Publication year
2017
Citation Title
Associations between PTSD and intimate partner and non-partner aggression among substance using veterans in specialty mental health.
Journal Name
Addictive Behaviors
Journal Volume
64
Page Numbers
194-199
DOI
10.1016/j.addbeh.2016.08.039
Summary
A randomized control trial that examined the associations between probable posttraumatic stress disorder (PTSD), heavy drinking, marijuana use, cocaine use, and partner and non-partner perpetration was conducted. Over 800 substance using Veterans responded to a survey assessing physical and injury aggression, as well as past-month substance use, probable PTSD, and probable depression. Results suggest that there are some associations between violence perpetration and Veterans with probable PTSD.
Key Findings
Veterans with probable PTSD were more likely to have reported past-year, non-partner physical aggression and non-partner injury aggression.
Probable PTSD among Veteran participants was not significantly associated with partner physical or partner injury violence after adjustment for other variables.
Cocaine and heavy drinking among participants were independently associated with non-partner aggression.
Implications for Program Leaders
Disseminate information regarding possible warning signs of interpersonal violence to professionals working with Service members and their families
Engage Service members in classes that aim to increase communication and decrease physical or verbal aggression
Continue providing training opportunities for professionals working with Service members with substance abuse to learn more about prevention of interpersonal aggression
Implications for Policy Makers
Continue support for programs that specifically address experiences of Service members and their partners with interpersonal violence and substance abuse
Build awareness across military branches around the importance of supporting and promoting mental health among returning Service members
Recommend education for professionals working with Service members and their families around the possible effects of PTSD, depression and substance abuse on aggression
Methods
Participants were recruited from three different clinics in Virginia: a substance use disorder clinic, a substance use intensive outpatient clinic, and a mental health clinic.
Measures used were the modified version of the Conflict Tactics Scale, PTSD checklist, depression module of the Patient Health Questionnaire, and the University of Arkansas Substance Abuse Outcomes Module.
Statistical analyses were conducted to examine the associations between PTSD and each type of aggression.
Participants
The majority of the 810 Veteran participants were male (93%), not partnered (69%), and White (73%).
About one third of the participants had probable depression (32%).
The majority of participants experienced at least one traumatic event (83%), and 39% were identified as having probable PTSD.
Limitations
The participant sample was drawn from one location in the U.S.; therefore, the findings may not be applicable to other regions or contexts.
Participants in the study were asked only about substance use 30 days prior to the survey administration; a more comprehensive measure of use may have yielded different results.
Probable PTSD was determined by self-report, which is not as accurate as a clinician administered assessment.
Avenues for Future Research
Investigate what treatments may be effective in decreasing aggression among substance using Service members
Explore the association between PTSD and different types of aggression among female substance using Service members
Utilize longitudinal designs to gain a better understanding of the associations between PTSD, depression, substance use and interpersonal violence
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Background: Risk factors of violence perpetration in veterans include substance use and posttraumatic stress disorder (PTSD); however, it is unknown whether these factors are associated with greater risk for partner or non-partner violence. This study investigated the associations between probable PTSD, heavy drinking, marijuana use, cocaine use, and partner and non-partner violence perpetration. Methods: Self-report questionnaires assessing past-year partner and non-partner aggression (CTS2) as well as past-month substance use (SAOM), probable PTSD (PCL-C), and probable depression (PHQ-9) were administered to 810 substance using veterans entering VA mental health treatment. Results: In bivariate analyses, probable PTSD in substance using veterans was associated with violence perpetration (partner physical, chi2 = 11.46, p = 0.001, phi = 0.12; non-partner physical, chi2 = 50.64, p < 0.001, phi = 0.25; partner injury, chi2 = 6.41, p = 0.011, phi = 0.09; non-partner injury, chi2 = 42.71, p < 0.001, phi = 0.23). In multiple logistic regression analyses that adjusted for sociodemographic characteristics, probable PTSD was independently associated with non-partner physical (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.97-4.05) and injury aggression (OR, 3.96; CI, 2.56-6.13). Cocaine and heavy drinking were independently associated with non-partner physical and injury aggression and non-partner injury aggression respectively. Conclusions: The results provide evidence that probable PTSD, heavy drinking, and cocaine use are associated with increased risk of non-partner violence perpetration in substance using veterans. These results underscore the importance of screening for PTSD symptoms and violence perpetration towards non-partners in substance using veterans presenting for treatment.
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