Beyond genetic analyses, which may capture more trait-like (e.g., aggerate lifetime risk) associations, current – as of time of enrollment – externalizing codes were associated with suicide related mortality, potentially capturing time-dependent risk. Our analyses demonstrate that both current and lifetime risk are important for the externalizing-suicide relationship. Importantly, the association with MVP-EXT and suicide-related mortality remains in the context of risk for other causes of death. Given the multitude of negative health correlates of EXT found in previous analyses of MVP (e.g., cirrhosis, chronic airway obstruction, viral hepatitis C, etc.)21 these results help frame the clinical importance of externalizing beyond the specific health consequence related to substance use. Development and implementation of externalizing risk screeners at intake may help to mitigate a variety of negative health outcomes, including suicidality.
