Research paperSubstance use disorders and self- and other-directed violence among adults: Results from the National Survey on Drug Use And Health

- This study identifies 0.06% of U.S. adults with the co-occurrence of self- and other-directed violence in the past-year.
- The combined self-/other-directed violence is associated with 89.6% of severe psychological distress (SPD).
- Nicotine dependence and DSM-IV SUDs for alcohol, marijuana, and pain relievers are associated with violence categories.
- Other correlates for violence include SPD, major depressive episodes, assault arrest, and criminal justice involvement.
- The tetrachoric correlation between self- and other-directed violence is not negligible (0.40).

BackgroundPrevious studies have identified a violence typology of self- and other-directed violence. This study examines the extent to which substance use disorders (SUDs) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), independent of serious psychological distress, major depressive episodes, assault arrest, and criminal justice involvement, are associated with these violence categories.MethodData were obtained from the National Survey on Drug Use and Health (NSDUH) pooled across survey years 2008-2015, with a combined sample of 314,881 adult respondents. According to self-report data on suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed), violence was categorized in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression was used to estimate the adjusted odds ratios associated with the risk factors for different forms of violence.ResultsNicotine dependence and the number of DSM-IV SUDs criteria (except the criterion of legal problems) for alcohol, marijuana, and pain reliever use disorders are significantly associated with the self-/other-directed violence categories.LimitationsCross-sectional data do not allow assessment of directionality of important factors.ConclusionsThe identification of the combined self- and other-directed violence among adults in the general population extends studies in the adolescent population, and significant correlation between self- and other-directed violence provides additional support for clinical studies that established this association. Findings expand the associated risk factors identified in previous studies for the adult population. Prevention and treatment programs need to address both forms of violence and suicidality.