was less likely to be related to SI and SA in African-Americans relative to their European-American counterparts. Future studies with larger sample sizes for African-American participants might be better suited to the identification of aspects of substance use and misuse that relate to SI and SA in this population. Importantly, MDD diagnosis that preceded early substance use and SI as well as SA exerted a protective influence (OR = 0.33 – 0.59; Table S5). We attribute this negative association (i.e. OR < 1) to the time-varying nature of MDD because analyses in which MDD was not required to have occurred prior to the dependent variable showed OR > 5. Thus, the OR associated with MDD reflects meeting criteria for a diagnosis at a fairly young age, which may be related to even earlier, but not subsequent, onsets of SI and SA. We, unfortunately, did not have age of onset data on first dysphoric or anhedonic symptom to be able to evaluate their time-varying effect on SI and SA.
