Psychological Reports, 1990, 66, 1363-1366. O Psychological Reports 1990
RELATIONSHIP BETWEEN ALCOHOL DEPENDENCY AND SUICIDE IDEATION AMONG HIGH SCHOOL STUDENTS ' MICHAEL WORKMAN AND JOHN BEER United School District Number 392, Osborne, Kansa~ Summary.-126 high school students completed the MacAndrew Alcohol Scale and a modified version of the Beck Scale for Suicide Ideation. Analyses of variance (2 x 4) showed boys were not experiencing suicide ideation any more than girls; suicide ideation was similar across the four grades, but on alcohol-dependency boys scored significantly higher than girls and scores for Grade 9 were significantly higher than those for Grade 10. The sophomores' scores on alcohol dependency were significantly lower than the freshmen's scores. One Pearson r of 0.28 between alcohol dependency and suicide ideation was significant but research must explore better the associations of thoughts of suicide and dmglalcohol dependency among high school students so strategies may focus upon prevention and intervention.
The major element of the alcohol dependency syndrome is the extent to which there is impairment of control over alcohol (control over how much to drink and when to drink). Some other aspects include severe withdrawal symptoms, awareness of a compulsion to excessive drinking, increased tolerance of alcohol, and evidence of alcohol-seeking behavior. Higher alcohol dependence was associated with greater quantities of alcohol consumed and various psychosocial problems related to excessive drinking, for example, poor social stabihty, low self-esteem, physical symptoms (Skinner, 1981). Workman and Beer (1989) reported that freshmen had lower alcohol dependency scores than sophomores, juniors, and seniors. Self-esteem and depression scores were negative and significantly correlated but positive for scores on depression and alcohol dependency. The present study was undertaken to estimate the correlation between alcohol dependency and suicide ideation among hlgh school students. As alcohol dependency increases, suicide ideation increases. Boys should show greater alcohol dependency than girls, but girls should have higher suicide ideation than boys. The dependent measures were scores on the MacAndrew Alcohol Scale and the Beck suicide ideation scale. Independent measures were high school grade (freshman, sophomore, junior, and senior) and sex (girls and boys). The MacAndrew Alcohol Scale contains 49 truelfalse items (MacAndrew, 1965; Rosenberg, 1972; Apfeldorf & Hundley, 1981) which can be hand-scored in two or three minutes. The scale is widely used and is con-
'The opinions expressed here are those of the authors and do not necessarily represent those of the district. Reprints available from John Beer, 300 E. New Hampshire, Osborne, KS 67473.
1364
M.WORKMAN & J. BEER
structed of items from the Minnesota Multiphasic Person&ty Inventory (MMPI). It was developed by MacAndrew from studies of 300 male alcoholic outpatients and 300 nonalcoholic male psychiatric outpatients from an urban clinic for treatment (MacAndrew, 1965). The scale is used as a diagnostic questionnaire to assess the severity of alcoholism. A high score indicates the presence of alcoholism while a low score indicates nonexcessive drinking. The cut-off score is 24 which indicates the presence of an alcohol problem. Suicide, willfully and purposefully taking one's own life, is one of the 10 leading causes of death in the United States. Suicide ideators are people who have wishes and plans to commit suicide, but they have not made any actual attempt at suicide (Beck, Davis, Frederick, Perlin, Pokorny, Schulrnan, Seiden, & Wittlin, 1972). The Beck Scale for Suicide Ideation "was designed to quantify the intensity of current conscious suicidal intent by scaling various dimensions of self-destructive thoughts or wishes" (Beck, Kovacs, & Weissman, 1979, p. 345). It consists of 19 multiple-choice questions. The person completing the form circles one of the numerals 0, 1, 2 below each question. The total score is obtained by adding all of the circled numbers for a range of scores 0 to 38. In this case the first 11 questions were used as a measure of suicide which has a range of scores 0 to 22. The first five questions were from I. Characteristics of Attitude Toward Living/ Dying and the next six questions were from 11. Characteristics of Suicide Ideationwish. The subjects were recruited from a small north central Kansas high school with approval from the administration. There were 40 freshmen (19 girls, 21 boys), 31 sophomores (20 girls, 11 boys), 27 juniors (12 girls, 15 boys), and 28 seniors (16 girls, 12 boys). Each subject completed the MacAndrew Alcohol Scale and a modified version of the Beck Scale for Suicide Ideation. The Beck Scale for Suicide Ideation was modified by using the first 11 questions and by making the phrases into sentences without changing the meanings. Background information was collected from each subject including age, grade, and sex. Teachers in the high school administered the pencil-and-paper questionnaires in their classes. Descriptive statistics for the suicide ideation and alcohol dependency scores, and age are summarized in Table 1. A series of 2 x 4 analyses of variance were performed, using independent variables of sex (boy, girl) and grade (freshman, sophomore, junior, senior) on the two measures, the Beck Scale for Suicide Ideation and the MacAndrew Alcohol Scale. For the suicide ideation scores there were no significant effects for sex (F,,,,,= 2.87, p > .05) or grade ( F,,,,, = 0.45, p > .05) and none for their interaction (F,,,,, = 0.75, p > .05). Boys were not experiencing suicide ideation any more than girls, and no differences were observed across grades.
HIGH SCHOOL STUDENTS: SUICIDE, ALCOHOL DEPENDENCY
1365
On alcohol-dependency scores there were significant effects for sex (F,,,,, 13.83, p < .01) and for grade (F,,,,, = 2.61, p < .05) but no significant interaction. To locate the differences among the grades, Fisher's LSD multiple comparisons were used. The mean for Grade 9 was significantly different from that for Grade 10. The sophomores' scores on alcohol dependency were significantly lower than the freshmen's scores. =
TABLE 1 ns, MEANS,AND STANDARD DEVIATIONS FORAGE,S U I C ~ EA N, D ALCOHOLISM SCORES IN GRADES 9, 10, 11, A N D 12 FORHIGHSCHOOLSTUDENTS Group
n
Beck Suicide Scores M
.SD
McAndrew Scores M
Range
Age
M
SD
SD
All Girls All Boys Freshman Girls Boys Sophomore Girls Boys Junior Girls Boys Senior Girls
Boys
On group means for suicide ideation, seniors scored higher than any other grades. The mean scores ranged from lowest 2.36 (junior boys) and 2.92 (senior boys) to highest 4.53 (freshman girls) and 5.63 (senior girls). Though the mean scores of the girls were higher than the mean scores of the boys, the scores were not significantly different, although girls were expected to score higher than boys on the suicidal measure. There is no critical cut-off score for the ideation measure so no comparison can be made. It can be stated that the higher the ideation score, the more problem one will have with suicidal thoughts. For the MacAndrew Alcohol Scale 24 is the cut-off score which indicates problems with alcohol. The mean score of each grade was lower than 24, but the senior and freshman boys both had scores exceeding 23, so these two groups of students are at risk for alcohol problems, with boys having higher means on alcohol dependency than girls as expected. Freshmen had significantly higher scores than sophomores, but freshmen had the highest mean high school grade. Senior and freshman boys had highest mean scores while sophomore and junior girls had the lowest.
1366
M. WORKMAN & J. BEER
Alcohol dependency correlated significantly with suicide ideation (Pearson r,,, = .28, p
RELATIONSHIP BETWEEN ALCOHOL DEPENDENCY AND SUICIDE IDEATION AMONG HIGH SCHOOL STUDENTS ' MICHAEL WORKMAN AND JOHN BEER United School District Number 392, Osborne, Kansa~ Summary.-126 high school students completed the MacAndrew Alcohol Scale and a modified version of the Beck Scale for Suicide Ideation. Analyses of variance (2 x 4) showed boys were not experiencing suicide ideation any more than girls; suicide ideation was similar across the four grades, but on alcohol-dependency boys scored significantly higher than girls and scores for Grade 9 were significantly higher than those for Grade 10. The sophomores' scores on alcohol dependency were significantly lower than the freshmen's scores. One Pearson r of 0.28 between alcohol dependency and suicide ideation was significant but research must explore better the associations of thoughts of suicide and dmglalcohol dependency among high school students so strategies may focus upon prevention and intervention.
The major element of the alcohol dependency syndrome is the extent to which there is impairment of control over alcohol (control over how much to drink and when to drink). Some other aspects include severe withdrawal symptoms, awareness of a compulsion to excessive drinking, increased tolerance of alcohol, and evidence of alcohol-seeking behavior. Higher alcohol dependence was associated with greater quantities of alcohol consumed and various psychosocial problems related to excessive drinking, for example, poor social stabihty, low self-esteem, physical symptoms (Skinner, 1981). Workman and Beer (1989) reported that freshmen had lower alcohol dependency scores than sophomores, juniors, and seniors. Self-esteem and depression scores were negative and significantly correlated but positive for scores on depression and alcohol dependency. The present study was undertaken to estimate the correlation between alcohol dependency and suicide ideation among hlgh school students. As alcohol dependency increases, suicide ideation increases. Boys should show greater alcohol dependency than girls, but girls should have higher suicide ideation than boys. The dependent measures were scores on the MacAndrew Alcohol Scale and the Beck suicide ideation scale. Independent measures were high school grade (freshman, sophomore, junior, and senior) and sex (girls and boys). The MacAndrew Alcohol Scale contains 49 truelfalse items (MacAndrew, 1965; Rosenberg, 1972; Apfeldorf & Hundley, 1981) which can be hand-scored in two or three minutes. The scale is widely used and is con-
'The opinions expressed here are those of the authors and do not necessarily represent those of the district. Reprints available from John Beer, 300 E. New Hampshire, Osborne, KS 67473.
1364
M.WORKMAN & J. BEER
structed of items from the Minnesota Multiphasic Person&ty Inventory (MMPI). It was developed by MacAndrew from studies of 300 male alcoholic outpatients and 300 nonalcoholic male psychiatric outpatients from an urban clinic for treatment (MacAndrew, 1965). The scale is used as a diagnostic questionnaire to assess the severity of alcoholism. A high score indicates the presence of alcoholism while a low score indicates nonexcessive drinking. The cut-off score is 24 which indicates the presence of an alcohol problem. Suicide, willfully and purposefully taking one's own life, is one of the 10 leading causes of death in the United States. Suicide ideators are people who have wishes and plans to commit suicide, but they have not made any actual attempt at suicide (Beck, Davis, Frederick, Perlin, Pokorny, Schulrnan, Seiden, & Wittlin, 1972). The Beck Scale for Suicide Ideation "was designed to quantify the intensity of current conscious suicidal intent by scaling various dimensions of self-destructive thoughts or wishes" (Beck, Kovacs, & Weissman, 1979, p. 345). It consists of 19 multiple-choice questions. The person completing the form circles one of the numerals 0, 1, 2 below each question. The total score is obtained by adding all of the circled numbers for a range of scores 0 to 38. In this case the first 11 questions were used as a measure of suicide which has a range of scores 0 to 22. The first five questions were from I. Characteristics of Attitude Toward Living/ Dying and the next six questions were from 11. Characteristics of Suicide Ideationwish. The subjects were recruited from a small north central Kansas high school with approval from the administration. There were 40 freshmen (19 girls, 21 boys), 31 sophomores (20 girls, 11 boys), 27 juniors (12 girls, 15 boys), and 28 seniors (16 girls, 12 boys). Each subject completed the MacAndrew Alcohol Scale and a modified version of the Beck Scale for Suicide Ideation. The Beck Scale for Suicide Ideation was modified by using the first 11 questions and by making the phrases into sentences without changing the meanings. Background information was collected from each subject including age, grade, and sex. Teachers in the high school administered the pencil-and-paper questionnaires in their classes. Descriptive statistics for the suicide ideation and alcohol dependency scores, and age are summarized in Table 1. A series of 2 x 4 analyses of variance were performed, using independent variables of sex (boy, girl) and grade (freshman, sophomore, junior, senior) on the two measures, the Beck Scale for Suicide Ideation and the MacAndrew Alcohol Scale. For the suicide ideation scores there were no significant effects for sex (F,,,,,= 2.87, p > .05) or grade ( F,,,,, = 0.45, p > .05) and none for their interaction (F,,,,, = 0.75, p > .05). Boys were not experiencing suicide ideation any more than girls, and no differences were observed across grades.
HIGH SCHOOL STUDENTS: SUICIDE, ALCOHOL DEPENDENCY
1365
On alcohol-dependency scores there were significant effects for sex (F,,,,, 13.83, p < .01) and for grade (F,,,,, = 2.61, p < .05) but no significant interaction. To locate the differences among the grades, Fisher's LSD multiple comparisons were used. The mean for Grade 9 was significantly different from that for Grade 10. The sophomores' scores on alcohol dependency were significantly lower than the freshmen's scores. =
TABLE 1 ns, MEANS,AND STANDARD DEVIATIONS FORAGE,S U I C ~ EA N, D ALCOHOLISM SCORES IN GRADES 9, 10, 11, A N D 12 FORHIGHSCHOOLSTUDENTS Group
n
Beck Suicide Scores M
.SD
McAndrew Scores M
Range
Age
M
SD
SD
All Girls All Boys Freshman Girls Boys Sophomore Girls Boys Junior Girls Boys Senior Girls
Boys
On group means for suicide ideation, seniors scored higher than any other grades. The mean scores ranged from lowest 2.36 (junior boys) and 2.92 (senior boys) to highest 4.53 (freshman girls) and 5.63 (senior girls). Though the mean scores of the girls were higher than the mean scores of the boys, the scores were not significantly different, although girls were expected to score higher than boys on the suicidal measure. There is no critical cut-off score for the ideation measure so no comparison can be made. It can be stated that the higher the ideation score, the more problem one will have with suicidal thoughts. For the MacAndrew Alcohol Scale 24 is the cut-off score which indicates problems with alcohol. The mean score of each grade was lower than 24, but the senior and freshman boys both had scores exceeding 23, so these two groups of students are at risk for alcohol problems, with boys having higher means on alcohol dependency than girls as expected. Freshmen had significantly higher scores than sophomores, but freshmen had the highest mean high school grade. Senior and freshman boys had highest mean scores while sophomore and junior girls had the lowest.
1366
M. WORKMAN & J. BEER
Alcohol dependency correlated significantly with suicide ideation (Pearson r,,, = .28, p
