Publication year
2014
Citation Title
PTSD symptoms and family versus stranger violence in Iraq and Afghanistan veterans.
Journal Name
Law and Human Behavior
Journal Volume
38
Issue Number
1
Page Numbers
9-Jan
DOI
10.1037/lhb0000035
Summary
Several studies have demonstrated a link between posttraumatic stress disorder (PTSD) symptoms and aggressive, violent behavior among Veterans. Data from Iraq and Afghanistan Veterans were used to examine the association between specific PTSD symptoms and family and stranger violence. Results indicated that combat exposure, anger symptoms, substance use, and flashbacks were related to different types of violence (i.e., family versus stranger), and gender differences between violence types were found.
Key Findings
Overall baseline rates of aggression were relatively low with only 13% and 9% of Veterans reporting family-directed and stranger-directed aggression, respectively, during the one year of the study.
High combat exposure was associated with approximately 2.5 greater odds of stranger aggression and severe stranger aggression. Although high combat exposure was not related to family aggression per se, it was associated with nearly four-fold odds of severe family violence.
PTSD related anger was related to greater odds (1.3) for both family aggression and severe family aggression, and PTSD flashbacks were related to greater odds for stranger aggression (1.16) and severe stranger aggression (1.26).
Substance misuse was associated with 2.5 and 2.93 greater odds of stranger aggression and severe aggression, respectively; substance misuse was not associated with family aggression.
Implications for Program Leaders
Provide education for Veterans who have high combat exposure that explicitly conveys strategies that can be used to minimize aggression to families (e.g., conflict disengagement strategies)
Offer workshops to Service members and their families regarding substance use and PTSD symptoms aggressive behaviors
Distribute information regarding resources and services available to military families coping with mental health issues, substance abuse, or aggressive behaviors
Implications for Policy Makers
Recommend a systematic review of services and treatments for Service members and Veterans who engage in stranger and family violence
Encourage programs that serve Service members and Veterans with PTSD and substance abuse issues to make systematic, routine assessment for stranger and family violence a required component of their screening procedures
Recommend professional education to service providers working with military families regarding the influence of substance use and PTSD on aggressive behaviors
Methods
This study utilized a two-group pre/post-test with a non-matched comparison group design.
Data were collected using web-based surveys or paper surveys mailed to participant.
Participants were sampled from the VA Environmental Epidemiological Service in May of 2009; all were U.S. separated Veterans who served on or after September 11, 2001.
Participants
One thousand and ninety Veterans who served on or after September 11, 2001.
Eighty-five percent of participants were male, and the average age was 34.4 years.
Race/ethnicity and Service branch of participants was not provided.
Limitations
Participants were self-selected and may not represent the larger sample.
Traumatic brain injury was not examined in this study and may be related to aggressive behavior.
The use of self-report data means that results may be biased.
Avenues for Future Research
Examine the association between PTSD symptoms and specific forms of aggressive behavior
Explore whether the aggression outcomes are the result of PTSD or caused by something else (e.g., combat exposure, personality characteristics)
Explore the influence of PTSD on rates of child maltreatment among Service members
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
As a diagnosis, posttraumatic stress disorder (PTSD) has been associated with violence committed by veterans in many studies; however, a potential link to specific PTSD symptoms has received relatively less attention. This paper examines the relationship between PTSD symptoms and different types of violent behavior in Iraq and Afghanistan veterans. Participants were randomly sampled from a roster of all separated U.S. military service members or national guard/reservists who served after September 11, 2001. Data were collected at baseline and 1-year follow-up from a national sample of N = 1,090 veterans, from 50 states and all military branches. Of these veterans, 13% reported aggression toward a family member and 9% toward a stranger during the 1-year study period. Anger symptoms at baseline predicted higher odds of family violence at follow-up, both severe (OR = 1.30, CI [1.13, 1.48], p < .0001) and any (OR = 1.28, CI [1.19, 1.37], p <.0001). PTSD flashback symptoms at baseline predicted higher odds of stranger violence at follow-up, both severe (OR = 1.26, CI [1.11, 1.42], p = .0001) and any (OR = 1.16, CI [1.05, 1.28], p = .0029). Analyses revealed that males were more likely to engage in stranger violence, whereas females were more likely to endorse aggression in the family context. The results provide limited support to the hypothesis that PTSD "flashbacks" in veterans are linked to violence. The differing multivariate models illustrate distinct veteran characteristics associated with specific types of violence.
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