To examine the within-person relations between acute alcohol use and interpersonal negative life events (INLEs) in the 24 h preceding suicide attempts.

Participants were 151 adult patients (67.55 % female; M age = 36.00) who were hospitalized within 24 h of a suicide attempt. Participants completed the Timeline Follow-back for Suicide Attempts interview to gather information about hourly events for the 24 h preceding their suicide attempt. Hierarchical logistic models were estimated to examine the influence of acute INLEs on next-hour alcohol use and acute alcohol use on next-hour INLEs. Biological sex and chronic alcohol use (past year) were evaluated as potential moderators.

Overall, acute alcohol use was associated with increased odds of next-hour INLEs and acute INLEs were associated with increased odds of next-hour alcohol use. Moderator analyses indicated that the influence of alcohol use on INLEs increased as participants' level of chronic alcohol use decreased, and relations did not vary by biological sex.

There is a bidirectional relation between INLEs and alcohol use in the hours preceding suicide attempts. Understanding that these within-person interrelations may differ in strength depending on one's level of chronic alcohol use has practical utility for providers tasked with clinical decision making.