VIOLENCE, SUICIDALITY, AND ALCOHOL DRUG USE INVOLVEMENT IN ADOLESCENTFEMALES WITH A PSYCHOACTIVE SUBSTANCE USE DISORDER AND CONTROLS/

This study had three aims: (1) to determine the relations between beha vioral dysregulation, negative affectivity, and familial impairment wi th violence and suicidality (i.e., severity of ideation and attempts) in a sample of adolescent females with a psychoactive substance use di sorder and controls; (2) to determine whether these relations are medi ated by internalizing (depression/anxiety) and externalizing (nonviole nt antisocial behavior) symptomatology; and (3) to determine whether s everity of alcohol/drug use involvement moderates the relations betwee n the mediating variables with violence and suicidality, Multiple beha vioral, psychiatric interview, and self-report measures were used to i ndex behavioral dysregulation, negative affectivity, familiar impairme nt, internalizing and externalizing symptomatology, and violence and s uicidality in one hundred sixty-one 14- to 18-year-old adolescent fema les with a psychoactive substance use disorder and in 80 controls. Str uctural equation modeling was used to determine the proposed relations . Results indicated that behavioral dysregulation, negative affectivit y, and familiar impairment were related to violence, whereas only fami lial impairment was related to suicidality, Internalizing symptomatolo gy mediated the relation between familial impairment and suicidality, and was related to violence, whereas externalizing symptomatology medi ated the relations between behavioral dysregulation, negative affectiv ity, and familial impairment with violence, Severity of alcohol/drug u se involvement did not moderate the relations between internalizing or externalizing symptomatology with suicidality or violence. Neverthele ss, the relation between internalizing symptomatology and suicidality was stronger in females with a greater degree of alcohol/drug use invo lvement, compared with those with a milder degree of involvement. Ther efore, from a prevention standpoint, behavioral dysregulation, negativ e affectivity, familiar impairment, as well as internalizing and exter nalizing symptoms, may serve as clinical ''points of intervention'' fo r altering the development of violence and suicidality in high risk an d substance abusing youth.