ArticleJournal of affective disorders2026
Examination of the moderating role of internalizing symptoms in the direct and indirect relationships between alcohol use severity, rumination, and suicidal ideation.
Article in Journal of affective disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveAlcohol use is associated with suicidal ideation (SI). Rumination, an established suicide risk factor, is elevated following alcohol use, suggesting its potential relevancy in the relationship between alcohol use and SI. The nature of this relationship is understudied, and more work is necessary to understand the dynamic interaction between alcohol use and SI. The current study aimed to examine this relationship indirectly through rumination, as well as examining the moderating roles of depression and anxiety symptoms on these paths.
methodsParticipants were 278 community-based adults with current SI and/or a lifetime suicide attempt (M
resultsRumination did not account for the relationship between alcohol use severity and SI (B = 0.02, SE = 0.02, 95 % CI [-0.02, 0.07]). Depression and anxiety symptoms significantly moderated (1) the relationship between alcohol use severity and rumination; (2) the relationship between rumination and SI; and (3) the relationship between alcohol use severity and SI. The nature of simple slopes differed across paths.
conclusionThe indirect relationship between alcohol use severity and SI through rumination was non-significant, yet internalizing symptoms of depression and anxiety significantly moderated the relationships between alcohol use severity, rumination, and SI. Varying levels of these symptoms influenced these associations differently, which may reveal how internalizing symptoms impact risk factors for suicide differentially, suggesting notable clinical and research implications.
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