Aggression in US soldiers post‐deployment: Associations with combat exposure and PTSD and the moderating role of trait anger

Abstract

Anger and aggression are among the most common issues reported by returning service members from combat deployments. However, the pathways between combat exposure and anger and aggression have not been comprehensively characterized. The present study aimed to characterize the relationship between trait anger, combat exposure, post-deployment PTSD, and aggression. U.S. Army soldiers (N = 2,420) were administered anonymous surveys assessing combat exposure, current PTSD symptoms and aggression, as well as trait anger items 3 months after returning from deployment to Afghanistan. PTSD symptom levels were related to aggression at higher levels of trait anger, but not evident among soldiers who had lower levels of trait anger. The pathway from combat exposure to PTSD, and then to aggression, was conditional upon levels of trait anger, such that the pathway was most evident at high levels of trait anger. This was the first study to our knowledge that concurrently modeled unconditional and conditional direct and indirect associations between combat exposure, PTSD, trait anger, and aggression. The findings can be helpful clinically and for developing screening protocols for combat exposed Soldiers. The results of this study suggest the importance of assessing and managing anger and aggression in soldiers returning from combat deployment. Anger is one of the most common complaints of returning soldiers and can have debilitating effects across all domains of functioning. It is imperative that future research efforts are directed toward understanding this phenomenon and developing and validating effective treatments for it.

Prediction of Possible Biomarkers and Novel Pathways Conferring Risk to Post-Traumatic Stress Disorder

“…After exposure to a traumatic event, only a few individuals develop PTSD [58] which is known to be the risk of suicide attempt in the adults with recurrent major depression [59]. A previous population-based study showed that there would be a direct relation between the aggression and post-deployment PTSD [60] and the degree of symptom heterogeneity is known to differ by time point in PTSD [61]. Current understanding of the pathophysiology of PTSD is hampered by the complexity of the human system and lack of understanding regarding how exposures lead to symptoms thereby causing deployment-related psychological injury [62].…”

Magnitude of problematic anger and its predictors in the Millennium Cohort

“…Anger may be particularly relevant to the military in several ways. Not only does more problematic anger appear to be associated with combat exposure over time [ 6 , 13 ], but anger frequently persists over the course of the post-deployment period [ 13 ], negatively impacting service members’ ability to adjust following deployment and increasing their risk of developing PTSD [ 14 , 15 ]. Besides this increased risk, problematic anger has important implications for clinical treatment, including that evidence-based treatment of PTSD may be less effective for veterans reporting high levels of co-occurring anger [ 16 ].…”

Characterizing anger-related affect in individuals with posttraumatic stress disorder using ecological momentary assessment

“…Since then research has continued to demonstrate that posttraumatic stress is, indeed, associated with affective disturbances other than fear (Power and Fyvie, 2013; Tye et al, 2015). A meta-analysis found that PTSD is associated with anger particularly in military samples (Orth and Wieland, 2006), and anger is a frequently cited problem in military personnel returning from combat deployments (Gonzalez et al, 2016; Heesink et al, 2015; Sayer et al, 2010; Wilk et al, 2015). Dealing with anger is cited as one of the primary concerns among help-seeking veterans with PTSD (Crawford et al, 2015).…”