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Substance Use as a Mediator of the Association Between Demographics, Suicide Attempt History, and Future Suicide Attempts in Emergency Department Patients

Year: 2016

Type: article

Abstract: 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.

Source: Crisis

DOI: 10.1027/0227-5910/a000380

Authors: Sarah A. Arias, Orianne Dumas, Ashley F. Sullivan, Edwin D. Boudreaux, Ivan Miller, Carlos A. Camargo, Jr.