Modeling the reciprocal dynamic between alcohol and suicide urges among college students: Ecological momentary assessment study.

Abstract

Objective: Alcohol use is associated with suicidal thoughts, urges, and behavior. However, prior research has been mostly cross-sectional, limiting understanding of how these variables influence one another across short time periods. The present study used ecological momentary assessment methods to establish the temporal ordering of alcohol- and suicide-related phenomena, specifically exploring the momentary dynamic between these variables.

Method: A diverse sample of college students (N = 527, 50.5% Asian, 72.0% cisgender female, M_age = 19.4) completed smartphone ecological momentary assessment up to 6 times daily for 6 to 8 weeks (81,299 total observations; M_Observations = 154 per person), answering questions about current urge to use alcohol and urge to engage in suicidal behavior. Dynamic structural equation modeling was used to investigate within-person autoregressive and cross-lagged effects.

Results: Autoregressive effects were found, such that urge to do a behavior at the previous time point (t-1) positively predicted urge to do that same behavior at the current time point (t). Cross-lagged analyses revealed that alcohol urges at the previous time point positively predicted suicide urges at the current time point, and suicide urges at the previous time point positively predicted alcohol urges at the current time point, demonstrating a reciprocal dynamic (i.e., positive feedback loop).

Conclusions: Results provide initial empirical support for a reciprocal dynamic between drinking urges and urge to engage in suicidal behavior among young people and college students that occurs over a short time period, underscoring the potential importance of in the moment intervention strategies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).