# Examining the Relationship Between Ongoing Alcohol Use, Suicidal Thoughts and Behaviors and Related Constructs, and Behavioral Economic Decision-Making

> **NIH NIH K99** · UNIVERSITY OF KENTUCKY · 2024 · $130,031

## Abstract

PROJECT SUMMARY
 Factors that lead to suicidal thoughts and behaviors (STBs; i.e., passive or active suicidal ideation,
behaviors, plans, gestures, or attempts) are complex. An important factor in suicide deaths and attempts is
alcohol use; up to 36% of completed suicides involve acute alcohol use, while those with AUD may account for
up to 20-40% of suicides. Despite this relationship, processes that may underlie the two are unclear. A
common variable between alcohol use and STBs appears to be behavioral economic decision-making such as
delay discounting (i.e., devaluing a commodity as a function of time). However, other forms of discounting (i.e.,
probability; devaluing an outcome based on its likelihood, social; devaluing an outcome based on the
closeness of another) have not been explored. Other behavior economic decision-making, such as demand for
alcohol (i.e., continued purchasing and consumption a commodity as prices increase) has been related to
increased discounting. Furthermore, losses of close social supports, through suicide or overdose death, could
result in allocation towards further alcohol use, which could affect decision-making and therefore affect suicide
risk. Together, excessive discounting and demand with losses of social reinforcers might be markers for
suicide risk for those with excessive alcohol use. Behavioral economic decision-making has also been
predictive of engagement and success of substance use treatment. The contextualized reinforcer pathology
model allows for integration of these different factors to help better understand how alcohol use could influence
suicide risk, as well as who might engage in treatment for alcohol use. Therefore, the purpose of this proposed
K99/R00 is to determine relationships between alcohol use, behavioral economic decision-making,
bereavement, and STBs within a contextualized reinforcer pathology framework. In Study 1 (K99) this will first
be assessed within a group of adults with risky alcohol use (n = 100) to determine cross-sectional associations,
prevalence of STBs in this sample, and determine factors that predict engagement with a remote intervention
for alcohol and its effects on alcohol use. Participants will complete a baseline assessment and be given
access for remote, self-guided CBT4CBT modules for alcohol use. Participants will also complete three follow-
up assessments over three months to determine engagement with CBT4CBT and changes in alcohol use. In
Study 2 (R00), adults with risky alcohol use without current STBs (n = 100) and with current STBs (n = 100) will
be compared using a 2x2 design to further determine relationships between alcohol use and STBs (Study
2/R00). Half will be randomized to immediate access to CBT4CBT, while the other will be waitlist controls and
receive access 28 days later, with remaining procedures being similar to Study 1. This allows for determination
of predictors of engagement and efficacy of a remote intervention for alcohol use as a fu...

## Key facts

- **NIH application ID:** 10984778
- **Project number:** 1K99AA031309-01A1
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Mark Justin Rzeszutek
- **Activity code:** K99 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $130,031
- **Award type:** 1
- **Project period:** 2024-09-15 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10984778

## Citation

> US National Institutes of Health, RePORTER application 10984778, Examining the Relationship Between Ongoing Alcohol Use, Suicidal Thoughts and Behaviors and Related Constructs, and Behavioral Economic Decision-Making (1K99AA031309-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10984778. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*