Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans

Elbogen, Eric B.; Johnson, Sally C.; Wagner, H. Ryan; Sullivan, Connor; Taft, Casey T.; Beckham, Jean C.

doi:10.1192/bjp.bp.113.134627

Cited by 134 publications

(122 citation statements)

References 40 publications

(80 reference statements)

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“…Nor did we find any significant relationship between demographic data and IPV perpetration. In contrast to current research linking co-occurring alcohol misuse, PTSD, and violent aggression (Elbogen et al 2014), we found no relationship between substance abuse as measured by the AUDIT and DAST, and IPV perpetration. Only binge drinking was linked to IPV perpetration in our sample.…”

Section: Ipv Severity Timeline/monthscontrasting

confidence: 99%

“…717) of PTSD and drinking frequency and quantity was associated with partners' reports of physical and psychological abuse (Savarese et al 2001). The presence of both PTSD and alcohol misuse has been associated with severe violence in military Veterans (Elbogen et al 2014). These complex associations among drinking, IPV, general violence and aggression, and other psychosocial or behavioral variables have also been identified in studies with active duty service members (Bell et al 2006).…”

Section: Introductionmentioning

confidence: 99%

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Comparing Intimately Violent to Non-violent Veterans in Treatment for Posttraumatic Stress Disorder

et al. 2016

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The impact on relationships and adjustment to life after warzone deployments is a major concern, especially when the Veteran also struggles with posttraumatic stress disorder (PTSD). In this manuscript, we describe and compare Veterans who are intimately violent to non-violent Veterans who are in treatment for PTSD. In order to accurately identify the presence of intimate partner violence (IPV) we relied on both Veterans' and their partners' reports in the form of interviews and questionnaires. Additionally, we examined the following variables to determine if PTSD severity, childhood witnessing of inter-parental IPV, substance use/abuse, mutuality, and demographic variables could reliably differentiate Veterans perpetrating IPV from those who were not. Of the overall sample (N = 882; Veterans and partners), 43% of the male Veterans met our operationally defined criteria for IPV. Among the variables identified above, only the level of relationship mutuality significantly differentiated the intimately violent from non-violent.

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Section: Ipv Severity Timeline/monthscontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing Intimately Violent to Non-violent Veterans in Treatment for Posttraumatic Stress Disorder

et al. 2016

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“…For example, we did not include depression in the model because it has not as reliably been associated with aggression as male gender, combat, and substance abuse (Elbogen et al, 2014), factors that we did include. However, a recent paper by Flory and Yehuda (2015) suggests that while depression and other “internalizing” disorders may not necessarily provide a direct link between aggression and PTSD, they may nevertheless be important constructs in a more nuanced understanding of the relationship.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Stress Disorder, Hostile Cognitions, and Aggression in Iraq/Afghanistan Era Veterans

Voorhees¹,

Dennis

Neal

et al. 2016

Psychiatry

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OBJECTIVE Though most veterans with Posttraumatic Stress Disorder (PTSD) are not violent, research has demonstrated that there is substantial minority who are at increased risk. This study tested hypotheses regarding hyperarousal symptoms and hostile cognitions (i.e. “hostility”) as potential mechanisms of the association between PTSD and physical aggression in a longitudinal sample of Iraq/Afghanistan era veterans. METHOD U.S. veterans between the ages of 18 and 70 who served in the military after September 11, 2001 were eligible for participation. At baseline, 301 veterans were evaluated for PTSD and completed self-report measures of hostility. At 6 month follow-up 275 veterans and their family members or friends reported on the veteran’s physical aggression over the preceding interval. OLS and logistic regression were used to evaluate relationships among PTSD status, hyperarousal cluster symptoms, and hostility at baseline, and physical aggression at 6 months. Bootstrapping was used to test for the mediation of baseline PTSD and 6-month aggression by hostility. RESULTS PTSD significantly predicted physical aggression over 6 months, but hyperarousal cluster symptoms did not account for unique variance among the three clusters. Hostility partially mediated the association of PTSD at baseline and physical aggression at 6 months. CONCLUSIONS Hostility may be a mechanism of the association of PTSD and physical aggression in veterans, suggesting the potential utility of targeting hostile cognitions in therapy for anger and aggression in veterans with PTSD.

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“…Numerous epidemiological studies have examined predictors of violence among active duty military personnel (Gallaway et al , 2012, Killgore et al , 2008, MacManus et al , 2012a, MacManus et al , 2012b, MacManus et al , 2013) and veterans (Elbogen et al , 2014a, Elbogen et al , 2013, Elbogen et al , 2012, Elbogen et al , 2014b, Elbogen et al , 2010b, Hellmuth et al , 2012, Jakupcak et al , 2007, Sullivan and Elbogen, 2014). A recent review (Elbogen et al , 2010a) organized the significant predictors in these studies into four broad categories: socio-demographic and dispositional (e.g., sex, race-ethnicity, personality); historical (e.g., childhood experiences, military career experiences, prior violence); clinical (e.g., mental and physical disorders); and contextual-environmental (e.g., access to weapons).…”

Section: Methodsmentioning

confidence: 99%

Predicting non-familial major physical violent crime perpetration in the US Army from administrative data

et al. 2015

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BACKGROUND Although interventions exist to reduce violent crime, optimal implementation requires accurate targeting. We report the results of an attempt to develop an actuarial model using machine learning methods to predict future violent crimes among U.S. Army soldiers. METHODS A consolidated administrative database for all 975,057 soldiers in the U.S. Army in 2004-2009 was created in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). 5,771 of these soldiers committed a first founded major physical violent crime (murder-manslaughter, kidnapping, aggravated arson, aggravated assault, robbery) over that time period. Temporally prior administrative records measuring socio-demographic, Army career, criminal justice, medical/pharmacy, and contextual variables were used to build an actuarial model for these crimes separately among men and women using machine learning methods (cross-validated stepwise regression; random forests; penalized regressions). The model was then validated in an independent 2011-2013 sample. RESULTS Key predictors were indicators of disadvantaged social/socio-economic status, early career stage, prior crime, and mental disorder treatment. Area under the receiver operating characteristic curve was .80-.82 in 2004-2009 and .77 in a 2011-2013 validation sample. 36.2-33.1% (male-female) of all administratively-recorded crimes were committed by the 5% of soldiers having highest predicted risk in 2004-2009 and an even higher proportion (50.5%) in the 2011-2013 validation sample. CONCLUSIONS Although these results suggest that the models could be used to target soldiers at high risk of violent crime perpetration for preventive interventions, final implementation decisions would require further validation and weighing of predicted effectiveness against intervention costs and competing risks.

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Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans

Cited by 134 publications

References 40 publications

Comparing Intimately Violent to Non-violent Veterans in Treatment for Posttraumatic Stress Disorder

Comparing Intimately Violent to Non-violent Veterans in Treatment for Posttraumatic Stress Disorder

Posttraumatic Stress Disorder, Hostile Cognitions, and Aggression in Iraq/Afghanistan Era Veterans

Predicting non-familial major physical violent crime perpetration in the US Army from administrative data

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