A typology of violence against self and others and its associations with drinking and other drug use among high school students in a U.S. general population survey

Background. Violent behaviors among adolescents continue to be of major public health concern in the U.S. While numerous studies have established strong associations between substance abuse and violent behaviors, findings suggest a complex and multifaceted relationship. Moreover, high-profile teenage murder-suicide cases indicate an emerging problem in recent years. This study attempts to broaden the framework in studies of violent behavior by examining a typology of violence against self and others and its associations with drinking, drug use, and other risk factors.

Methods. Data were from the Youth Risk Behavior Surveys for 2001, 2003, and 2005 (n=42,732 students). A violence typology was constructed based on a cross-tabulation of other-directed violence (past-year fighting) and self-directed violence (past-year suicide ideation/planning/attempts), resulting in four categories: other-directed, self-directed, both other- and self-directed, and none. Multinomial logistic regression estimated odds ratios of these categories for drinking, other substance use, and psychological status. Separate models will examine how these associations vary by gender and race/ethnicity.

Results. The four categories were distributed as: other-directed, 12.9%; self-directed, 14.8%; both, 6.3%; none, 65.9%. Compared with females, males had higher prevalence of other-directed violence and lower self-directed violence. Both self- and other-directed violence did not differ by gender. Multinomial logistic models indicated that drinking and other substance use were all significantly associated with increased risks for each of the violence categories relative to the none category. Furthermore, frequency of binge drinking showed monotonic increases in the odds ratios for the other-directed and both categories relative to the self-directed category.