The Mediating Roles of Mental Health and Substance Use on Suicidal Behavior Among Undergraduate Students With ADHD

Brown, Natasha; McLafferty, Margaret; O’Neill, Siobhan; Hugh, Rachel Mc; Ward, Caoimhe; McBride, Louise; Brady, John; Bjourson, Anthony J.; Walsh, Colum P.; Murray, Elaine

doi:10.1177/10870547221075844

Cited by 9 publications

(5 citation statements)

References 55 publications

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“…However, these traits have been found to mainly predict suicide attempts and to a much lesser extent, suicidal ideation [ 86 ]. Nevertheless, some studies have observed direct associations of ADHD with suicidality after controlling for comorbid psychiatric disorders [ 87 – 89 ]. To the best of our knowledge, none of the previous studies has tested the mediating effect of PLEs in the association between ADHD symptoms and suicidality.…”

Section: Discussionmentioning

confidence: 99%

Association of sociodemographic, proximal, and distal clinical factors with current suicidal ideation: Findings from a nonclinical sample of young adults

et al. 2023

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Section: Discussionmentioning

confidence: 99%

Association of sociodemographic, proximal, and distal clinical factors with current suicidal ideation: Findings from a nonclinical sample of young adults

et al. 2023

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“…For example, Evans et al (2022) found that there may be a correlation between ADHD symptoms and NSSI in veterans. Brown et al (2022) found that the incidence of suicide and NSSI among college students with ADHD was significantly higher than that of college students without ADHD. Their conclusions identified specific risk predictors for students with ADHD.…”

Section: Introductionmentioning

confidence: 91%

A study of the interactive mediating effect of ADHD and NSSI caused by co-disease mechanisms in males and females

Cheng,

Shi,

Xie

et al. 2024

PeerJ

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Background Non-suicidal self-injury (NSSI), of which the predisposing factors are complex and diverse, profoundly affects the physical and mental health of young people. Therefore, this work established an NSSI intermediary network model considering the interaction of multiple factors. A mediating effect between attention-deficit/hyperactivity disorder (ADHD) and NSSI, considering the influence of comorbidities, such as depression, anxiety, and impulsive personality, was proposed based on sex differences. Methods A total of 2,689 middle school students in Ningbo City, Zhejiang Province, China, were randomly sampled and participated in this study. Data regarding their demographic characteristics, attention deficit, hyperactivity/impulsivity, NSSI, anxiety, depression, internet addiction, and other comorbid symptoms were collected and analyzed. After initially screening the data, variables were assessed for significance using a single-factor inter-group difference analytic method, and a binary logistic regression analysis was performed. The intermediary effect of factors influencing NSSI in males and females was also analyzed. Results The overall NSSI rate was 15.16%. The results showed that the impact of individual impulsivity characteristics (impulsiveness, the ADHD with hyperactivity/impulsivity subtype) on NSSI behavior was not significant (regression results, P > 0.05). The degree of association between ADHD with attention deficit and ADHD with comprehension deficit subtypes, and other comorbid symptoms (depression, anxiety, and internet addiction disorder) and NSSI, with odds ratios (ORs) of 7.6/6.42/436.68/3.82/1.86, and 95% bootstrap confidence intervals (CIs) of 4.64, 12.87/3.46, 12.67/137.42, 2659.13/2.32, 6.37/1.31, 2.82, respectively. The results also showed significant effects of ADHD subtypes on comorbid symptoms and the path effects of NSSI (P < 0.01). Among them, the mediating effect was the strongest when anxiety was the mediating variable, and the mediating effect of girls was higher than that of boys. Conclusion The results of this work demonstrated the influence of ADHD symptoms on NSSI behavior. Among patients with ADHD, patients with subtypes with obvious attention deficit characteristics were more likely to exhibit NSSI behavior, whereas the hyperactive impulse subtype had no direct impact on NSSI. We conclude that adolescent impulsivity may not be directly related to NSSI behavior and that impulsive characteristics jointly affect NSSI behavior through a series of NSSI comorbid symptoms. Notably, the probability of symptom onset and the degree of comorbidity was significantly higher in girls than in boys of the same age, and girls were more prone to NSSI behavior. These findings provide effective theoretical support for the prevention and treatment of adolescent NSSI behavior.

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“…With similar findings corroborated in ADHD samples, 14 this heightened risk in autistic people with ADHD is importantly independent of psychiatric conditions like anxiety, depression and substance abuse, 13 which are also more common in this cohort 15,16 and a major correlate and risk factor for suicidality, in and of themselves, in both autistic and ADHD populations. 2,17,18 Similarly, a number of studies report an association between ADHD and suicidality 14,[19][20][21] which is separate from these confounds and seemingly reflects something about living in the world as an individual with ADHD. 22 These concerning findings highlight the need to examine the role of co-occurring ADHD in autistic suicidality and to identify the mechanisms through which these individuals might be at greater risk.…”

Section: Introductionmentioning

confidence: 99%

Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide

Moseley

Gregory

Smith

et al. 2024

Autism in Adulthood

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BackgroundAutistic people with co-occurring ADHD appear to be at heightened risk of suicide. To understand why, we explored two explanatory mechanisms from the interpersonal theory of suicide: first, that co-occurring ADHD might be associated with greater risk through greater thwarted belongingness and perceived burdensomeness; and secondly, that hyperactive/impulsive features might incur additional risk through their association with painful and provocative events, which are suggested to create 'capability' for suicide. MethodsAutistic adults (n = 314) completed an online survey including measures of thwarted belongingness, perceived burdensomeness, painful and provocative events, acquired capability for suicide, and ADHD features. Creating an overall index of likely ADHD, we examined associations between likely ADHD, suicide ideation and lifetime suicide attempts via the parallel mediators of thwarted belongingness, perceived burdensomeness, anxiety and depression. In several models, we then examined hyperactive, impulsive and inattentive features as predictors of exposure to painful and provocative events and subsequent capability for suicide, and examined whether these two variables, sequentially or individually, mediated an association with lifetime suicide attempts. ResultsLikely ADHD was associated with past-year suicide ideation via greater depression and perceived burdensomeness, which also mediated its association with more suicide attempts.Hyperactive and impulsive features were associated with exposure to painful and provocative events and through this acquired suicide capability. Both features were associated with more numerous suicide attempts via these two mediators sequentially, and via exposure to painful and provocative events alone. ConclusionsThese data suggest that suicidality in autistic people with ADHD may be partially related to perceived burdensomeness and to acquired suicide capability following exposure to painful and provocative events. However, as we observed a pathway to suicidality associated with painful and provocative events alone, it is likely that there are also other explanatory mechanisms for the influence of traumatic events on suicide risk.

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The Mediating Roles of Mental Health and Substance Use on Suicidal Behavior Among Undergraduate Students With ADHD

Cited by 9 publications

References 55 publications

Association of sociodemographic, proximal, and distal clinical factors with current suicidal ideation: Findings from a nonclinical sample of young adults

Association of sociodemographic, proximal, and distal clinical factors with current suicidal ideation: Findings from a nonclinical sample of young adults

A study of the interactive mediating effect of ADHD and NSSI caused by co-disease mechanisms in males and females

Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide

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