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Violent behavior toward others
The tendency to engage in violent behavior is a potentially important risk factor for suicide in substance abusers. Up to 75% of those who begin addiction treatment report having engaged in violent behavior (eg, physical assault, mugging, attacking others with a weapon). Emerging research also indicates that violence may partially account for the connection between substance abuse and suicide risk. For example, in those seeking treatment for substance use disorders, the perception that they have difficulty in controlling their own violent behavior was associated with a greater likelihood of a prior suicide attempt. Individuals who have difficulty in controlling their anger may be more likely to act impulsively, thus turning the violence on themselves rather than on others.
Individuals with alcohol use disorders and prior aggressive behavior are more likely to report suicidal thoughts or past suicide attempts. In one recent study of more than 6000 adults who began addictions treatment, those who had committed serious violent acts (eg, rape, murder, assault resulting in serious injury) were more than twice as likely to report multiple suicide attempts. This finding held true even after statistically controlling for demographic characteristics, depression, and past victimization.