{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:56:14Z","timestamp":1791222974123,"version":"4.1.0"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescent suicide attempts remain difficult to predict, in part because research has concentrated on a narrow set of risk factors. We examined whether self-reported plain-water consumption is associated with past-year suicide attempt among U.S. adolescents, whether that association is graded across levels of intake, and whether a zero-intake response adds information beyond established risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed the 2017, 2019 and 2021 cycles of the U.S. national Youth Risk Behavior Survey (n\u2009=\u200936,779). Missing data, including the plain-water item, were multiply imputed (40 datasets) and pooled by Rubin\u2019s rules, accounting for the survey design. The association was estimated unadjusted, then adjusted for demographics, each of six risk domains, and all domains together. Least absolute shrinkage and selection operator (LASSO) models, tuned under two metrics and two penalty rules, provided variable selection and held-out performance; odds ratios come from unpenalized models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reporting no plain water was uncommon (3.6%) and associated with past-year suicide attempt (survey-weighted odds ratio 2.14, 95% CI 1.70\u20132.71), in each cycle. The association was confined to the zero category: the adjusted odds ratio for none was 2.55 (1.91\u20133.39) against 3 times\/day, whereas among those reporting any plain water there was no gradient (1.01, 0.97\u20131.06). It remained associated after adjustment for each domain separately (1.45\u20132.01) but attenuated to 1.34 (0.97\u20131.85) under simultaneous adjustment. LASSO retained it in every model at the discrimination optimum and, under the one-standard-error rule, in five of six domains but not the full model. Adding it changed held-out discrimination by at most 0.0011.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reporting no plain-water consumption in the past seven days was consistently associated with higher odds of a past-year suicide attempt among U.S. adolescents. However, the association was confined to the zero-water category, attenuated after simultaneous adjustment for all risk domains, and did not improve prediction. These findings suggest that the zero-water response may function as a behavioral marker of broader risk rather than as an independent risk factor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0359065","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:28:22Z","timestamp":1791221302000},"page":"e0359065","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between plain-water consumption and suicide attempts among U.S. adolescents: Evidence from the 2017\u20132021 Youth Risk Behavior Survey"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6854-5205","authenticated-orcid":true,"given":"Catalina","family":"Canizares","sequence":"first","affiliation":[{"name":"Steinhardt School of Culture, Education, and Human Development, New York University","place":["New York, United States of America"],"department":["Department of Applied Psychology"]},{"name":"School of Social Sciences, Universiad de los Andes","place":["Bogot\u00e1, Colombia"],"department":["Department of Psychology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Cardozo","sequence":"additional","affiliation":[{"name":"Miller School of Medicine, University of Miami","place":["Florida, United States of America"],"department":["Department of Psychiatry and Behavioral Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8354-5353","authenticated-orcid":true,"given":"Abiraahmi","family":"Shankar","sequence":"additional","affiliation":[{"name":"Steinhardt School of Culture, Education, and Human Development, New York University","place":["New York, United States of America"],"department":["Department of Applied Psychology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9856-5901","authenticated-orcid":true,"given":"Raymond","family":"Balise","sequence":"additional","affiliation":[{"name":"Miller School of Medicine, University of Miami","place":["Florida, United States of America"],"department":["Department of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Morris-Perez","sequence":"additional","affiliation":[{"name":"Steinhardt School of Culture, Education, and Human Development, New York University","place":["New York, United States of America"],"department":["Department of Applied Psychology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"2","key":"pone.0359065.ref001","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1037\/bul0000084","article-title":"Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research","volume":"143","author":"JC Franklin","year":"2017","journal-title":"Psychol Bull"},{"key":"pone.0359065.ref002","doi-asserted-by":"crossref","first-page":"101940","DOI":"10.1016\/j.cpr.2020.101940","article-title":"Machine learning for suicidology: A practical review of exploratory and hypothesis-driven approaches","volume":"82","author":"CR Cox","year":"2020","journal-title":"Clin Psychol Rev"},{"issue":"3","key":"pone.0359065.ref003","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/bsl.2392","article-title":"Machine learning in suicide science: Applications and ethics","volume":"37","author":"KP Linthicum","year":"2019","journal-title":"Behav Sci Law"},{"issue":"2","key":"pone.0359065.ref004","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1037\/a0018697","article-title":"The interpersonal theory of suicide","volume":"117","author":"KA Van Orden","year":"2010","journal-title":"Psychol Rev"},{"key":"pone.0359065.ref005","doi-asserted-by":"crossref","first-page":"106549","DOI":"10.1016\/j.ypmed.2021.106549","article-title":"The three-step theory of suicide: Description, evidence, and some useful points of clarification","volume":"152","author":"ED Klonsky","year":"2021","journal-title":"Prev Med"},{"issue":"1754","key":"pone.0359065.ref006","doi-asserted-by":"crossref","first-page":"20170268","DOI":"10.1098\/rstb.2017.0268","article-title":"The integrated motivational-volitional model of suicidal behaviour","volume":"373","author":"RC O\u2019Connor","year":"2018","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"issue":"1","key":"pone.0359065.ref007","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1186\/s12889-022-12843-4","article-title":"Suicide rate and social environment characteristics in South Korea: The roles of socioeconomic, demographic, urbanicity, general health behaviors, and other environmental factors on suicide rate","volume":"22","author":"H Jang","year":"2022","journal-title":"BMC Public Health"},{"key":"pone.0359065.ref008","doi-asserted-by":"crossref","first-page":"145750","DOI":"10.1016\/j.scitotenv.2021.145750","article-title":"A natural experiment reveals impacts of built environment on suicide rate: Developing an environmental theory of suicide","volume":"776","author":"B Jiang","year":"2021","journal-title":"Sci Total Environ"},{"issue":"5","key":"pone.0359065.ref009","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.3390\/ijerph19052669","article-title":"Inequalities of suicide mortality across urban and rural areas: A literature review","volume":"19","author":"J Casant","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"7","key":"pone.0359065.ref010","article-title":"A systematic review on suicide and youth: biological, psychological, social and environmental risk factors","volume":"12","author":"ZC Chai","year":"2022","journal-title":"IJARBSS"},{"key":"pone.0359065.ref011","volume-title":"Association of dietary intake with suicidal ideation or suicide attempts in adolescents [Doctoral dissertation]","author":"Z Bryant","year":"2018"},{"key":"pone.0359065.ref012","article-title":"Association between dietary and suicidal behaviors in adolescents in Korea based on the Youth Risk Behavior Survey (2015-2020)","volume":"44","author":"Y Lee","year":"2022","journal-title":"Epidemiol Health"},{"key":"pone.0359065.ref013","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jad.2020.01.130","article-title":"Fast food consumption and suicide attempts among adolescents aged 12-15 years from 32 countries","volume":"266","author":"L Jacob","year":"2020","journal-title":"J Affect Disord"},{"issue":"1","key":"pone.0359065.ref014","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1038\/s41562-025-02334-y","article-title":"Bringing natural ecosystems into the bioecological model of human development","volume":"10","author":"J Cuartas","year":"2026","journal-title":"Nat Hum Behav"},{"issue":"2","key":"pone.0359065.ref015","doi-asserted-by":"crossref","first-page":"382","DOI":"10.3945\/jn.111.142000","article-title":"Mild dehydration affects mood in healthy young women","volume":"142","author":"LE Armstrong","year":"2012","journal-title":"J Nutr"},{"issue":"10","key":"pone.0359065.ref016","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1017\/S0007114511002005","article-title":"Mild dehydration impairs cognitive performance and mood of men","volume":"106","author":"MS Ganio","year":"2011","journal-title":"Br J Nutr"},{"issue":"3","key":"pone.0359065.ref017","doi-asserted-by":"crossref","first-page":"88","DOI":"10.5498\/wjp.v8.i3.88","article-title":"Drinking plain water is associated with decreased risk of depression and anxiety in adults: Results from a large cross-sectional study","volume":"8","author":"F Haghighatdoost","year":"2018","journal-title":"World J Psychiatry"},{"key":"pone.0359065.ref018","article-title":"Association of plain water intake with self-reported depression and suicidality among Korean adolescents","volume":"46","author":"JW Lee","year":"2024","journal-title":"Epidemiol Health"},{"issue":"5","key":"pone.0359065.ref019","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1177\/0890117120911885","article-title":"Correlates of infrequent plain water intake among US high school students: National youth risk behavior survey, 2017","volume":"34","author":"S Park","year":"2020","journal-title":"American Journal of Health Promotion"},{"issue":"7","key":"pone.0359065.ref020","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1038\/s44221-024-00261-2","article-title":"Trends and disparities in concurrent tap water avoidance and household food insecurity among US children","volume":"2","author":"AY Rosinger","year":"2024","journal-title":"Nat Water"},{"issue":"1","key":"pone.0359065.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/YIC.0000000000000048","article-title":"Lithium in drinking water and suicide prevention: A review of the evidence","volume":"30","author":"A Vita","year":"2015","journal-title":"Int Clin Psychopharmacol"},{"issue":"6","key":"pone.0359065.ref022","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1192\/bjp.2020.128","article-title":"Association between naturally occurring lithium in drinking water and suicide rates: Systematic review and meta-analysis of ecological studies","volume":"217","author":"A Memon","year":"2020","journal-title":"Br J Psychiatry"},{"key":"pone.0359065.ref023","first-page":"1","article-title":"Methodology of the Youth Risk Behavior Surveillance System--2013","volume":"62","author":"(CDC) Centers for Disease Control and Prevention","year":"2013","journal-title":"MMWR Recomm Rep"},{"issue":"3","key":"pone.0359065.ref024","article-title":"mice: Multivariate imputation by chained equations in R","volume":"45","author":"van Buuren S","year":"2011","journal-title":"J Stat Soft"},{"issue":"17","key":"pone.0359065.ref025","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1002\/sim.3177","article-title":"How should variable selection be performed with multiply imputed data?","volume":"27","author":"AM Wood","year":"2008","journal-title":"Statistics in Medicine"},{"issue":"9","key":"pone.0359065.ref026","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1093\/jamia\/ocac093","article-title":"The harm of class imbalance corrections for risk prediction models: illustration and simulation using logistic regression","volume":"29","author":"R van den Goorbergh","year":"2022","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"pone.0359065.ref027","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/EDE.0b013e3181c30fb2","article-title":"Assessing the performance of prediction models: A framework for traditional and novel measures","volume":"21","author":"EW Steyerberg","year":"2010","journal-title":"Epidemiology"},{"issue":"1","key":"pone.0359065.ref028","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1186\/s12916-019-1466-7","article-title":"Calibration: the Achilles heel of predictive analytics","volume":"17","author":"Topic Group \u2018Evaluating diagnostic tests and prediction models\u2019 of the STRATOS initiative","year":"2019","journal-title":"BMC Med"},{"issue":"9","key":"pone.0359065.ref029","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1093\/aje\/kwh101","article-title":"Limitations of the odds ratio in gauging the performance of a diagnostic, prognostic, or screening marker","volume":"159","author":"MS Pepe","year":"2004","journal-title":"Am J Epidemiol"},{"issue":"7","key":"pone.0359065.ref030","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1161\/CIRCULATIONAHA.106.672402","article-title":"Use and misuse of the receiver operating characteristic curve in risk prediction","volume":"115","author":"NR Cook","year":"2007","journal-title":"Circulation"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0359065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:28:27Z","timestamp":1791221307000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0359065"}},"subtitle":[],"editor":[{"given":"Javier","family":"Fagundo-Rivera","sequence":"first","affiliation":[{"name":"University of Huelva: Universidad de Huelva","place":["SPAIN"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":30,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0359065","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}