Publication year
2014
Citation Title
The effects of alcohol problems, PTSD, and combat exposure on nonphysical and physical aggression among Iraq and Afghanistan war veterans.
Journal Name
Psychological Trauma: Theory, Research, Practice, and Policy
Journal Volume
6
Issue Number
1
Page Numbers
65-72
DOI
10.1037/a0031468
Summary
Iraq and Afghanistan War Veterans completed questionnaires to determine whether aggressive behavior following deployment was related to alcohol problems, posttraumatic stress disorder (PTSD), or combat exposure. Perpetration of nonphysical aggression was positively correlated with PTSD symptom severity, younger age, and alcohol use. Perpetration of physical abuse was associated with ethnic minority status, younger age, combat exposure, and PTSD symptom severity.
Key Findings
Eighteen percent of the Veterans reported perpetrating non-physical violence only, and 14% reported perpetrating either physical violence or both kinds of violence.
Twenty-five percent of the Veterans reported symptoms of alcohol abuse, and 13% reported a history of childhood physical abuse.
Participants who had perpetrated aggression were more likely to abuse alcohol, be young, and have greater PTSD symptom severity.
Nonphysical aggression was positively correlated with younger age, PTSD symptom severity, and alcohol use.
Implications for Program Leaders
Consider offering classes for military couples on the dangers of excessive alcohol use
Host workshops for Service members on effective coping tools for a range of PTSD symptoms
Provide concrete information on normative versus problematic children’s responses to deployment and non-abusive strategies parents can use to address children's distress
Implications for Policy Makers
Recommend targeted violence prevention interventions for younger Service members with combat experience
Continue to support the development of programs for military families that teach positive coping skills and awareness of available resources
Recommend routine screening for substance use and family violence before and after deployment
Methods
Veterans completed a survey on military deployment, combat exposure, and physical and mental health problems.
Childhood physical abuse was assessed in a single question,and combat exposure, alcohol problems, PTSD severity, and aggression were assessed using validated survey instruments.
Data were analyzed to explore potential relationships among the variables.
Participants
Participants were recruited from a Veterans Affairs post-deployment health clinic between 2004 and 2007.
Three hundred thirty-seven Iraq and Afghanistan War Veterans participated in the study. Most participants were male (91%) and White (69%).
The average Veteran age was 31.1 years (SD = 8.5 years), and most Veterans served in the Army (75%) and were unmarried (54%).
Limitations
The short time period under study (four months) may have contributed to lower-than-usual rates of aggression.
The study did not assess if the Veteran was using alcohol when he/she was perpetrating the aggression.
The study did not assess the quantity and frequency of alcohol consumption.
Avenues for Future Research
Replicate the study and assess whether Service members perpetrated physical aggression prior to military service
Collect similar data from Service members who reside in more geographically representative locations and from other military branches
Explore the relationships between drug use and perpetrating physical or nonphysical aggression among Service members
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Aggression among combat veterans is of great concern. Although some studies have found an association between combat exposure and aggressive behavior following deployment, others conclude that aggression is more strongly associated with symptoms of posttraumatic stress disorder (PTSD), and that alcohol misuse may influence this association. Many of these studies have assessed aggression as a single construct, whereas the current study explored both nonphysical aggression only and physical aggression in a sample of Iraq and Afghanistan war veterans (N = 337; 91% male). We found that alcohol problems interacted with PTSD symptom severity to predict nonphysical aggression only. At low levels of PTSD symptoms, veterans with alcohol problems were more likely to perpetrate nonphysical aggression only, as compared with no aggression, than veterans without an alcohol problem. There was no difference in the likelihood of nonphysical aggression only between those with and without alcohol problems at high levels of PTSD symptoms. The likelihood of nonphysical aggression only, as compared with no aggression, was also greater among younger veterans. Greater combat exposure and PTSD symptom severity were associated with an increased likelihood of perpetrating physical aggression, as compared with no aggression. Ethnic minority status and younger age were also associated with physical aggression, as compared with no aggression. Findings suggest that a more detailed assessment of veterans’ aggressive behavior, as well as their alcohol problems and PTSD symptoms, by researchers and clinicians is needed in order to determine how best to intervene.
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