Perpetrating–Suffering Intimate Violence: Self-Harm–Suicide Thoughts and Behaviors, Mental Health, and Alcohol Use Among Mexican Youth During COVID-19

<b>Background</b> The COVID-19 epidemic had a deleterious impact on mental health and substance abuse and led to an increase in several forms of violence, including self-harm and interpersonal violence among youth from low- and middle-income countries. Nevertheless, the relationship between the variables and their directionality has not been recognized. This study describes the relationship directionality between these variables among 18- to 20-year-old Mexican youths during the COVID-19 pandemic. <b>Methods</b> The longitudinal cohort study comprises an evolving group of young Mexican adults: 1390 participants aged 18 in 2021, 654 aged 19 in 2022, and 442 aged 20 in 2023. Proportions by sex-50% were matched in every cohort, and the evolution-age sample accomplishment accounted for 47% in 2022 and 32% in 2023. <b>Results</b> According to a structural equation model, which fit the data from 195 iterations with 246 parameters (<i>X</i>²[2722] = 8327.33, <i>p</i> < 0.001), yielding a CFI of 0.946, a TLI of 0.943, and an RMSEA of 0.029 [0.028-0.029]), perpetrating intimate violence, preceded by suffering intimate violence, combined with suffering anxiety symptoms, was associated with self-harm-suicide thoughts and behaviors (ShSTB), marked distress, dysfunction, and somatization symptoms. The relationship was stronger in women and 20-year-old Mexicans. In men, this pathway was exclusively associated with ShSTB. Suffering from intimate violence has been associated with depression, anxiety, and PTSD symptoms, as well as harmful alcohol use. <b>Conclusions</b> During an epidemic, prevention programs should be designed to warn about self-harm-suicide thoughts and behaviors, not only to ensure the safety of the victims of intimate personal-violence but also to prevent the suicidal behavior of perpetrators.