Publication year
2012
Citation Title
Posttraumatic stress disorder symptom severity predicts aggression after treatment.
Journal Name
Journal of Anxiety Disorders
Journal Volume
26
Issue Number
2
Page Numbers
337-342
DOI
10.1016/j.janxdis.2011.11.012
Summary
The authors examine the relationship between specific posttraumatic stress disorder (PTSD) symptoms and interpersonal aggression (verbal, psychological, and physical) among male Veterans completing a residential PTSD treatment program. Results indicate that specific PTSD symptoms and severity predicted aggression at follow-up. Post-treatment maintenance of non-aggression behaviors may be necessary to reduce aggressive behaviors after intensive PTSD treatment.
Key Findings
Veterans reported significantly lower PTSD symptoms immediately after treatment (i.e., at the post-test) than at the pretest, but no significant change in reports of aggression.
Greater severity of PTSD symptoms after treatment predicted higher levels of aggression at both the post-test and follow-up.
Specifically, hyperarousal symptoms of PTSD were the strongest predictor of aggression at the four-month follow-up.
Implications for Program Leaders
Offer education for Service members or partners experiencing aggression regarding safety planning, emotional well-being, and continued assessment of aggression and PTSD
Offer support groups to military families coping with PTSD symptoms and to those who are at risk for aggressive behaviors
Disseminate information regarding the association between PTSD symptoms and aggressions and the resources available to cope
Implications for Policy Makers
Recommend continued assessment of PTSD symptoms and aggressive behaviors throughout Service members careers as a way to prevent domestic violence in military families
Encourage collaboration between DoD, private, and community-based programs and organizations to address gaps in PTSD and aggression screening and services, particularly as Service members transition out of the military
Continue to support programs and services that identify, treat, and provide long-term follow-up related to PTSD and aggression experienced by Service members
Methods
Participants were recruited from a residential PTSD treatment program (to which they had been referred by a clinician because outpatient treatment was not effective).
This study focused on Veterans accessing services through the VA.
Veterans completed self-report measures of PTSD symptoms and aggression before treatment (pre-test), immediately after treatment (post-test), and four months after treatment (follow-up).
Participants
Participants were 175 male Veterans participating in a residential PTSD treatment program (n = 74 at follow-up).
The sample was primarily White (56%); the average age was 53 years (range 29 to 69 years).
No information regarding service branch was provided.
Limitations
The authors did not include other variables that may account for the association between PTSD symptoms and aggression (e.g., depression, life satisfaction, social support), which may have biased the results.
Follow-up data was only available for a sub-set of the sample, limiting the power of the analyses conducted.
The data focused on Veterans in treatment and may not be generalizable to other groups (e.g., women, Service members participating in only out-patient treatment).
Avenues for Future Research
Examine the association between PTSD and aggression in different groups of Veterans (e.g., younger populations, women)
Include longer-term outcomes (i.e., one and two years post-treatment) to better understand treatment effects over time
Evaluate the effectiveness of current DoD programs aimed at reducing aggression and domestic violence in the military
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
This study examined the relation between posttraumatic stress disorder (PTSD) severity and aggression (verbal, psychological, and physical aggression) in a longitudinal dataset. Participants were 175 males in PTSD residential treatment who were assessed at pre-treatment, post-treatment, and at 4-month follow-up. Post-treatment PTSD severity predicted aggression at post-treatment and 4-month follow-up, adjusting for age, pre-treatment PTSD severity, and pre-treatment aggression. When examining the relation between aggression and specific PTSD symptom clusters, post-treatment Reexperiencing, Avoidance/Numbing and Hyperarousal symptoms predicted aggression at posttreatment and 4-month follow-up. These results support the hypothesis that post-treatment PTSD severity may be an important marker of post-treatment aggression risk and may offer unique information important to clinicians and patients focused on the development and maintenance of adaptive, non-aggressive relationships after intensive PTSD treatment.
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