Mental health correlates of anger and violence among individuals entering substance use treatment

Abstract

Individuals with substance use disorders (SUDs) have consistently been shown to report elevated levels of anger and rates of violence perpetration. Given that heightened anger can increase risk for violence and also impede treatment for SUD, it is important to identify correlates of anger and violence among individuals in SUD treatment settings. While previous research has identified factors associated with anger and violence among individuals with SUD, these studies tend not to adequately address the role of comorbidity or trait aggression in their samples. This is particularly important given that comorbid mental health disorders, for example post traumatic stress disorder (PTSD), have been shown to be associated with anger and violence perpetration among individuals with SUD. This paper aims to examine demographic and mental health correlates of anger and violence among individuals in treatment for SUD. Structured interviews were carried out with 58 participants recruited from a residential detoxification clinic. Findings indicate that individuals with comorbid mental health symptoms, particularly symptoms of anxiety, are also likely to present with elevated levels of anger. In addition, a history of childhood trauma exposure and high levels of trait aggression were significantly associated with violence perpetration in the sample. This information can assist clinicians in identifying individuals prone to anger and violence and aid in the development of interventions designed to reduce anger and the likelihood of violence among individuals entering substance use treatment.

Illicit drug use and male barroom aggression among members of the Australian construction industry: Associations with personality and masculinity factors

“…Trait physical aggression significantly increased the odds of reporting physical MBA perpetration. This is consistent with results observed in previous research [3, 4, 55], and is expected given trait aggressiveness and engagement in illicit substance use share similar predictors [56]. Furthermore, it has been suggested that an aggressive personality may influence a user's ‘drug of choice’, with such selections facilitating key features of temperament and levels of social deviance [57].…”

“…ATS can also increase wakefulness which can lessen the sedating effects of alcohol and heighten alcohol-related intoxication, which may help explain their significant influence on physical MBA perpetration even after the inclusion of HID in the present study 4.2 | Trait variables, illicit drugs and male barroom aggression Trait physical aggression significantly increased the odds of reporting physical MBA perpetration. This is consistent with results observed in previous research [3,4,55], and is expected given trait aggressiveness and engagement in illicit substance use share similar predictors [56]. Furthermore, it has been suggested that an aggressive personality may influence a user's 'drug of choice', with such selections facilitating key features of temperament and levels of social deviance [57].…”

Mental health outcomes associated with the use of amphetamines: A systematic review and meta-analysis

“…There were differences the strength of the association depending on the measure of violence used. Unadjusted odds ratios were large and consistent for violent behaviour (OR 3.7, 95% CI 3.1–4.5, p < 0.001; i 2 = 34%, p = 0.163) [47], [48], [49], [50], [51]; in contrast there was no significant effect for violent offending (OR 1.0, 95% CI 0.4–2.7, p = 0.961; i 2 = 94%, p < 0.001) [45,[52], [53], [54], [55]]. One large cross-sectional survey of tertiary students found more perpetration of sexual exploitation/abuse among people using amphetamines [50]; another study of substance users found increased likelihood of intimate partner violence among those using amphetamines [56].…”

Targets for intervention to prevent substance use in young people exposed to childhood adversity: A systematic review

“…Anger was associated with increased substance use and problematic use, demonstrating some of the largest mediated effects [ 27 , 39 , 40 ]. Importantly, anger is associated with poorer substance use treatment outcomes [ 90 ], as well as comorbid mental health problems in those with substance use disorders [ 91 ]. Taken together, these findings suggest anger is an important individual factor to target among young people exposed to adversity to prevent substance misuse.…”