Self- and other-directed forms of violence and their relationship with lifetime DSM-5 psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol Related Conditions−III (NESARC−III)

Abstract

A combined history of violence toward self and others has been reported in clinical and incarcerated populations. Psychiatric disorders have been implicated as risk factors. This study examines the lifetime prevalence of this combined violence in the general population and its associations with DSM-5 psychiatric disorders in comparison with other- and self-directed violence. Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) were analyzed, including 36,309 U.S. adults ages 18 and older. Violent behavior was defined by suicide attempts; recurrent suicidal behavior; gestures, threats, or self-mutilating behavior (self-directed); and multiple items of violence toward others (other-directed) in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression examined these violence categories in association with sociodemographics and lifetime DSM-5 psychiatric disorders. Results show that approximately 18.1% of adults reported violent behavior, including self-directed only (4.4%), other-directed only (10.9%), and combined self- and other-directed violence (2.8%). DSM-5 psychiatric disorders significantly associated with the violence typology include alcohol, tobacco, cannabis, and other drug use disorders; mood disorders; posttraumatic stress disorder; and schizotypal, antisocial, and borderline personality disorders. Findings extend the clinical literature regarding the co-occurrence of self- and other-directed violent behaviors to the general population.

Awareness of and attitudes toward CBT, DBT, and ACT in an acute psychiatric sample

“…The scope of mental illness in the United States is extensive, with estimates suggesting that approximately one‐fifth of the population experiences moderate or severe psychological distress within any given month (Mojtabai & Jorm, ). Similarly, lifetime prevalence rates for specific psychiatric disorders are high, including major depressive disorder (20.6%), borderline personality disorder (11.4%), and any anxiety disorder (17.2%; Harford, Chen, Kerridge, & Grant, ; Hasin & Grant, ). Mental and substance use disorders are the fourth most expensive healthcare condition in the United States with annual personal healthcare spending estimated to be above $187 billion (Dieleman et al, ).…”

Cues for different diagnostic patterns of interpersonal violence in a psychiatric sample: an observational study

“…Schizophrenia, mood disorders, post-traumatic stress disorder, personality disorders and substance use disorders are related to a high occurrence of violent behaviors, especially when active symptoms or a relapse are present [5][6][7][8][9][10]. In fact, most patients with stable mental illness do not present an increased risk of violence [8] and are more likely to be victims than perpetrators [9,11,12].…”

“…A broad body of research focused on the detection of risk factors for violence related to psychiatric morbidity. Most of the epidemiological and clinical studies support the notion that mental disorders provide a modest contribution to violence risk among adults [6,14,15] and concludes that a mental disorder is not a necessary or sufficient cause of violent behaviors [11] nor an independent predictor [16]. That patients who reported more frequent violent experiences showed other factors associated with violence, such as historical, dispositional, and contextual ones [8,14,16].…”

“…Among the demographic variables connected to violence, age and gender have received the largest attention so far [17]. Literature consistently reports that young age is associated to high levels of violence in general, clinical, and forensic populations [2,6,7,11,12,[16][17][18][19][20]. On the other hand, the role of gender in IV is largely debated and controversial.…”

“…In clinical populations the pattern of expressed violence is was found to be uneven: some investigations showed a greater prevalence in one of the genders (i.e. males, [6,8,11,16]; females, [12]; some others found similar rates in males and females [22][23][24]. The gender pattern of victimization is more consistent, women being overly victimized compared to men [7,9,12,22,[25][26][27][28][29].…”