Facets of anger, childhood sexual victimization, and gender as predictors of suicide attempts by psychiatric patients after hospital discharge.

Models of suicidal behavior that assess the interplay of multiple risk factors are needed to better identify at-risk individuals during periods of elevated risk, including following psychiatric hospitalization. This study investigated contributions of facets of anger, gender, and sexual victimization to risk for suicide attempts after hospital discharge. Psychiatric patients (N = 748; ages 18-40; 44% female) recruited from 3 inpatient facilities were assessed during hospitalization and every 10 weeks during the year following discharge as part of the MacArthur Violence Risk Assessment Study. Multiple logistic regression models with facets of anger (disposition toward physiological arousal, hostile cognitions, and angry behavior) from the Novaco Anger Scale (Novaco, 1994), gender, and childhood sexual victimization history were used to predict suicide attempts in the year following hospital discharge. Facets of anger differentially predicted suicide attempts as a function of gender and sexual victimization history, over and above the variance accounted for by symptoms of depression, anxiety, and recent suicide attempts. In men, greater disposition toward angry behavior predicted an overall greater likelihood of a suicide attempt in the year following hospital discharge, particularly among men with childhood sexual victimization. In women with a history of childhood sexual victimization, physiological arousal predicted suicide attempts. Results indicate that facets of anger are relevant predictors of suicide attempts following hospital discharge for psychiatric patients with a history of childhood sexual victimization. Further, results suggest that incorporating gender and victimization history into models of risk for suicide can help clarify relationships between anger and self-directed violence.