Las estrategias de regulación emocional median en la relación entre el consumo excesivo de alcohol y riesgo suicida Emotion regulation strategies mediate the relationship between excessive use of alcohol and suicide risk

Autores/as

DOI:

https://doi.org/10.20882/adicciones.2418

Palabras clave:

alcohol, suicidio, regulación emocional, tolerancia a la angustia, habilidades de afrontamiento alcohol, suicide, emotional regulation, tolerance of distress, coping skills

Resumen

El alcohol es una de las sustancias más consumidas en todo el mundo. Se hipotetiza que las personas que consumen alcohol tienen pobres estrategias de regulación emocional, algo que comparten las personas que se suicidan. Por ello, el objetivo de este trabajo es estudiar el efecto mediacional de las estrategias de afrontamiento y la tolerancia a la angustia en la relación entre el consumo excesivo de alcohol y el riesgo suicida. En una muestra de 1014 participantes (33,82% hombres, 66,17% mujeres; M = 33,0, DE = 15,15) se aplicó un cuestionario sociodemográfico personalizado, el Test de Identificación de Trastornos por Consumo de Alcohol (AUDIT), el Cuestionario de Afrontamiento del Estrés (CSQ), la escala de Tolerancia al Distrés (DTS) y el de Riesgo Suicida (RS). Se realizaron dos modelos de mediación en los que se utilizaron las puntuaciones del AUDIT como variable independiente, la puntuación del RS como dependiente y el sexo como covariable. En el primer modelo la variable mediadora fueron las puntuaciones CSQ y en el segundo las puntuaciones DTS. La relación fue mediada positivamente por Autoenfoque Negativo, Valoración y Absorción, y negativamente por Búsqueda de Apoyo Social y Tolerancia. La regulación emocional es una estrategia transdiagnóstica que puede reducir no sólo el consumo de alcohol, sino también el riesgo suicida. Dados estos resultados, existe una necesidad imperiosa de desarrollar programas preventivos centrados en estrategias adaptativas de regulación emocional. La regulación emocional juega un papel clave en la relación entre el consumo excesivo de alcohol y el riesgo suicida
Alcohol is one of the most widely consumed substances worldwide. It is hypothesized that people who use alcohol have poor emotional regulation strategies, something shared by people who commit suicide. Therefore, the aim of this work is to study the mediational effect of coping strategies and distress tolerance in the relationship between excessive alcohol use and suicidal risk. A sample of 1014 participants (33.82% male, 66.17% female; M = 33.0, SD = 15.15) were assessed using a custom sociodemographic questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), the Coping with Stress Questionnaire (CSQ), Distress Tolerance Stress (DTS), and Suicide Risk (RS). Two mediation models were performed in which AUDIT scores were used as the independent variable, RS score as the dependent and sex as a covariate. In the first model the mediating variable was the CSQ scores and in the second the DTS scores. The relationship was mediated positively by Negative Auto-Focused, Appraisal and Absorption, and negatively by Social Support Seeking and Tolerance. Emotional regulation is a transdiagnostic strategy that can reduce not only alcohol consumption, but also suicidal risk. Given these results, there is a pressing need to develop preventive programs centered on adaptive emotion regulation strategies. Emotional regulation plays a key role in the relationship between excessive alcohol use and suicidal risk

Biografía del autor/a

Celia Antuña Camblor, Universidad a Distancia de Madrid (UDIMA)

Facultad de Psicología y Ciencias de la Salud, Universidad a Distancia de Madrid (UDIMA), Madrid

Gabriel Esteller-Collado, Universidad de Valencia

Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología, Universidad de Valencia, Valencia

Roger Muñoz-Navarro, Universidad de Valencia

Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología, Universidad de Valencia, Valencia

Citas

Aldao, A., Nolen-Hoeksema, S. & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004

Al-Halabí, S. & Fonseca-Pedrero, E. (2023). Are there Common Components in Effective Psychotherapies for Suicidal Behavior? Implications for Professional Practice. Revista de Psicoterapia, 34(124), 83–99. https://doi.org/10.5944/rdp.v34i124.37050

Al-Halabí, S. & Fonseca-Pedrero, E. (2024). Editorial for Special Issue on Understanding and Prevention of Suicidal Behavior: Humanizing Care and Integrating Social Determinants. Psicothema, 36(4), 309–318. https://doi.org/10.7334/psicothema2024.341

Anestis, M. D., Bagge, C. L., Tull, M. T. & Joiner, T. E. (2011). Clarifying the role of emotion dysregulation in the interpersonal-psychological theory of suicidal behavior in an undergraduate sample. Journal of Psychiatric Research, 45(5), 603–611. https://doi.org/10.1016/j.jpsychires.2010.10.013

Antuña-Camblor, C., Esteller-Collado, G., Muñoz-Navarro, R., Rabito-Alcón, M. F. & Rodríguez-Díaz, F. J. (2024). Emotional Disorders, Distress Tolerance and Suicide Risk: A Mediation Model. OMEGA - Journal of Death and Dying. https://doi.org/10.1177/00302228241299287

Bousoño, M., Al-Halabí, S., Burón, P., Garrido, M., Díaz-Mesa, E. M., Galván, G., García-Álvarez, L., Velasco, Á., Rodríguez-Revuelta, J., Wasserman, C., Carli, V., Hoven, C., Sarchiapone, M., Wasserman, D., Bousoño, M., García-Portilla, M. P., Iglesias, C., Sáiz, P. A. & Bobes, J. (2021). Consumo de alcohol y factores de riesgo de conductas autolesivas en adolescentes españoles. Adicciones, 33(1), 53. https://doi.org/10.20882/adicciones.1239

Fletcher, J. M. (2019). Estimating causal effects of alcohol access and use on a broad set of risky behaviors: Regression discontinuity evidence. Contemporary Economic Policy, 37(3), 427–448. https://doi.org/10.1111/coep.12405

Fonseca-Pedrero, E. & Al-Halabí, S. (2024). Sobre la conducta suicida y las conductas adictivas. Adicciones, 36(2), 121–128. https://doi.org/10.20882/adicciones.2074

Glantz, M. D., Bharat, C., Degenhardt, L., Sampson, N. A., Scott, K. M., Lim, C. C. W., Al-Hamzawi, A., Alonso, J., Andrade, L. H., Cardoso, G., De Girolamo, G., Gureje, O., He, Y., Hinkov, H., Karam, E. G., Karam, G., Kovess-Masfety, V., Lasebikan, V., Lee, S.,… Kessler, R. C. (2020). The epidemiology of alcohol use disorders cross-nationally: Findings from the World Mental Health Surveys. Addictive Behaviors, 102, 106128. https://doi.org/10.1016/j.addbeh.2019.106128

Griswold, M. G., Fullman, N., Hawley, C., Arian, N., Zimsen, S. R. M., Tymeson, H. D., Venkateswaran, V., Tapp, A. D., Forouzanfar, M. H., Salama, J. S., Abate, K. H., Abate, D., Abay, S. M., Abbafati, C., Abdulkader, R. S., Abebe, Z., Aboyans, V., Abrar, M. M., Acharya, P.,… Gakidou, E. (2018). Alcohol use and burden for 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 392(10152), 1015–1035. https://doi.org/10.1016/S0140-6736(18)31310-2

Hawton, K., Bergen, H., Cooper, J., Turnbull, P., Waters, K., Ness, J. & Kapur, N. (2015). Suicide following self-harm: Findings from the Multicentre Study of self-harm in England, 2000–2012. Journal of Affective Disorders, 175, 147–151. https://doi.org/10.1016/j.jad.2014.12.062

Hawton, K., Knipe, D. & Pirkis, J. (2024). Restriction of access to means used for suicide. The Lancet Public Health, 9(10), e796–e801. https://doi.org/10.1016/S2468-2667(24)00157-9

Joiner, T. (2005). Why people die by suicide. Harvard University Press.

Kranzler, H. R. & Soyka, M. (2018). Diagnosis and Pharmacotherapy of Alcohol Use Disorder. JAMA, 320(8), 815. https://doi.org/10.1001/jama.2018.11406

Krug, E. G., Mercy, J. A., Dahlberg, L. L. & Zwi, A. B. (2002). The world report on violence and health. The Lancet, 360(9339), 1083–1088. https://doi.org/10.1016/S0140-6736(02)11133-0

Linehan, M. M. (1993). Cognitive behavioral therapy of borderline personality disorder. Guilford Press.

Melli, G., Chiorri, C., Lebruto, A., Drabik, M. J., Puccetti, C. & Caccico, L. (2021). Psychometric Properties of the Italian Version of the Distress Tolerance Scale (DTS). Journal of Psychopathology and Behavioral Assessment, 43(3), 698–706. https://doi.org/10.1007/s10862-021-09876-1

Neacsiu, A. D., Eberle, J. W., Kramer, R., Wiesmann, T. & Linehan, M. M. (2014). Dialectical behavior therapy skills for transdiagnostic emotion dysregulation: A pilot randomized controlled trial. Behaviour Research and Therapy, 59, 40–51. https://doi.org/10.1016/j.brat.2014.05.005

O’Connor, R. C. & Kirtley, O. J. (2018). The integrated motivational–volitional model of suicidal behaviour. Philosophical Transactions of the Royal Society B: Biological Sciences, 373(1754), 20170268. https://doi.org/10.1098/rstb.2017.0268

Pérula de Torres, L. A., Fernández-García, J. A., Arias-Vega, R., Muriel-Palomino, M., Márquez-Rebollo, E. & Ruiz-Moral, R. (2005). Validación del cuestionario AUDIT para la identificación del consumo de riesgo y de los trastornos por el uso de alcohol en mujeres. Atención Primaria, 36(9), 499–506. https://doi.org/10.1016/S0212-6567(05)70552-7

Rehm, J., Gmel, G. E., Gmel, G., Hasan, O. S. M., Imtiaz, S., Popova, S., Probst, C., Roerecke, M., Room, R., Samokhvalov, A. V., Shield, K. D. & Shuper, P. A. (2017). The relationship between different dimensions of alcohol use and the burden of disease—an update. Addiction, 112(6), 968–1001. https://doi.org/10.1111/add.13757

Romero, D. H., Riggs, S. A., Raiche, E., McGuffin, J. & Captari, L. E. (2020). Attachment, coping, and psychological symptoms among military veterans and active duty personnel. Anxiety, Stress, & Coping, 33(3), 326–341. https://doi.org/10.1080/10615806.2020.1723008

Rottenberg, J., Gross, J. J. & Gotlib, I. H. (2005). Emotion Context Insensitivity in Major Depressive Disorder. Journal of Abnormal Psychology, 114(4), 627–639. https://doi.org/10.1037/0021-843X.114.4.627

Sandín, B. & Chorot, P. (2003). Cuestionario de afrontamiento del estrés (CAE) : Desarrollo y validación preliminar. Revista de Psicopatología y Psicología Clínica, 8(1). https://doi.org/10.5944/rppc.vol.8.num.1.2003.3941

Sandín, B., Simons, J. S., Valiente, R., Simons, R. M. & Chorot, P. (2017). Psychometric properties of the spanish version of The Distress Tolerance Scale and its relationship with personality and psychopathological symptoms. Psicothema, 29(3), 421–428.

Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R. & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption‐II. Addiction, 88(6), 791–804. https://doi.org/10.1111/j.1360-0443.1993.tb02093.x

Simons, J. S. & Gaher, R. M. (2005). The Distress Tolerance Scale: Development and Validation of a Self-Report Measure. Motivation and Emotion, 29(2), 83–102. https://doi.org/10.1007/s11031-005-7955-3

Spanish Ministry of Health. (2025). Encuesta sobre el alcohol y otras drogas en España en 2024 (EDADES). https://pnsd.sanidad.gob.es/profesionales/sistemasInformacion/sistemaInformacion/pdf/2024_Informe_EDADES.pdf

Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A. & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600. https://doi.org/10.1037/a0018697

Vujanovic, A. A., Berenz, E. C. & Bakhshaie, J. (2017). Multimodal Examination of Distress Tolerance and Suicidality in Acute-Care Psychiatric Inpatients. Journal of Experimental Psychopathology, 8(4), 376–389. https://doi.org/10.5127/jep.059416

Waesche, M. C., Clark, C. B. & Cropsey, K. L. (2016). The Connection Between Thwarted Belongingness, Alcohol Consumption, Suicidal, and Homicidal Ideation in a Criminal Justice Sample. Journal of Addiction Medicine, 10(6), 437–442. https://doi.org/10.1097/ADM.0000000000000257

Wilcox, H. C., Conner, K. R. & Caine, E. D. (2004). Association of alcohol and drug use disorders and completed suicide: An empirical review of cohort studies. Drug and Alcohol Dependence, 76, S11–S19. https://doi.org/10.1016/j.drugalcdep.2004.08.003

World Health Organization. (2019). Global status report on alcohol and health 2018.

World Health Organization. (2021). Suicide worldwide in 2019. https://www.who.int/publications/i/item/9789240026643

Descargas

Publicado

2026-03-31

Número

Vol. 38 Núm. 1 (2026)

Sección

Originales