Ron Albucher, M.D.

All Publications

• Suicidality and Alcohol Use as Predictors of Future Suicidal Behavior in College Students. Alcohol and alcoholism (Oxford, Oxfordshire) Coryell, W., Horwitz, A., Albucher, R., Zheng, K., Pistorello, J., Eisenberg, D., Favorite, T., King, C. 2022

  Abstract

  AIMS: There has been a marked increase in suicide fatalities among college-age students in recent years. Moreover, heavy alcohol use, a well-known risk factor for suicide, is present on most campuses. Yet, no prospective studies have examined alcohol use patterns among college students as predictors of suicidal behaviors.METHODS: Online of 40,335 students at four universities took place at the beginning of four academic years, 2015-2018. Of these, 2296 met criteria for an increased risk of suicidal behavior and completed 1- and/or 6-month follow-up evaluation(s). Baseline assessments included the Alcohol Use Disorders Identification Test to quantify alcohol consumption and resulting problems, and measures of depression, suicidal ideation and suicidal behavior.RESULTS: Suicide attempts during follow-up were reported by 35 (1.5%) of high-risk students. Regression analyses indicated that baseline severity of alcohol use consequences, but not amount of alcohol consumption, was associated with greater odds of a follow-up suicide attempt after controlling for baseline suicidal ideation, functional impairment and history of suicide attempts.CONCLUSIONS: Among college students at elevated risk for suicide, the severity of alcohol-related consequences was a significant predictor of future suicide attempts. Alcohol consumption was not a significant predictor, suggesting that the amount students drink is less of a concern for suicidal behavior than are the problems (e.g. failing to meet expectations, experiencing blackouts) associated with drinking.

  View details for DOI 10.1093/alcalc/agac037

  View details for PubMedID 36055977

• Suicide risk profiles and barriers to professional help-seeking among college students with elevated risk for suicide. Journal of psychiatric research Bornheimer, L. A., Czyz, E., Koo, H. J., Li Verdugo, J., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R. C., Coryell, W., Favorite, T., King, C. A. 2022; 152: 305-312

  Abstract

  Suicide is the second leading cause of death among college students, yet many students with elevated suicide risk do not seek professional help. This study identified suicide risk profiles among college students and examined these in relation to students' perceived barriers to professional help-seeking. Data were obtained from college students (n = 1689) identified to be at elevated risk for suicide based at four US universities. Latent class analysis was performed to determine risk profiles, followed by examinations of differences in help-seeking barriers by profile groupings. Results revealed three student groupings: (1) moderate internalizing and externalizing symptoms (with low alcohol misuse), (2) highest internalizing and externalizing symptoms (with highest social disconnection), and (3) lowest internalizing symptoms and low externalizing (with highest social connection and alcohol misuse). Group 1 included the youngest and most racially and sexually diverse students, Group 2 endorsed the most help-seeking barriers, and Group 3 endorsed the fewest barriers. Group 2 is especially concerning, considering the severe clinical characteristics, high number of barriers, and low connectedness to others for potential support. Understanding these differences across risk and barrier profiles is an important step towards developing tailored approaches to increase mental health care in college populations.

  View details for DOI 10.1016/j.jpsychires.2022.06.028

  View details for PubMedID 35772258

• Engagement With Personalized Feedback for Emotional Distress Among College Students at Elevated Suicide Risk. Behavior therapy Horwitz, A. G., Hong, V., Eisenberg, D., Zheng, K., Albucher, R., Coryell, W., Pistorello, J., Favorite, T., King, C. A. 2022; 53 (2): 365-375

  Abstract

  Depression and suicidal ideation have substantially increased among college students, yet many students with clinically significant symptoms do not perceive their distress as warranting mental health services. Personalized feedback (PF) interventions deliver objective data, often electronically, comparing an individual's reported symptoms or behaviors to a group norm. Several studies have shown promise for PF interventions in the context of mood and depression, yet little is known regarding how, and for whom, mood-focused PF interventions might be best deployed. The primary aim of this study was to examine the sociodemographic, clinical, and treatment-seeking factors associated with reviewing PF reports on emotional distress among college students (N = 1,673) screening positive for elevated suicide risk and not receiving mental health treatment. Results indicated that PF engagement was greatest among those with higher depression scores, and those reporting privacy/stigma concerns as barriers to treatment. Sexual minority students were more likely to review their PF than heterosexual students. Taken together, PF interventions may be a useful tool for engaging those with greater clinical acuity, and those hesitant to seek in-person care. Further research is warranted to examine the circumstances in which PF interventions might be used in isolation, or as part of a multitiered intervention strategy.

  View details for DOI 10.1016/j.beth.2021.10.001

  View details for PubMedID 35227410

• Electronic Bridge to Mental Health for College Students: A Randomized Controlled Intervention Trial JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY King, C. A., Eisenberg, D., Pistorello, J., Coryell, W., Albucher, R. C., Favorite, T., Horwitz, A., Bonar, E. E., Epstein, D., Zheng, K. 2022

  Abstract

  Suicide is the second leading cause of death among college students in the United States, and the percentage of students reporting suicidal thoughts is increasing. Nevertheless, many students at risk do not seek mental health (MH) services. This randomized controlled trial (RCT) examined the efficacy of Electronic Bridge to Mental Health for College Students (eBridge) for increasing at-risk students' linkage to MH services.Students from four universities were recruited via email; 40,347 (22.6%) completed the online suicide risk screen; and 3,363 (8.3%) met criteria for randomization based on suicide risk factors and lack of current treatment (62.2% female, 35.0% male, 2.8% transgender/nonbinary; 73.2% White, 7.0% Black, 19.9% Asian, 11.7% other; 12.4% Hispanic, 76.2% undergraduate). These students were randomized to eBridge [personalized feedback (PF) with option of online counseling] or Control (PF). The primary outcome was linkage to MH services within 6 months.Among students assigned to eBridge, 355 students (21.0%) posted ≥1 message, and 168 (10.0%) posted ≥2 messages to the counselor. In intent-to-treat analyses, there was no eBridge effect on obtaining MH services. However, within the eBridge group, students who posted ≥1 message were significantly more likely to link to MH services.eBridge shows promise for reaching a relatively small subset of college students at risk for suicide; however, engagement in eBridge was low. This study underscores the urgent need for more effective strategies to engage young adults in online mental health interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

  View details for DOI 10.1037/ccp0000709

  View details for Web of Science ID 000748000100001

  View details for PubMedID 35099205

• Alcohol intake in relation to suicidal ideation and behavior among university students. Journal of American college health : J of ACH Coryell, W., Horwitz, A., Albucher, R., Zheng, K., Pistorello, J., Eisenberg, D., Favorite, T., King, C. 2021: 1-5

  Abstract

  Heavy alcohol use has been clearly linked to risk for suicidal behaviors and is also prevalent on many American college campuses. This report uses a large sample of college students to explore relationships between alcohol use, depressive symptoms, and suicidality. Methods: A brief suicide screen was completed by 40,335 university students at four pariticipating sites. Assessments quantified recent depressive symptoms, alcohol use, suicidal ideation, and suicide attempts. Results: Problems from alcohol use were consistently associated with suicidal thoughts and attempts in the previous month, and in the previous year, but the quantity of alcohol used was not. Alcohol related problems exerted effects on the likelihood of both suicide ideation and attempts beyond those explained by their relationship with depressive symptoms. Conclusions: Screens for individuals at increased risk for suicidal ideation and behavior should emphasize alcohol-related problems over quantification of alcohol intake.

  View details for DOI 10.1080/07448481.2021.1950160

  View details for PubMedID 34398708

• Alcohol intake in relation to suicidal ideation and behavior among university students JOURNAL OF AMERICAN COLLEGE HEALTH Coryell, W., Horwitz, A., Albucher, R., Zheng, K., Pistorello, J., Eisenberg, D., Favorite, T., King, C. 2021

  View details for DOI 10.1080/07448481.2021.1950160

  View details for Web of Science ID 000675701500001

• Variation in Suicide Risk among Subgroups of Sexual and Gender Minority College Students. Suicide & life-threatening behavior Horwitz, A. G., Berona, J., Busby, D. R., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R., Coryell, W., Favorite, T., Walloch, J. C., King, C. A. 2020

  Abstract

  OBJECTIVE: Sexual and gender minorities are at elevated risk for suicide, yet few studies have examined differences in risk within many sexual and gender minority subgroups. The purpose of this study was to examine differences in prevalence for suicide risk factors among a wide range of sexual orientations and gender identities.METHOD: Forty-one thousand four hundred and twelve college students (62% cis-female, 37% cis-male, 1% transgender/genderqueer) completed a wellness screen that included four suicide risk factors (depression, heavy alcohol use, suicide ideation, suicide attempt).RESULTS: Gender minority students (i.e., transgender, genderqueer/non-binary) had significantly higher rates of depression, suicide ideation, and suicide attempts relative to cisgender peers, although there were no within-group differences among gender minority students. Adjusted odds ratios for endorsing two or more (2+) suicide risk factors were substantially higher for all sexual minority subgroups relative to heterosexuals. Among sexual minorities, those identifying as pansexual, bisexual, queer, or mostly gay/lesbian had greater odds of endorsing 2+ suicide risk factors relative to students identifying as mostly heterosexual, gay/lesbian, asexual, or 'other sexual minority'. Pansexual students had 33% greater odds of endorsing 2+ suicide risk factors relative to bisexual students.CONCLUSIONS: These findings highlight significant variation in suicide risk among sexual minority subgroups and the need for targeted interventions for subgroups at highest risk.

  View details for DOI 10.1111/sltb.12637

  View details for PubMedID 32291833

• Sociodemographic differences in barriers to mental health care among college students at elevated suicide risk. Journal of affective disorders Horwitz, A. G., McGuire, T. n., Busby, D. R., Eisenberg, D. n., Zheng, K. n., Pistorello, J. n., Albucher, R. n., Coryell, W. n., King, C. A. 2020; 271: 123–30

  Abstract

  College student mental health (MH) problems and suicide risk have steadily increased over the past decade and a significant number of students with MH problems do not seek treatment. While some barriers to mental health care service utilization (MHSU) have been identified, very little is known regarding how these barriers differ among sociodemographic subgroups of students.Participants were 3,358 college students from four US universities who screened positive for elevated suicide risk (defined as 2 or more of: depression, alcohol misuse, suicidal ideation, suicide attempt) and were not actively receiving MH services. Reported barriers to MHSU were categorized into: Low perceived need, privacy/stigma concerns, questioning helpfulness of treatment, logistics, time constraints, finances, and cultural issues.Adjusted odds ratios indicated that finances were a greater barrier for women, sexual and gender minority students, and Black and Hispanic students. Privacy/stigma concerns were more prominent for men and young undergraduate students. White students and older undergraduate and graduate students were more likely to report a lack of time, and cultural sensitivity issues were significant barriers for sexual and gender minority, and racial/ethnic minority, students.Participating sites were not nationally representative. The barriers assessment did not examine the degree to which a specific barrier contributed to lack of MHSU relative to others.In light of the significant variation in barriers based on age, gender identity, race/ethnicity, and sexual orientation, efforts to increase MHSU should be tailored to meet the unique needs of specific sociodemographic student subgroups.

  View details for DOI 10.1016/j.jad.2020.03.115

  View details for PubMedID 32479307

• Black college students at elevated risk for suicide: Barriers to mental health service utilization. Journal of American college health : J of ACH Busby, D. R., Zheng, K., Eisenberg, D., Albucher, R. C., Favorite, T., Coryell, W., Pistorello, J., King, C. A. 2019: 1–7

  Abstract

  Objective: To examine differences between Black students who do and do not screen positive for suicide risk; to describe barriers to mental health service utilization (MHSU) among participants with a positive screen and no current MHSU and; to determine if barriers vary by student characteristics. Participants: 1,559 Black students (66% female), ages 18years and older (M=21years, SD=2.61) recruited from September 2015 to October 2017 across four universities. Method: Participants completed an online survey assessing demographics, suicide risk, MHSU, and barriers to MHSU. Results: Seventeen percent of students screened positive for risk; 66% of these students were not receiving MHS. Students who screened positive were female and younger. Perceived problem severity (74%) was reported most frequently. Conclusions: Efforts to improve MHSU among Black college students at risk for suicide should address students' awareness of treatable MH problems and time concerns.

  View details for DOI 10.1080/07448481.2019.1674316

  View details for PubMedID 31662044

• Suicide risk among gender and sexual minority college students: The roles of victimization, discrimination, connectedness, and identity affirmation. Journal of psychiatric research Busby, D. R., Horwitz, A. G., Zheng, K. n., Eisenberg, D. n., Harper, G. W., Albucher, R. C., Roberts, L. W., Coryell, W. n., Pistorello, J. n., King, C. A. 2019; 121: 182–88

  Abstract

  Little is known about how victimization and discrimination relate to suicide risk among sexual and gender minority (SGM) college students, or what is protective for these students. The current study will: 1.) determine the extent to which interpersonal victimization, discrimination, identity affirmation, and social connectedness are associated with suicide risk characteristics, and if race and/or ethnicity moderates this association; 2.) examine whether identity affirmation and social connectedness are protective against associations between victimization or discrimination and suicide risk characteristics.Participants were 868 students (63.6% female) from four United States universities who completed an online screening survey and met the following study inclusion criteria: self-identification as gender and/or sexual minority, endorsement of at least one suicide risk characteristic and no current use of mental health services. Participants also completed measures that assessed demographics, non-suicidal self-injury (NSSI), victimization, discrimination, connectedness, and LGBTQ identity affirmation.Victimization was positively associated with depression severity, suicidal ideation, alcohol misuse, suicide attempt history, and NSSI. Discrimination was positively associated with depression severity, suicide attempt history, and NSSI. Connectedness was inversely associated with depression severity, suicidal ideation severity, suicide attempt history, and NSSI, and moderated the association between victimization and suicide attempt history. LGBTQ identity affirmation moderated the link between victimization and depression.Results suggest efforts to decrease victimization and discrimination and increase connectedness may decrease depressive morbidity and risks for self-harm among SGM college students. Further, increasing LGBTQ identity affirmation may buffer the impact of victimization on depression.

  View details for DOI 10.1016/j.jpsychires.2019.11.013

  View details for PubMedID 31837538

• Assessing adult attention deficit hyperactivity disorder (ADHD) in the university setting JOURNAL OF AMERICAN COLLEGE HEALTH Tinklenberg, J., Patel, B., Gelman, K., Albucher, R. 2018; 66 (2): 141–44

  Abstract

  To address the increasing demand for assessments of Adult Attention Deficit Hyperactivity Disorder (ADHD), the primary author developed a protocol for Counseling and Psychological Services (CAPS) at Stanford University's Vaden Student Health Center to improve the efficiency of such evaluations.As part of quality assurance, we reviewed the charts of Stanford students who sought assessment for ADHD before the protocol was implemented (September 2011-June 2013) and after the protocol was established (October 2013-August 2014). An IRB exemption was obtained.The protocol includes questionnaires that solicit detailed clinical information from a variety of sources prior to the student's initial visit.A peer chart review of 35 randomly selected charts showed that students completing the protocol are receiving a more thorough assessment.The new Stanford ADHD protocol, designed to improve clinic efficiency, also increases the availability of relevant clinical information.

  View details for PubMedID 29028463

• An Integrationist Perspective: A Response to "Bias: Thinking about College Student Psychotherapy versus Drug Treatment and Disability" JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY Albucher, R. C. 2013; 27 (4): 299–303

  View details for DOI 10.1080/87568225.2013.824324

  View details for Web of Science ID 000218116200004