Symposia
Suicide and Self-Injury
Sarah Thomas, Ph.D.
Assistant Professor
Alpert Medical School of Brown University
Providence, Rhode Island
Elizabeth Thompson, Ph.D.
Assistant Professor
Rhode Island Hospital/Alpert Medical School of Brown University
Providence, Rhode Island
Micaela M. Maron, B.S.
Clinical Research Assistant
Bradley Hospital/Warren Alpert Medical School of Brown University
Providence, Rhode Island
Sarah K. Ryan, PhD
Clinical Research Assistant
Bradley Hospital/Warren Alpert Medical School of Brown University
Providence, Rhode Island
Samuel Meisel, Ph.D.
F32 Postdoctoral Fellow
Alpert Medical School of Brown University
Providence, Rhode Island
Jessica R. Peters, Ph.D. (she/her/hers)
Assistant Professor
Brown University
Providence, Rhode Island
Jennifer Wolff, Ph.D.
Associate Professor
Warren Alpert School of Medicine, Department of Psychiatry, Brown University
Providence, RI
Substance use among teens admitted for psychiatric hospitalization may have a negative impact on the course of care and prognosis. Among teen inpatients, there is a link between suicide attempts and use of substances such as nicotine, alcohol, and cannabis. The goals of the current study were to assess: 1) rates of substance use before and during the COVID-19 pandemic among hospitalized youth, 2) assess motivation to engage in substance use to cope with Covid-related stressors, and 3) to assess psychiatric correlates of substance use. This information can inform service in emergency contexts.
The sample included teens psychiatrically hospitalized before and during the COVID-19 pandemic. We first assessed if number of days of alcohol and cannabis use differed for teens hospitalized between 1/1/18 & 3/13/20 (“pre-Covid”) vs. 3/14/20 to 6/1/21 (“Covid”; n=816, 11-18 years, 62% female). Within a subsample of inpatients (n=124; 75% female) hospitalized between 12/16/20 & 4/5/21, we then evaluated psychiatric correlates of endorsing using alcohol, cannabis, or e-cigarettes to cope with the pandemic and changes/rules enacted due to the virus.
Teens admitted during Covid reported significantly more days using alcohol (t=-3.29, p=.001) and cannabis (t=-2.33, p=.02) relative to teens admitted pre-Covid. This effect remained significant when controlling for age and sex for alcohol, but not for cannabis. In the COVID sub-sample, youth endorsed using cannabis (33.1%), alcohol (19.4%), and e-cigarettes/vaping (25%) to cope with COVID-19.
Endorsement of using cannabis to cope with COVID-19 was linked to more adverse childhood experiences (ACES; t=-2.25, p=.026). Using alcohol to cope was linked to more ACES (t=-2.01, p=.046), functional impairment (t=-2.24, p=.027), internalizing symptoms (t=-2.03, p=.045), and suicidal ideation (t=-2.06, p=.042). E-cigarettes/vaping to cope was linked to greater impulsive emotion dysregulation (t=-2.02, p=.045). Lastly, when evaluating whether endorsing substance use to cope during COVID-19 was linked to a lifetime history of suicide attempt, only endorsing e-cigarette/vaping was significant, controlling for age/sex (B=.30, p=.005).
Teens had a higher rate of substance use during COVID-19, and they indicated that use was coping-related. Substance use screening remains an important tool for identifying youth at greater risk for harm during a mental health crisis. Implications for cognitive behavioral treatment will be discussed, including capitalizing on youths’ ability to recognize the need to cope.