(PS9-C64) Alcohol and Drug Use Moderate the Relationship Between Agitation and Suicidal Ideation and Intent

Background: A known risk factor for suicidal ideation and intent includes agitation, which is characterized by distressing arousal and increased motor function. Possible contributors to this relationship are alcohol and drug use, which have been individually implicated as a risk factor for suicidal ideation and intent, as well as associated with agitation. This study examined how alcohol and drug use moderate the relationship between agitation and both suicidal ideation (SI) and intent.

Methods: Data were collected as part of a larger study of suicidal thoughts and behaviors in young adults. Agitation was measured using the Brief Self-Report Measure of Agitation (BAM). Alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT), and drug use was measured using the Drug Use Disorders Identification Test (DUDIT). SI was measured using the Depressive Symptom Index-Suicidality Subscale (DSI-SS), and suicidal intent was measured by a single-item measure asking participants to rate their intent to die by suicide in the near future on a scale of 0 (no intent) to 10 (definite intent).

Linear regression models were estimated to examine the moderating effects of alcohol and drug use, respectively. The Johnson-Neyman technique was utilized to assess whether the moderation effect of alcohol and substance use varied in significance across their levels.

Results: Agitation (β = .60, p < .001), but not alcohol use (β = .13, p > .05), significantly correlated with SI; their interaction term was also statistically significant, such that agitation and SI were especially associated at high levels of alcohol use (β = .35, p < .001), but not at mean and lower levels (p > .05). The same applied for suicidal intent: agitation (β = .25, p < .001), but not alcohol use (β = .02, p > .05) significantly correlated with intent; their interaction term was also statistically significant, such that agitation and intent were especially associated at high levels of alcohol use (β = .09, p = .05), but not at mean and lower levels (p > .05). Agitation (β = .57, p < .001) and drug use (β = .16, p = .05) significantly correlated with SI; their interaction term was also statistically significant, such that agitation and SI were especially associated at mean (β = .16, p = .05) and high levels of drug use (β = .47, p < .001), but not at lower levels (p > .05). Suicidal intent significantly correlated with agitation (β = .24, p < .001) but not drug use (β = .04, p > .05); their interaction term was also statistically significant, such that agitation and intent were especially associated at high levels of drug use (β = .14, p < .001), but not at lower levels (p > .05). 

Discussion: Results suggest that high alcohol and drug use heightens the effect of agitation on suicidality. The inclusion of alcohol and drug use, and agitation measures in suicide risk screening may benefit prevention efforts.