Substance Use as a Mediator of the Association Between Demographics, Suicide Attempt History, and Future Suicide Attempts in Emergency Department Patients
Department of Emergency Medicine
Emergency Medicine | Psychiatry and Psychology | Substance Abuse and Addiction
BACKGROUND: Identification of factors that predict and protect against attempted suicide are critical for the development of effective suicide prevention and intervention programs.
AIMS: To examine whether substance use mediates the association between demographic characteristics, suicide attempt history, and reports of a suicide attempt within 12 months after screening positive for active suicidal ideation or behavior during the index emergency department (ED) visit.
METHOD: Data were collected during the first two phases of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study. Data collection included baseline interview; 6- and 12-month chart reviews; and 6-, 12-, 24-, 36-, and 52-week telephone follow-up assessments. Structural equation modeling was used. All p values were two-tailed, with p < .05 considered statistically significant.
RESULTS: Among the 874 subjects, 195 (22%) reported a suicide attempt within 12 months after the index ED visit. Of participants reporting a suicide attempt, 59% were < 40 years old, 59% female, and 76% non-Hispanic White. Associations between race, sex, and suicide attempt 12 months after the index ED visit may be mediated by a combination of alcohol misuse and cocaine use.
CONCLUSION: Findings from the mediation analyses provide insight into the impact of substance use on future suicide attempts in various sociodemographic groups.
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Citation: Crisis. 2016 Sep;37(5):385-391. Epub 2016 Apr 4. Link to article on publisher's site
emergency departments, statistical mediation analysis, structural equation modeling, substance use, suicide attempt
Arias, Sarah A.; Dumas, Orianne; Sullivan, Ashley F.; Boudreaux, Edwin D.; Miller, Ivan; and Camargo, Carlos A. Jr., "Substance Use as a Mediator of the Association Between Demographics, Suicide Attempt History, and Future Suicide Attempts in Emergency Department Patients" (2016). University of Massachusetts Medical School Faculty Publications. 1136.