Association between substance use disorders and self- and other-directed aggression: An integrated model approach

Elias Ghossoub, Salim M. Adib, Fadi T. Maalouf, Ghada E.H. Fuleihan, Hani Tamim, Ziad Nahas

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Our study's objective is to determine whether substance use disorders’ association with aggression differs according to the type of substance and/or the form of aggression, within the same population. We used data from the National Survey on Drug Use and Health across 2008–2014, with a pooled sample of 270,227 adult respondents. We used regression models to estimate the odds ratios for those having alcohol and/or drug use disorder(s) perpetrating (a) each form of aggression compared with no aggression and (b) other-directed compared with self-directed aggression. Alcohol use disorder alone and drug use disorder(s) alone were both associated with significantly increased odds of committing self-directed, other-directed, and combined aggression. Individuals with drug use disorder(s) alone were more likely to commit other-directed than self-directed aggression (adjusted odds ratio = 1.46, 95% CI = 1.04–2.05). Individuals with alcohol use disorder alone were not likely to commit one over the other (adjusted odds ratio = 1.20, 95% CI = 0.90–1.61). In conclusion, the integrated model of aggression based on the stress–diathesis model is a relevant framework to study risk factors for aggression. Further research is needed to identify longitudinal predictors of directionality of aggression.

Original languageEnglish (US)
Pages (from-to)652-661
Number of pages10
JournalAggressive Behavior
Issue number6
StatePublished - Nov 1 2019

Bibliographical note

Funding Information:
Research reported in this publication was supported by the Fogarty International Center and Office of Dietary Supplements of the National Institutes of Health under award number D43 TW009118. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.


  • aggression
  • epidemiology
  • substance use disorders
  • suicide


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