Negative life events, alcohol use and suicides: A complex relationship

Suicide is a global public health problem.Hence, understanding modifiable factors that precede suicidal behaviour is crucial.Research indicates that the time immediately preceding a suicide attempt differs from other periods in an individual's life, highlighting the importance of identifying specific triggers.Previous studies have shown that interpersonal negative life events (INLEs) and alcohol use play a key role in contributing to suicidal ideation (SI) and suicide attempts.Alcohol consumption increases the likelihood of experiencing INLEs by impairing cognitive control and promoting risky behaviours, which in turn elevates the risk of stress-reactive suicide attempts.Additionally, individuals may resort to alcohol as a coping mechanism in response to INLEs, aligning with the tensionreduction theory, further reinforcing the cycle of distress and self-destructive behaviours.The bidirectional relationship between alcohol use and INLEs remains largely unexplored in the critical hours preceding suicide.Two potential moderators in this phenomenon could be (i) gender (alcohol consumption and use disorders are more prevalent amongst males, while females experience a higher frequency of INLEs), and (ii) alcohol use disorders.To better understand how these within-person processes contribute to suicide risk, it is essential to examine how chronic risk factors influence these proximal associations and whether they differ across key subgroups.Therefore, this study was planned to (i) study the temporal relations between acute INLEs and acute alcohol use in the 24 hours preceding suicide attempts, and (ii) explore biological sex and chronic alcohol use as potential moderators.A total of 151 individuals were recruited. 1articipants were included in the study if they were 18 years or older, admitted within 24 hours of a suicide attempt, exhibited a clear intent to die, and provided informed consent to participate.Exclusion criteria included individuals with severe acute medical conditions, the presence of thought disorder symptoms such as hallucinations, or cognitive impairment that could interfere with their ability to engage in the study.Timeline follow-back for suicide attempts (TLFB-SA) and alcohol use disorders identification test (AUDIT) were used to assess the retrospective hourly INLEs and alcohol use.Separate hierarchical