Other- and Self-Directed Forms of Violence and Their Relationship With Number of Substance Use Disorder Criteria Among Youth Ages 12–17: Results From the National Survey on Drug Use and Health

Abstract

ABSTRACT. Objective: The purpose of this study was to examine the associations between the number of substance use disorder (SUD) criteria as listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and other-and self-directed forms of violence among youth ages 12-17 in the general population. Method: Data were obtained from the National Survey on Drug Use and Health pooled across survey years 2008-2013, with a combined sample of 108,560 respondents ages 12-17. Violence categories defined by suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed) were categorized as follows: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression estimated odds ratios of the increased number of criteria for alcohol, marijuana, and other illicit drug use, and nicotine dependence for each violence category, by controlling for sociodemographics and criminal justice involvement. Results: The multivariable model indicates that increased number of SUD criteria confers significantly higher odds for each violence category versus no violence. For combined violence versus self-directed violence, male gender, non-Hispanic Black and mixed race (with non-Hispanic White as referent), nicotine dependence, increased number of alcohol use disorder criteria, and other drug use disorder criteria have significantly higher odds, whereas Native Hawaiian/Pacific Islander and age have significantly lower odds. For combined violence versus other-directed violence, non-Hispanic mixed race and the increased number of other drug use disorder criteria have significantly higher odds, whereas male gender, non-Hispanic Black and Native Hawaiian/Pacific Islander, and Hispanic have significantly lower odds. Conclusions: The identification of the combined self-/otherdirected violence in the general population provides additional support for clinical studies that established associations between self-and otherdirected violent behaviors. Prevention and treatment programs need to address both instances of violence and suicidality. (J. Stud. Alcohol Drugs, 77, 277-286, 2016)

Drug Use Disorders and Violence: Associations With Individual Drug Categories

“…We identified 18 eligible studies (for details, see Figure 1 and Table 1 ) that included 591,411 individuals with drug use disorders. Studies were from 5 countries: 14 from the United States ( n = 542,393, 91.7%) ( 53 , 54 , 56–67 ) and 1 each from New Zealand ( n = 182, 0.03%) ( 68 ), Denmark ( n = 43,403, 7.3%) ( 69 ), the Netherlands ( n = 5,303, 0.9%) ( 70 ), and Turkey ( n = 130, 0.02%) ( 71 ). Eight studies used case–control designs ( 53 , 54 , 56 , 58 , 63 , 66 , 67 , 71 ); the remaining 10 studies were longitudinal cohorts with a median follow-up of 9.5 years.…”

“…For outcome measurement, 2 studies used violent conviction from official records ( 65 , 69 ) and 1 reported intimate partner violence from the partner’s report ( 62 ). Most used self-report items in the Diagnostic Interview Schedule ( 56 ), PPC Delinquency and Criminal Behavior inventory ( 57 ), Aggression Questionnaire ( 58 ), Conflict Tactics Scale ( 63 ), physical aggression subscale in Buss-Perry Scale ( 71 ), and specially developed questionnaires ( 53 , 54 , 60 , 61 , 66 , 67 , 70 ). A combination of several measures (e.g., official records and self-report) was applied in 3 studies ( 59 , 64 , 68 ).…”

“…We identified 6 cohort investigations ( 57 , 60 , 64 , 65 , 69 , 70 ) and 6 case-control reports ( 53 , 54 , 56 , 63 , 66 , 67 ) that examined the risk of violence in any or polydrug use disorder. The odds ratios ranged from 1.3 (95% confidence interval (CI): 0.1, 13.0) to 25.0 (95% CI: 16.1–39.0) ( Figure 2 ).…”

“…Six cohort studies ( 57 , 59 , 61 , 62 , 64 , 68 ) and 5 case-control investigations ( 53 , 54 , 56 , 67 , 71 ) examined the link between cannabis/marijuana use disorder and violence. The odds ratios ranged from 1.3 (95% CI: 1.1, 1.7) to 11.5 (95% CI: 7.8, 17.2).…”

“…The same variables were used in the subgroup and meta-regression analyses, and only nonoverlapping samples were included in the analyses. When testing the effect of sample size, we excluded 2 studies that were disproportionately large ( 53 , 54 ). We set the years of follow-up as a continuous variable and also a dichotomous variable using the median period as the cut-off.…”