Abstract
Alcohol dependence (AD) and aggression-impulsivity are both associated with increased suicide risk. There is a need to evaluate clinical tools in order to improve suicide risk assessment of AD patients. The present study consisted of 95 individuals with a diagnosis of AD, consecutively admitted for addiction treatment, compared with 95 healthy controls. Suicidal risk was assessed together with exposure of violence and impulsivity. AD patients reported significantly higher rates of exposure to violence in childhood, as measured by the Karolinska Interpersonal Violence Scale (KIVS), compared to HC. Within the AD group, individuals with history of suicidal ideation and suicidal behavior reported higher levels of violence experience compared to AD individuals without such history. AD patients with previous suicidal ideation scored higher on self-reported impulsivity as assessed by the Barratt Impulsivity Scale (BIS). Our main finding was that experience of trauma and expression of violent behavior, coupled with increased impulsivity are associated with an elevated suicide risk in AD patients. Future longitudinal studies assessing these traits are needed to evaluate their potential role in identifying AD patients at risk of future suicide.
Highlights
It is well known that exposure to violence in childhood[17] and aggressive behaviors are known risk factors for suicidal behavior[18,19]
The main finding of the present study was that Alcohol dependence (AD) patients with a history of suicidal ideation and suicidal behavior, report increased levels of experience of violence
Our findings are corroborated by several previous studies that have shown an association between both violence/aggression and suicide in general among individuals with mental disorders[18,20,21,22,27], and in AD patients[30,40]
Summary
It is well known that exposure to violence in childhood[17] and aggressive behaviors are known risk factors for suicidal behavior[18,19]. AD patients with previous suicidal behavior scored higher on self-rated trait impulsivity[31,32]. In the current study we investigated whether impulsivity measured by the widely used Barratt Impulsivity Scale (BIS) is associated with different levels of suicide risk in AD patients. Commonly used suicide risk assessments such as the SAD PERSONS scale[33] are aimed at capturing more traditional risk factors ( e.g. previous suicide attempt) and do not include items regarding either violence experience or impulsivity. In the present study we investigated the association between self-rated impulsivity, experience of violence and suicide risk in AD patients in an outpatient addiction treatment facility
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