Role of Self-Esteem, Abstinence, and Attendance at 12-Step Meetings

Abstract

This study tested if a three-way interaction between gender, abstinence, and self-esteem could predict the occurrence of suicidal thoughts in a sample of drug users who are one year post-treatment. It was expected that those who resolved their drug and alcohol problems and had higher self-esteem would have a lower risk of suicide ideation than those who had resolved their drug and alcohol problems (e.g. were abstinent) and had lower self-esteem, and that this effect would be stronger for women than men. Using a 3-step hierarchical logistic regression, results indicated a significant 2-way interaction between self-esteem and abstinence in the predicted direction, and no effect for gender. However, it was also found that those who had lower levels of self-esteem, regardless of abstinence or continued use, had virtually identical odds of suicidal ideation. Further, increased frequency of attendance at AA/NA meetings also predicted a higher risk of suicide ideation. This suggests that careful assessment of depression symptoms or suicidal ideation for drug users seeking assistance be completed before automatically urging attendance at 12-step meetings. Implications for clinical work with clients are presented.

• Suicidal ideation
• Substance abuse
• Recovery
• Gender differences
• Abstinence
• Self-esteem