Protective Mechanisms and Prevention of Violence and Aggression in Veterans

Authors
Elbogen, E. B. Johnson, S.C. Newton, V. M. Timko, C. Vasterling, J. J. Van Male, L. M. Wagner, H. R. Beckham, J. C.
Publication year
2014
Citation Title
Protective mechanisms and prevention of violence and aggression in veterans.
Journal Name
Psychological Services
Journal Volume
11
Issue Number
2
Page Numbers
220-228
DOI
10.1037/a0035088
Summary
Many OIF/OEF Veterans report problematic aggression and violence; however, little research has examined risk or protective factors of Veteran violence. Associations between potential risk and protective factors for later violence were explored among OIF/OEF Veterans in a national longitudinal survey. Eight risk factors and eight protective mechanisms were found to impact Veteran violence, and protective mechanisms were especially beneficial among high-risk Veterans.
Key Findings
Protective mechanisms of basic needs being met, healthy sleep, and no reported pain were associated with less violence at follow-up among Veterans at both high and low risk for violence.
Protective mechanisms of resilience, perceived life control, social support, self-care, and steady employment were associated with less violence at follow-up among only high-risk Veterans.
Eight violence risk factors (i.e., younger age, family violence, arrest history, combat exposure, substance misuse, posttraumatic stress disorder (PTSD), and traumatic brain injury) were identified.
Cumulatively, protective mechanisms decreased the odds of violence reported at follow-up more for highrisk Veterans (25%) than low-risk Veterans (11%).
Implications for Program Leaders
Offer Service members post-deployment workshops to help manage aggression and violence
Provide military spouses and children support groups for those who have experienced or witnessed Service member violence
Disseminate information regarding risk factors related to Service member violence and resources for Service members who are concerned that they may act violently
Implications for Policy Makers
Continue to support programs for education and prevention of violence among Service members
Recommend education for professionals who work with Service members and their families regarding potential protective mechanisms that may decreased risk of Service member violence
Encourage the development of programs that address physical, psychosocial, and occupational needs of Service members and integrate these factors to reduce risk of violence
Methods
The Veterans Affairs (VA) department’s National Post-Deployment Adjustment Survey randomly recruited, via mail, all OIF/OEF Veterans who were no longer Active Duty in May 2009.
Veterans self-reported adjustment back to civilian life, including risk and protective factors, at baseline (47% response rate, 56% completion rate) and one-year follow-up (79% retention rate).
Associations between baseline risk and protective factors and violence at follow-up were examined; analyses were weighted to reflect the proportion of females in the military.
Participants
Participants included 1,090 Veterans (weighted n = 866) with a median age of 34 years
The sample identified as primarily White (73%), Black (11%), or Latino (8%) and reported serving in the Army (55%), Air Force (20%), Navy (15%), Marines (10%), and Cost Guard (<1%)
At the one-year follow-up, 27% of Veterans reported acting violently in the past year
Limitations
Veterans who responded to the initial and follow-up surveys may have differed from those who did not.
Veterans may have under-reported violence in an effort to appear more socially acceptable.
Veterans’ risk for violence was arbitrarily split into high- and low-risk depending upon their amount of reported risk factors at baseline rather than viewing risk on a continuum.
Avenues for Future Research
Examine protective factors as they relate to violence in subgroups of Veterans known to be at increased risk for violence, such as Veterans diagnosed with PTSD or traumatic brain injury
Test the effectiveness of a prevention program for Veteran violence that promotes building skills related to the identified protective mechanisms
Explore the effects of post-deployment violence education on rates of Veteran violence
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Although a subset of Iraq and Afghanistan Veterans show aggression toward others after they return home from military service, little is known about protective mechanisms that could be bolstered to prevent violence. A national longitudinal survey was conducted between 2009 and 2011 using a random sample of veterans who served in Operation Iraqi Freedom or Operation Enduring Freedom. One thousand and ninety veterans, from 50 states representing all military branches, completed 2 waves of data collection, 1 year apart (retention rate 79%). The final sample resembled the U.S. military post 9/11 in terms of age, sex, ethnicity, geography, and service branch. Protective mechanisms in socioeconomic (money to cover basic needs, stable employment), psychosocial (resilience, perceiving control over one’s life, social support), and physical (healthy sleep, no physical pain) domains were examined. We found these protective mechanisms predicted decreased aggression and violence at follow-up, particularly among higher risk veterans. Multivariable analyses confirmed that protective mechanisms lowered violence through their interaction with risk factors. This study identifies protective mechanisms related to decreased community violence in veterans and indicates that rehabilitation aimed at improving socioeconomic, psychosocial, and physical well-being has potential promise to reduce aggression and violence among veterans after returning home from military service.
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