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

1 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


  • aggression
  • epidemiology
  • substance use disorders
  • suicide

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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