Health-risk behaviors and suicidal ideation: a preliminary study of cognitive and developmental factors

Various theorists have suggested that unhealthy behaviors such as cigarette smoking and problem drinking may be subtle forms of suicidality. Consistent with this view, prior research has shown an association between health risk behaviors and suicidal ideation. In the present study we examined relationships among suicidal ideation, health-related attitudes and behaviors, and adverse childhood events. We hypothesized that unhealthy attitudes, perhaps shaped by adverse childhood events, would help explain the association between suicidal phenomena and unhealthy behaviors. Three-hundred eighteen college students completed surveys covering health risk behaviors, depression, suicidal ideation, and health-related attitudes. Results supported the hypothesized associations among these variables. However, contrary to our hypotheses, the association between suicidal ideation and health-compromising behaviors was limited largely to substance-related behaviors. Moreover, the association between suicidal ideation and health-related attitudes was mediated by depression. Adverse childhood events were associated with health-related attitudes, but this relationship was mediated by depression. These results are less suggestive of the notion of unhealthy behaviors as subtle suicidality than a model in which suicidality associates specifically with psychopathological states such as depression and substance abuse. Implications for treatment and prevention programs are discussed.