Victimization, Suicidal Ideation, and Alcohol Use From Age 13 to 15 Years: Support for the Self-Medication Model

J Adolesc Health. 2017 Apr;60(4):380-387. doi: 10.1016/j.jadohealth.2016.09.019. Epub 2016 Nov 30.


Purpose: Recent years have seen increased coverage of adolescent victimization and suicide. Both adolescent peer victimization and substance use have been associated with suicidal ideation, with evidence suggesting that all three factors are interrelated. There are at least four models which can explain the associations between these factors (i.e., self-medication, secondary mental disorder, bidirectional, and common factor). However, none of them is being empirically supported as the dominant model because few longitudinal studies have explored the association between these factors.

Methods: The present study compared longitudinal paths of all four models simultaneously using a cross-lagged model. This was done using self-reported measures of peer victimization, suicidal ideation, and alcohol use at age 13, 14, and 15 years in a longitudinal sample of 238 adolescents.

Results: All three variables were moderately stable across time. Significant cross-lagged associations were found, showing that frequent peer victimization at age 13 years was associated with higher odds of having suicidal ideation at age 14 years (odds ratio, 1.82; p < .05). In turn, presence of suicidal ideation at age 14 years was significantly associated with higher alcohol use frequency at age 15 years (β = .13; p < .05).

Conclusions: Results support previous literature suggesting that peer victimization predates alcohol use and extends it by showing clear directionality between suicidal ideation and alcohol use over 1 year, supporting the self-medication model. Clarifying the empirical basis of these underlying models could allow for earlier prevention strategies, by targeting the risk factor that appears the earliest in the model.

Keywords: Adolescent; Alcohol use; Peer victimization; Secondary mental health model; Self-medication model; Suicidal thoughts.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Alcohol Drinking / psychology*
  • Bullying*
  • Crime Victims / psychology*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Models, Psychological
  • Peer Group
  • Quebec
  • Self Medication / methods
  • Self Medication / psychology*
  • Self Report
  • Suicidal Ideation*