Substance Use and Suicidal Ideation Among Child Welfare Involved Youth

Abstract

Substance use and suicide among adolescents is a pervasive problem in the United States. It is estimated that over 190,000 youth go to the emergency department each year as a result of alcohol related injuries and over 5,000 youth are estimated to die each year from alcohol related incidents. Moreover, suicide is the second leading cause of death for adolescents, resulting in more than one in ten deaths among adolescents. Research has demonstrated that a history of childhood abuse is a strong risk factor for suicidal ideation and alcohol misuse and related problems. It is estimated that 29% of maltreated youth engage in substance use with 9% reporting moderate to high levels of use and 5% reporting risky suicidal behavior. Although prior studies provide a foundation for understanding substance use and suicidal thoughts among maltreated youth, some significant gaps remain in the knowledge base including the use of older data, treating all maltreated youth as a homogenous group, and looking at substance use and suicidal thoughts as independent outcomes. This dissertation fills some of these gaps in the empirical literature by focusing on three specific aims: 1) examine the co-occurrence of substance use and suicidal thoughts among maltreated youth; 2) investigate the longitudinal predictors of substance use and suicidal thoughts among maltreated youth; and 3) assess whether the predictors of substance use and suicidal thoughts are similar or different across placement types (in-home care, kinship care, or foster care). The National Survey on Child and Adolescent Wellbeing (NSCAW II) restricted dataset is used as the primary source for the analyses to address each aim. Policy and practice implications are provided for the fields of addiction, mental health, and child welfare.