The Army National Guard in OIF/OEF: Relationships among combat exposure,postdeployment stressors,social support,and risk behaviors

With the continued operations in Iraq and Afghanistan, studies of the prevalence of posttraumatic stress disorder and related symptoms are now common. However, lacking is how these symptoms relate to precipitating conditions and the mitigating effects of social support on these symptoms. This is particularly relevant for reserve military personnel, who have been shown to be greater at-risk for postdeployment problems. The present study examined questionnaire data obtained from Army National Guard (ARNG) units immediately after their return from deployment to Iraq and Afghanistan during 2010 (N = 4329 soldiers in 50 units). Findings showed few soldiers displayed risk behaviors (i.e., daily alcohol use, use of illicit drugs, suicide thoughts, and physically threatening others) during and after deployment. Those most likely to have more postdeployment risk behaviors were also those who showed more risk behaviors during deployment. A substantial percentage of soldiers reported combat exposure, postdeployment negative emotions, and postdeployment loss of a personal relationship. These reported outcomes were all related to increased risk behaviors after deployment. The buffering effect of social support on postdeployment risk behaviors was equally evident when data were examined individually and when grouped by unit memberships. Implications of findings for future research, practice, and policies are discussed.     

Factors Associated With Physical Aggression Among US Army Soldiers

There are a growing number of studies that have approximated levels of aggression and associated outcomes among combat veterans returning from Iraq and Afghanistan using brief screening assessments. However, further research to evaluate the relative role of combat exposures and overt physical behaviors is required to further elucidate potential associations between military service, combat deployment, and overt physical aggression. The purpose of the current study was to assess the prevalence of self‐reported physical aggression in a sample of US Army soldiers using an adaptation of the Revised Conflict Tactics Scale (CTS2), and examine factors associated with higher levels of aggression. A population‐based cross‐sectional study was conducted at a single US Army Installation within a sample of active duty US Army soldiers (n = 6,128) from two large units. Anonymous surveys were collected 6 months following deployment to measure overt aggressive behaviors, posttraumatic stress disorder, anxiety, depression, traumatic brain injury, and misuse of alcohol. There were a relatively higher number of minor and severe physical overt aggressive actions reported among soldiers who previously deployed, notably highest among deployed soldiers reporting the highest levels of combat intensity. Soldiers screening positive for the misuse of alcohol were also significantly more likely to report relatively higher levels of physical aggression. This study quantified overt aggressive behaviors and associated factors, showing increasing combat exposures may result in increased physical aggression. Clinicians treating service members returning from combat may consider assessing relative levels of combat. Aggr. Behav. 38:357‐367, 2012. Published 2012 Wiley Periodicals, Inc.?     

Behavioral Health Adjustment in Reserve Component Soldiers During a Noncombat Deployment to Africa

This study benchmarked rates of mental health problems, adjustment difficulties, and perceptions of unit climate among 505 U.S. soldiers (primarily National Guard) deployed to the Horn of Africa in 2012. In addition, the study examined whether differences across these outcomes exist between combat veterans (n = 239) and noncombat veterans (n = 242). Rates of mental health problems among soldiers on this noncombat deployment were lower than rates typically found among soldiers on combat deployments. Furthermore, soldiers without previous combat experience had lower rates of mental health problems and aggression than combat veterans. Similar differences were evident when adjustment difficulties and unit climate variables were compared. Although combat veterans could be valuable in training new soldiers, the results of this study indicate that combat veterans may need more targeted resources to facilitate their adjustment if they are to be optimally utilized.     

Soldier Background and Postinvestigative Events Associated With Timing of Suicide Following Deployment of U.S. Army National Guard Soldiers

The present study examined the timing of suicide and its associated soldier background and postinvestigative events among deployed Army National Guard (ARNG) soldiers from calendar years 2007 through 2014. Suicide deaths were nearly equally distributed between soldiers who had been deployed and those who had not. Among those deployed, however, suicides occurred mostly 1 year or more after having returned from deployment. Soldier background and postsuicide investigative events were associated with the timing of suicide. Having more years of military service, more previous deployments, and being married were associated with in-theater suicides. Soldiers younger in age (17–24 years), single, nonprior service, and lower in rank, in addition to having parent-family conflicts, full-time employment problems, and military transition problems were associated with suicides that had occurred 1–120 days and 120–365 days since return from deployment. Soldiers aged (24–29 years), married, and higher in rank, along with more reported problems including past behavioral health conditions, postdeployment behavior health referrals, criminal behaviors, and military performance were associated with suicides that had occurred 1 year or more after return. Findings likely represent time periods of suicide vulnerability for identifiable groups of soldiers, based on soldier background and events surrounding the suicide. Practical and theoretical implications of the findings are discussed.     

Functional Impairment as a Variable in Adjustment Post-Combat

This study examined how functional impairment relates to postcombat adjustment over time, controlling for the influence of combat exposure. Analyses used sequential random coefficient models to examine 2 hypotheses: a) combat exposure and functional impairment predict the change in posttraumatic stress, depression, and anger/aggression symptoms during the first year postcombat; and b) combat exposure and functional impairment at reintegration predict symptom scores at 1 year postdeployment. A Brigade Combat Team completed surveys at reintegration, 4 months, and 12 months after a 1-year deployment to Iraq. Soldiers reporting high functional impairment at reintegration had higher symptoms at both follow-up periods, and functional impairment was a significant predictor of symptoms at the last time point, even after accounting for the influence of combat exposure. There was also an interaction effect, such that functional impairment exacerbated the impact of combat exposure on posttraumatic stress and anger/aggression symptoms at 12 months postdeployment.     

The cycle of violence as a function of PTSD and appetitive aggression: A longitudinal study with Burundian soldiers

During deployment, soldiers face situations in which they are not only exposed to violence but also have to perpetrate it themselves. This study investigates the role of soldiers' levels of posttraumatic stress disorder (PTSD) symptoms and appetitive aggression, that is, a lust for violence, for their engaging in violence during deployment. Furthermore, factors during deployment influencing the level of PTSD symptoms and appetitive aggression after deployment were examined for a better comprehension of the maintenance of violence. Semi-structured interviews were conducted with 468 Burundian soldiers before and after a 1-year deployment to Somalia. To predict violent acts during deployment (perideployment) as well as appetitive aggression and PTSD symptom severity after deployment (postdeployment), structural equation modeling was utilized. Results showed that the number of violent acts perideployment was predicted by the level of appetitive aggression and by the severity of PTSD hyperarousal symptoms predeployment. In addition to its association with the predeployment level, appetitive aggression postdeployment was predicted by violent acts and trauma exposure perideployment as well as positively associated with unit support. PTSD symptom severity postdeployment was predicted by the severity of PTSD avoidance symptoms predeployment and trauma exposure perideployment, and negatively associated with unit support. This prospective study reveals the importance of appetitive aggression and PTSD hyperarousal symptoms for the engagement in violent acts during deployment, while simultaneously demonstrating how these phenomena may develop in mutually reinforcing cycles in a war setting.     

Overt and Relational Aggression and Victimization: Multiple Perspectives within the School Setting

The current study involved a comprehensive comparative examination of overt and relational aggression and victimization across multiple perspectives in the school setting (peers, teachers, observers in the lunchroom, self-report). Patterns of results involving sociometic status, ethnicity and gender were explored among 4th graders, with particular emphasis on girls. Controversial and rejected children were perceived as higher on both forms of aggression than other status groups, but only rejected children were reported as victims. Both European American and African American girls showed a greater tendency toward relational aggression and victimization than overt aggression or victimization. Results indicated negative outcomes associated with both relational and overt victimization and especially overt aggression for the target girl sample. Poorer adjustment and a socially unskillful behavioral profile were found to be associated with these three behaviors. However, relational aggression did not evidence a similar negative relation to adjustment nor was it related to many of the behaviors examined in the current study. Implications of these results are discussed.     

Relational Aggression in Mothers and Children: Links with Psychological Control and Child Adjustment

This study assesses associations between mothers’ use of relational aggression with their peers and psychological control with their children, and child adjustment in a sample of fifty U.S. mothers of elementary and middle school children. Mothers completed surveys assessing their relational aggression and psychological control. Teachers completed surveys assessing children’s externalizing behavior, internalizing symptoms, and relational aggression. Results suggest that mothers who are relationally aggressive with their peers are more likely to be psychologically controlling with their children. Results also showed that relational aggression predicted adjustment problems in youth. Relational aggression was associated with externalizing problems among boys and girls, and with internalizing problems among boys. Few gender differences in mean levels of maternal or child behaviors emerged.     

Substance use and violent behavior in women with antisocial personality disorder

The purpose of this study was to examine the relationship between substance abuse and dependence and violent behavior in a sample of incarcerated women with antisocial personality disorder (ASPD). Among male populations, substance dependence is associated with aggression and criminal behavior. Individuals with ASPD have more severe substance dependence, including higher symptom counts, earlier age of onset, and more frequent co-morbidity. Incarcerated women have a high prevalence of ASPD and substance dependence, but there has been little detailed work regarding addiction severity. Similarly, work on association of substance abuse and dependence with specific violent behaviors has been limited. This study examined a group of 41 mid-sentence female felons with a diagnosis of ASPD to determine associations with substance abuse and dependence. Data were gathered through administration of the Semi-Structured Assessment of the Genetics of Alcoholism II (SSAGA II). Substance dependence was highly prevalent (i.e., alcohol dependence, 56.1%; opiate dependence, 48.8%; cocaine dependence, 61.0%). While specific diagnoses were not associated with violent behavior and offending, symptom severity (i.e., age of onset, symptom count, co-morbidity) was associated with violent behavior in women dependent on opiates, alcohol, and cocaine. Arrest for an assault 1 was associated with alcohol dependence and opiate dependence. These data suggest that measurement of symptom severity and co-morbidity is important in assessing violent behavior in incarcerated women with ASPD. These findings are potentially important in examining non-incarcerated, substance-dependent women.     

Change and Stability in Attitudes Toward Violence During ISAF Service

A Swedish contingent to the International Security Assistance Force (ISAF; N = approx. 320) was studied before and after deployment to Afghanistan to assess if the mission and experiences on it affected attitudes toward violence. Attitudes toward war violence and penal violence were assessed across t = 1 and t = 2, as were the effects of combat exposure on change and stability in attitudes. It was hypothesized that the attitudes would remain stable across the deployment due to their importance to the soldierly identity, but that experiences of combat exposure would cause an increase in the propensity toward change. Results demonstrate that attitudes did not change between the pre- and postdeployment stages. Unexpectedly, increasing levels of combat exposure did not predict higher rates of change, but rather increased stability in attitudes toward violence. The results demonstrate that in terms of the willingness to use force, peacekeeping deployments do not have detrimental effects on soldiers.     

Age differences in the prevalence of physical aggression among 5-11-year-old Canadian boys and girls

It has been proven extremely difficult in the past to estimate the prevalence of physical aggression in children for two main reasons: (a) a heterogeneous sampling of behaviors (i.e., mix between physically aggressive and non-physically aggressive antisocial behaviors), and (b) a lack of a "gold standard" to identify children who exhibit physically aggressive behaviors on a frequent basis. The goal of this study was to test for age differences in the prevalence of physical aggression in the Canadian population of school-aged boys and girls, using cross-sectional data from the National Longitudinal Survey of Children and Youth (NLSCY). The first wave of the NLSCY included a representative sample of 12,292 Canadian children aged 5-11 years. We used latent class analysis to identify children whose propensity to exhibit physically aggressive behaviors was much higher than that of other children of the same age and sex in the population. The prevalence of physical aggression was estimated at 3.7% in 5-11-year-old boys and ranged from .5% to 2.3% in 11 and 5-year-old girls, respectively. Hence, the results show a decreasing trend in the prevalence of physical aggression with age for girls, but not for boys. These findings suggest the importance of considering the developmental pathways of physical aggression for boys and girls separately.     

The Relationship Between Postdeployment Factors and PTSD Severity in Recent Combat Veterans

Combat traumas precipitate posttraumatic stress disorder (PTSD); however, nontraumatic deployment and postdeployment factors may also contribute to PTSD severity. The Deployment Risk and Resilience Inventory (DRRI) was used to investigate pre-, peri-, and postdeployment factors associated with current PTSD severity in 150 recent combat veterans with PTSD and hazardous alcohol use. Hierarchal linear regression analyzed what factors independently predicted PTSD severity when controlling for sociodemographic characteristics and combat specific variables. Four postdeployment factors independently predicted PTSD severity: unemployment, alcohol use, social support, and stressful (nontraumatic) life events. The centrality of trauma in the maintenance of PTSD and clinical implications for treatment providers are discussed.     

The prevalence of suicidal behaviors among Northern Plains American Indians

This study examined the prevalence of suicidal behaviors among 1,638 Northern Plains American Indians ages 15-57. Age and gender patterns were investigated as was comorbidity with psychiatric and substance use disorders. Data from a population-based survey indicated that suicidal behaviors were more frequently reported among females than males and among younger respondents than older respondents. In addition, suicidal behaviors were associated with depressive disorders, PTSD, substance abuse/dependence, and violent ideation/aggression. Results underscore the importance of effective and acceptable alcohol, drug, and mental health services in reducing the rates of suicidal behaviors in American Indian communities.     

Gender differences in predictors of suicidal thoughts and attempts among homeless veterans that abuse substances

This study of 315 male and 310 female homeless military veterans in a V.A. inpatient program designed to treat substance abusers, many of whom also suffer psychiatric disorders, was designed to examine gender differences in factors associated with the odds of having suicidal thoughts, and of attempting suicide, in comparison to being nonsuicidal. A maximum likelihood estimation multinomial logistic regression showed childhood and current sexual and physical abuses, depression, fearfulness, relationship problems, limited social support, and low self-esteem was more strongly associated with suicidal thoughts and attempts for women than for men veterans. Extent of alcohol and other drug abuse, aggression, resilience, self-efficacy, combat exposure, combat-related PTSD, and work problems were more strongly associated with suicidal thoughts and attempts for men than for women. Implications of these findings for V.A. programs are discussed.     

Predicting child behavior problems in maritally violent families

Previous research indicates that children from violent marriages are more likely to suffer from conduct problems and/or anxiety disorders than children from nonviolent, satisfactory marriages. However, knowledge regarding specific factors present in violent marriages relating to child problems is limited. The present study examined the relationships involving interspousal aggression, parent-child aggression, and child behavior problems in a sample of 45 children from maritally violent families. Mothers indicated how often their children witnessed interspousal aggression and were victims of parent-child aggression. Mothers also rated their children's problem behaviors while children reported on their own depressive symptoms. The witnessing of interspousal aggression was highly associated with parental aggression directed toward children. Parent-child aggression related to attention problems, anxiety-withdrawl, motor excess, and conduct problems in children. However, the witnessing of interspousal aggression was not significantly related to child behavior problems. These results are consistent with theoretical predictions linking marital problems to child behavior by virtue of their association with parenting.This research was supported in part by a Grant-in-Aid of Research awarded to the first author by Sigma Xi, the Scientific Research Society, and NIMH Grant No. MH35340 awarded to the third author. The authors wish to thank Martha Wray and her staff at VIBS for their help throughout this project.     

Relational aggression and social-psychological adjustment in a college sample

Although the understanding of aggression has been significantly advanced through the study of relational aggression, past research has been limited by its predominant focus on children. This study examines the associations between relational aggression and social-psychological adjustment in a sample of young adults. A peer-nomination instrument was constructed to assess relational aggression, and self-reports of adjustment were obtained from 225 college students (45% male; mean age = 19.5). Regression analyses showed that relational aggression provided unique information, after controlling for age and gender, about peer rejection, prosocial behavior, antisocial personality features, and borderline personality features. Interactions with gender further showed that, for women, relational aggression was linked with bulimic symptoms. The importance of relational aggression for understanding adjustment problems during young adulthood are discussed.     

Self-Regulation Deficits Explain the Link between Reactive Aggression and Internalizing and Externalizing Behavior Problems in Children

Childhood aggression is often associated with significant psychosocial maladjustment; however, adjustment difficulties may vary based on the function of aggression. The present study used the Behavior Rating Inventory of Executive Function (BRIEF; Gioia et al. Child Neuropsychology 6:235–238, 2000) to examine whether difficulties in particular domains of self-regulation serve as common mechanisms in the association between reactive (versus proactive) aggression and internalizing or externalizing adjustment problems in clinic-referred children. Reactive aggression was associated with poorer behavioral regulation and metacognition, whereas proactive aggression was not associated with poorer self-regulation. Further, the association between reactive aggression and adjustment problems, both internalizing and externalizing, was accounted for by poorer behavioral regulation and metacognitive skills. Gender, age, ADHD diagnosis, IQ, and psychotropic medication status did not account for the results. These findings suggest that self-regulation skills influence adjustment problems in reactively aggressive youth and may be important targets of intervention for such children.     

Intimate partner aggression reporting concordance and correlates of agreement among men with alcohol use disorders and their female partners

This study examined relationship aggression reporting concordance among 303 men with alcohol use disorders and their female partners enrolled in couples-based alcohol abuse treatment. Agreement for physical and psychological aggression was generally consistent with, or higher than, concordance rates reported among other populations. Men's antisocial personality disorder characteristics were the strongest predictor of higher concordance for male- and female-perpetrated aggression. Higher alcohol problem severity, poorer relationship adjustment, and higher psychopathic personality features were associated with better concordance in some analyses. Women reported experiencing more physical aggression than men reported perpetrating, and women reported perpetrating more psychological aggression than men reported experiencing. Findings highlight the importance of obtaining aggression reports from both partners and the need for research investigating methods for improving concordance.     

Corporal punishment and long-term behavior problems: the moderating role of positive parenting and psychological aggression

The aims of this study were: (a) to examine the prevalence of corporal punishment (CP) of children in Spain; (b) to analyze the extent to which CP is used in combination with psychological aggression and positive parenting among Spanish parents; and (c) to investigate whether the relation between CP and behavior problems is moderated by a positive parenting context in which CP may be used, and by the co-occurrence of psychological aggression. The sample comprised 1,071 Spanish university students (74.8% female; 25.2% male). Findings indicate a high prevalence of CP of Spanish students, revealing that significantly more mothers than fathers used CP. Furthermore, more CP is related to more use of psychological aggression and less of positive parenting. Regression analyses revealed that CP was associated with an increased probability of antisocial traits and behaviors regardless of whether there was positive parenting and psychological aggression. These results highlight that, though many Spanish parents use CP as a disciplinary strategy, it appears to be related to negative outcomes for children regardless the parental context in which it is used.     

Women experience more serious relationship problems when male partners endorse hostile sexism

Men's hostile sexism promotes aggressive attitudes, motivations and behaviors toward women. Despite the costs these effects should have for women, prior research has failed to test how men's hostile sexism predicts the problems women experience in important domains. We address this oversight by utilizing dyadic data from 363 heterosexual couples to test how male partners’ hostile sexism predicts women's relationship experiences and evaluations. Male partners’ hostile sexism was associated with women experiencing more severe problems across a greater number of domains. Moreover, the areas experienced as most problematic were consistent with the power, dependence, and trust concerns underlying men's hostile sexism, including problems with power dynamics, jealousy, and serious problems involving gender-role conflict, abuse, infidelity and alcohol/drugs. The greater problems associated with male partners’ hostile sexism predicted more negative relationship evaluations for women. These results demonstrate the importance of examining how men's hostile sexism harms women in important life domains.