Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA.
Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
Suicide Life Threat Behav. 2021 Apr;51(2):237-246. doi: 10.1111/sltb.12699.
Criminal justice involvement, substance use, and suicide pose significant public health concerns; however, the unique and synergistic effects of these experiences among high-risk individuals remain understudied. We hypothesized positive main effects for alcohol-related severity, drug-related severity, current criminal justice involvement, and thwarted belonging (TB) on suicide ideation history (SIH) and suicide attempt history (SAH) and that TB would moderate these associations.
We report on cross-sectional analyses of self-report assessments completed by 824 adult residential substance use patients.
Multinomial logistic regression analyses indicated that as alcohol- and drug-related severity increases, the probability of SIH and SAH increases; however, TB was only associated with a higher SIH probability. Significant two-way interactions (current criminal justice involvementTB; alcohol-related severityTB) indicated that (1) those high in TB with current criminal justice involvement were more likely to report a SIH than those without current criminal justice involvement; and (2) those low in TB and alcohol-related severity had the lowest SAH probability, whereas those low in TB and high in alcohol-related severity had the highest SAH probability.
The unique and combined effects of interpersonal and contextual risk factors may improve suicide risk conceptualization and assessment, and allow for tailored treatments for this high-risk population.
刑事司法涉入、物质使用和自杀对公共健康构成重大关切；然而，高风险个体中这些经历的独特和协同效应仍研究不足。我们假设酒精相关严重程度、药物相关严重程度、当前刑事司法涉入和归属感受挫（TB）对自杀意念史（SIH）和自杀企图史（SAH）有正向的主效应，并且 TB 会调节这些关联。
我们报告了对 824 名成年住院物质使用患者完成的自我报告评估的横断面分析。
多项逻辑回归分析表明，随着酒精和药物相关严重程度的增加，SIH 和 SAH 的概率增加；然而，TB 仅与更高的 SIH 概率相关。显著的双向交互作用（当前刑事司法涉入TB；酒精相关严重程度TB）表明：（1）TB 较高且有当前刑事司法涉入的个体比没有当前刑事司法涉入的个体更有可能报告 SIH；（2）TB 较低且酒精相关严重程度较低的个体自杀企图史的概率最低，而 TB 较低且酒精相关严重程度较高的个体自杀企图史的概率最高。
人际和环境风险因素的独特和综合效应可能会改善自杀风险概念化和评估，并为这一高风险人群提供量身定制的治疗。
