The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans

Abstract

This study examined the mental health impact of reported direct and indirect killing among 2,797 U.S. soldiers returning from Operation Iraqi Freedom. Data were collected as part of a postdeployment screening program at a large Army medical facility. Overall, 40% of soldiers reported killing or being responsible for killing during their deployment. Even after controlling for combat exposure, killing was a significant predictor of posttraumatic disorder (PTSD) symptoms, alcohol abuse, anger, and relationship problems. Military personnel returning from modern deployments are at risk of adverse mental health conditions and related psychosocial functioning related to killing in war. Mental health assessment and treatment should address reactions to killing to optimize readjustment following deployment.

Physical comorbidities of post‐traumatic stress disorder in Australian Vietnam War veterans

“…Exposure to combat on deployments to Iraq and Afghanistan has been linked with subsequent symptoms of PTSD [27,90,121,137]. Combat roles involve exposure to a variety of hazards with the potential to traumatise.…”

“…Combat roles involve exposure to a variety of hazards with the potential to traumatise. In particular, witnessing dead bodies [90,137], discharging a weapon in combat [90] and direct or indirect killing [121], have been shown to be strong predictors of PTSD in studies involving US personnel. Studies have also found that combat exposure is associated with alcohol misuse [95,104,121,188].…”

“…In particular, witnessing dead bodies [90,137], discharging a weapon in combat [90] and direct or indirect killing [121], have been shown to be strong predictors of PTSD in studies involving US personnel. Studies have also found that combat exposure is associated with alcohol misuse [95,104,121,188]. Both direct or indirect killing [121] and hostility from civilians during deployment [95] have been identified as risk factors for alcohol problems in UK and US military personnel.…”

“…Studies have also found that combat exposure is associated with alcohol misuse [95,104,121,188]. Both direct or indirect killing [121] and hostility from civilians during deployment [95] have been identified as risk factors for alcohol problems in UK and US military personnel. In addition, the fear of injury or death while on deployment has also been identified as a risk factor for both PTSD symptoms and alcohol misuse [95,137,188].…”

“…US studies have shown that in addition to injury on deployment, combat experiences [91,188], combat exposure [27,147], killing in war [27,121], witnessing dead bodies [90,137], discharging a weapon and deployment-related stressors [27] were related to adverse health conditions such as PTSD and alcohol problems. In addition to combat exposures, the fear of injury or death while on deployment has also been identified as an important risk factor for both PTSD symptoms and alcohol misuse [95,137,188].…”