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The Impact of Opioid Misuse Relative to Alcohol Misuse and No Substance Misuse on Suicidal Thoughts and Behaviors: An Examination of Underlying Mechanisms

Baer, Margaret M
http://rave.ohiolink.edu/etdc/view?acc_num=toledo1620502586951075

Abstract Details

2021, Master of Arts, University of Toledo, Psychology - Clinical.
Suicide-related behaviors and opioid misuse are co-occurring major public health problems that are responsible for decreased life expectancy. Despite advances using public health data on understanding the prevalence of both behaviors’ co-occurrence, there is a lack of research explicating why opioid use is associated with heightened suicide and suicide attempt risk. Contemporary models of self-injurious behavior suggest several variables predictive of suicidal behavior that may have relevance for opioid misuse: increased negative self-appraisal, decreased social norm espousal, fearlessness about death, pain habituation, and practical capability, or knowledge and familiarity with lethal means. Given that prior research has associated opioid misuse with elevated levels of these risk factors, they may explain the association between opioid misuse and suicide-related behavior. Further, to distinguish if any observed association is unique to opioid misuse, it is important to compare associations with other substances robustly associated with suicide risk, such as alcohol. To address this research gap, a community sample of participants with lifetime suicide ideation (N=283) was recruited across three groups: those with opioid misuse (n=99; Opioid group), alcohol misuse (n=80; Alcohol Group) and no problematic substance use (n=104; No Substance Misuse group). Participants completed self-report measures assessing characteristics of suicide risk (e.g., suicide ideation, planning and attempt) and assessing the above risk factors hypothesized to account for the link between opioid misuse and suicidal thoughts and behaviors. All examined factors except pain tolerance were associated with suicide risk characteristics. Only increased negative self-appraisal (measured by self-criticism and self-hate), and practical capability were statistically different across groups, such that Opioid group participants reported: (1) significantly less self-criticism than Alcohol group participants and No Substance Misuse group participants; (2) significantly less self-hatred than Alcohol group participants; and (3) significantly greater practical capability than Alcohol group and No Substance Misuse group participants, when controlling for sex, age, depressive symptoms and negative urgency. There was a significant indirect relation of group status to select suicide ideation variables for the Opioid versus No Substance Misuse group comparison and for the Opioid versus Alcohol group comparison. There was also a significant indirect relation of group status to suicidal thoughts and behaviors through self-hate for the Opioid versus Alcohol group comparison, and through practical capability for the Opioid versus No Substance Misuse group comparison and the Opioid versus Alcohol group comparison. Results provide a fine-grained examination of links between opioid misuse (as well as alcohol misuse) and suicide outcomes, and highlight a negative view of the self among individuals using alcohol and high practical capability among individuals using opioids as factors increasing suicide risk in these subgroups.
Matthew Tull, PhD (Committee Chair)
Clinical Psychology
Suicide; Opioid Misuse; Alcohol; Suicide Ideation; Suicide Attempt

Recommended Citations

Citations

  • Baer, M. M. (2021). The Impact of Opioid Misuse Relative to Alcohol Misuse and No Substance Misuse on Suicidal Thoughts and Behaviors: An Examination of Underlying Mechanisms [Master's thesis, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1620502586951075

    APA Style (7th edition)

  • Baer, Margaret. The Impact of Opioid Misuse Relative to Alcohol Misuse and No Substance Misuse on Suicidal Thoughts and Behaviors: An Examination of Underlying Mechanisms. 2021. University of Toledo, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1620502586951075.

    MLA Style (8th edition)

  • Baer, Margaret. "The Impact of Opioid Misuse Relative to Alcohol Misuse and No Substance Misuse on Suicidal Thoughts and Behaviors: An Examination of Underlying Mechanisms." Master's thesis, University of Toledo, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1620502586951075

    Chicago Manual of Style (17th edition)

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This open access ETD is published by University of Toledo and OhioLINK.