1
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Campbell-Sills L, Kautz JD, Choi KW, Naifeh JA, Aliaga PA, Jain S, Sun X, Kessler RC, Stein MB, Ursano RJ, Bliese PD. Effects of prior deployments and perceived resilience on anger trajectories of combat-deployed soldiers. Psychol Med 2023; 53:2031-2040. [PMID: 34802475 PMCID: PMC9124235 DOI: 10.1017/s0033291721003779] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Problematic anger is frequently reported by soldiers who have deployed to combat zones. However, evidence is lacking with respect to how anger changes over a deployment cycle, and which factors prospectively influence change in anger among combat-deployed soldiers. METHODS Reports of problematic anger were obtained from 7298 US Army soldiers who deployed to Afghanistan in 2012. A series of mixed-effects growth models estimated linear trajectories of anger over a period of 1-2 months before deployment to 9 months post-deployment, and evaluated the effects of pre-deployment factors (prior deployments and perceived resilience) on average levels and growth of problematic anger. RESULTS A model with random intercepts and slopes provided the best fit, indicating heterogeneity in soldiers' levels and trajectories of anger. First-time deployers reported the lowest anger overall, but the most growth in anger over time. Soldiers with multiple prior deployments displayed the highest anger overall, which remained relatively stable over time. Higher pre-deployment resilience was associated with lower reports of anger, but its protective effect diminished over time. First- and second-time deployers reporting low resilience displayed different anger trajectories (stable v. decreasing, respectively). CONCLUSIONS Change in anger from pre- to post-deployment varies based on pre-deployment factors. The observed differences in anger trajectories suggest that efforts to detect and reduce problematic anger should be tailored for first-time v. repeat deployers. Ongoing screening is needed even for soldiers reporting high resilience before deployment, as the protective effect of pre-deployment resilience on anger erodes over time.
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Affiliation(s)
| | - Jason D. Kautz
- Department of Organizations, Strategy, and International Management, University of Texas at Dallas, Dallas, TX, USA
| | - Karmel W. Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - James A. Naifeh
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Pablo A. Aliaga
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Xiaoying Sun
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Robert J. Ursano
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Paul D. Bliese
- Department of Management, Darla Moore School of Business, University of South Carolina, Columbia, SC, USA
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2
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Vest BM, Goodell EMA, Homish DL, Homish GG. Effects of Social Network Characteristics on Mental Health Outcomes Among United States Army Reserve and National Guard Soldiers. Community Ment Health J 2022; 58:1268-1278. [PMID: 34981277 PMCID: PMC9250539 DOI: 10.1007/s10597-021-00935-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
Abstract
We sought to examine the relative salience of multiple social network structural characteristics (e.g., size, composition, quality, substance use) for understanding soldiers' mental health symptoms (anger, anxiety, depression, PTSD). Data are drawn from soldiers (N = 421) participating in the Operation: SAFETY study. Negative binomial regression models examined the relationship between ten social network characteristics and mental health outcomes, controlling for age, sex, years of military service, and deployment history. Greater number of close network ties was associated with fewer symptoms of anger, anxiety, and depression (ps < 0.05), but not PTSD. Having more illicit drug-using network ties was associated with greater severity of anxiety symptoms (p < 0.05). Finally, more days spent drinking with network members was related to higher levels of anger (p < 0.05). Interpersonal relationships that entail substance use are associated with greater anxiety and anger while a greater number of close ties is associated with fewer anger, anxiety, and depression symptoms.
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Affiliation(s)
- Bonnie M Vest
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 77 Goodell Street, Suite 220, Buffalo, NY, 14203, USA.
| | - Erin M Anderson Goodell
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - D Lynn Homish
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Gregory G Homish
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 77 Goodell Street, Suite 220, Buffalo, NY, 14203, USA
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
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3
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Etchin AG, Corbo V, Brown E, Fortier CB, Fonda JR, Milberg WP, Currao A, McGlinchey RE. Associations Among Clinical Variables and Anger Differ by Early Life Adversity Among Post‐9/11 Veterans. Clin Psychol Psychother 2022; 29:1403-1415. [DOI: 10.1002/cpp.2722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Anna G. Etchin
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
| | - Vincent Corbo
- Department of Psychology Southern New Hampshire University Manchester NH USA
| | - Emma Brown
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
| | - Catherine B. Fortier
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Harvard Medical School Boston MA USA
| | - Jennifer R. Fonda
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Boston University Medical Campus Boston MA USA
| | - William P. Milberg
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Harvard Medical School Boston MA USA
- Geriatric Research Education and Clinical Center, VA Boston Healthcare System Boston MA USA
| | - Alyssa Currao
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
| | - Regina E. McGlinchey
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System Boston MA USA
- Department of Psychiatry Harvard Medical School Boston MA USA
- Geriatric Research Education and Clinical Center, VA Boston Healthcare System Boston MA USA
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4
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Van Voorhees EE, Dillon KH, Wilson SM, Dennis PA, Neal LC, Medenblik AM, Calhoun PS, Dedert EA, Caron K, Chaudhry N, White JD, Elbogen E, Beckham JC. A Comparison of Group Anger Management Treatments for Combat Veterans With PTSD: Results From a Quasi-Experimental Trial. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP10276-NP10300. [PMID: 34523367 PMCID: PMC8443849 DOI: 10.1177/0886260519873335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Difficulty controlling anger is a significant concern among combat veterans with posttraumatic stress disorder (PTSD), yet few controlled studies have examined the efficacy of anger treatments for this population. This study examined the effects of a group cognitive behavioral therapy (CBT) intervention compared with a group present-centered therapy (PCT) control condition in male and female combat veterans with PTSD. Thirty-six combat veterans with PTSD and anger difficulties began group treatment (CBT, n = 19; PCT, n = 17). Separate multilevel models of self-rated anger, PTSD symptoms, and disability were conducted using data from baseline, each of 12 treatment sessions, posttreatment, and 3- and 6-month follow-up time points. Significant decreases in anger and PTSD symptoms were observed over time, but no significant differences between CBT and PCT were observed on these outcomes. A significant interaction of therapy by time favoring the PCT condition was observed on disability scores. Gender differences were observed in dropout rates (i.e., 100% of female participants dropped out of CBT). Findings suggest that both CBT and PCT group therapy may be effective in reducing anger in combat veterans with PTSD. Results also highlight potential gender differences in response to group anger treatment.
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Affiliation(s)
- Elizabeth E Van Voorhees
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
| | - Kirsten H Dillon
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Sarah M Wilson
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
- VA Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Paul A Dennis
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
| | | | | | - Patrick S Calhoun
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
- VA Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Eric A Dedert
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
| | - Kelly Caron
- Durham Veterans Affairs Medical Center, NC, USA
| | | | | | - Eric Elbogen
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
| | - Jean C Beckham
- Durham Veterans Affairs Medical Center, NC, USA
- VISN 6 Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Duke University Medical Center, Durham, NC, USA
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5
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Resilience to mental health problems and the role of deployment status among U.S. Army Reserve and National Guard Soldiers. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1299-1310. [PMID: 32556425 PMCID: PMC7746625 DOI: 10.1007/s00127-020-01899-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 06/09/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE Research suggests that interpersonal and intrapersonal resiliency factors protect against poor post-deployment mental health outcomes among Reserve/Guard soldiers who have been deployed. There is increasing awareness that never-deployed soldiers are also at risk. The purpose of this study was to examine the relationships between resiliency factors and a range of mental health outcomes among a sample of United States Army Reserve and National Guard (USAR/NG) soldiers who have and have not experienced deployment. METHODS A subset of data was drawn from Operation: SAFETY (N = 360), an ongoing study examining the health and well-being of USAR/NG soldiers. We used a multivariate path analysis approach to examine the simultaneous effects of unit support, marital satisfaction, and psychological hardiness on the following mental health outcomes, concurrently: anger, anxiety, depression, and posttraumatic stress disorder (PTSD) symptomatology. We also examined interaction effects between resiliency factors and deployment status on mental health outcomes. RESULTS Greater unit support (ps < 0.01), marital satisfaction (ps < 0.001), and psychological hardiness (ps < 0.001) were associated with less anger, anxiety, depression, and PTSD symptomatology. Psychological hardiness had significant interactions with deployment status on anxiety, depression, and PTSD, such that the protective effects of psychological hardiness were even stronger among never-deployed soldiers than previously deployed solders. CONCLUSION Resiliency factors can be targeted for intervention to prevent poor mental health outcomes among USAR/NG soldiers, regardless of deployment status. Further, psychological hardiness may be an even more important protective factor among soldiers who have never been deployed.
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6
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Worthen M, Rathod SD, Cohen G, Sampson L, Ursano R, Gifford R, Fullerton C, Galea S, Ahern J. Risk and Protective Factors for Difficulty Controlling Violent Behavior in National Guard and Reserve Service Members. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:1049-1067. [PMID: 29294977 DOI: 10.1177/0886260517737552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Violent behavior is an important problem for military service members and veterans. A representative cohort of U.S. Reserve and National Guard personnel (N = 1,293) were interviewed to assess self-reported problems controlling violent behavior, deployment traumas, posttraumatic stress disorder (PTSD), alcohol abuse, and social support. Poisson regression models were used to estimate the associations of violent behavior with risk and protective factors. Problems controlling violent behavior were uncommon among male (3.3%) and female (1.7%) service members. Adjusted prevalence ratios (aPR) showed associations between violent behavior and deployment traumas (aPR = 1.67, 95% confidence interval [CI] = [1.34, 2.08]), PTSD (aPR = 9.95, 95% CI = [5.09, 19.48]), and PTSD symptom severity (aPR for each additional PTSD symptom = 1.07, 95% CI = [1.06, 1.09]). Social support was associated with lower prevalence of violent behavior (aPR = 0.62, 95% CI = [0.52, 0.76]). The association between violent behavior and alcohol abuse was not statistically significant (aPR = 1.94, 95% CI = [0.92, 4.09]). Results were consistent when the population was restricted to personnel who had deployed to a war zone. Problems controlling violent behavior were less common in this cohort than has been documented in other studies. Associations of violent behavior with risk and protective factors are consistent with prior research.
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Affiliation(s)
| | | | - Gregory Cohen
- Columbia University Mailman School of Public Health, New York, NY, USA
- Boston University School of Public Health, MA, USA
| | | | - Robert Ursano
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Robert Gifford
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Carol Fullerton
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Sandro Galea
- Boston University School of Public Health, MA, USA
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7
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Hoopsick RA, Homish DL, Collins RL, Nochajski TH, Read JP, Homish GG. Is deployment status the critical determinant of psychosocial problems among reserve/guard soldiers? Psychol Serv 2020; 17:461-471. [PMID: 30762411 PMCID: PMC6693987 DOI: 10.1037/ser0000331] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A general assumption that deployment is the primary catalyst for psychological and social difficulties may contribute to underrecognition and undertreatment of problems among never-deployed service members (i.e., having no history of ever being deployed). We aimed to determine if ever-deployed (i.e., having a history of at least one deployment) and never-deployed United States Army Reserve and National Guard (USAR/NG) soldiers differed in mental health, substance use, and resiliency factors, and to determine the relative influence of deployment status and each of these factors on poor psychosocial outcomes. We analyzed a subset of data from Operation: SAFETY (Soldiers and Families Excelling Through the Years) (N = 404), an ongoing study examining the health and well-being of USAR/NG soldiers. Bivariate analyses demonstrated that soldiers did not significantly differ across a range of measures on the basis of deployment status (ps > 0.05). In fact, Factor Analyses and Discriminant Function Analysis revealed that deployment status was the least salient factor to psychosocial problems among the measured variables and that the observed variables could not accurately discriminate between ever-deployed and never-deployed soldiers, F(8, 374) = 1.34, p > .05. Measures of mental health and substance use were more salient to psychosocial problems (ps < .05). Measures of resiliency loaded negatively onto psychosocial problems (ps < .05), indicating that they contribute to better well-being. Targeting screening and intervention efforts only on soldiers who have been deployed will miss opportunities to intervene on an equally affected group. Resiliency factors should be considered as intervention targets. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Rachel A. Hoopsick
- Department of Community Health and Health Behavior, School
of Public Health and Health Professions, University at Buffalo, The State University
of New York, Buffalo, NY 14215, USA
| | - D. Lynn Homish
- Department of Community Health and Health Behavior, School
of Public Health and Health Professions, University at Buffalo, The State University
of New York, Buffalo, NY 14215, USA
| | - R. Lorraine Collins
- Department of Community Health and Health Behavior, School
of Public Health and Health Professions, University at Buffalo, The State University
of New York, Buffalo, NY 14215, USA
| | - Thomas H. Nochajski
- School of Social Work, University at Buffalo, The State
University of New York, Buffalo, NY 14260, USA
| | - Jennifer P. Read
- Department of Psychology, College of Arts and Sciences,
University at Buffalo, The State University of New York, Buffalo, NY 14260,
USA
| | - Gregory G. Homish
- Department of Community Health and Health Behavior, School
of Public Health and Health Professions, University at Buffalo, The State University
of New York, Buffalo, NY 14215, USA
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8
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Kim J, Kim J, Park S. Military hazing and suicidal ideation among active duty military personnel: Serial mediation effects of anger and depressive symptoms. J Affect Disord 2019; 256:79-85. [PMID: 31158719 DOI: 10.1016/j.jad.2019.05.060] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 04/09/2019] [Accepted: 05/27/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Military hazing is one of most serious problems affecting suicidal ideation (SI) among active duty personnel, but has received limited research attention. Studies on hazing and SI indicate anger and depressive symptoms as mediators for SI. METHODS A sample of active duty military personnel (N = 944) completed an offline survey, consisting of the revised Conflict Tactics Scale-2, Composite International Diagnostic Interview Screening Scale, and revised Columbia Suicide Severity Rating Scale. Frequency, bivariate correlation, and serial mediation analyses were conducted to assess the serial effects of military hazing on SI, mediated via anger and depressive symptoms. RESULTS Military hazing, anger, depressive symptoms, and SI were positively related to each other in bivariate analyses. In serial mediation analyses, hazing was found to be a significant predictor of higher levels of anger, consequently triggering depressive symptoms, which, in turn, were associated with greater SI. LIMITATIONS Study limitations included the use of cross-sectional data with the use of retrospective self-report. CONCLUSION Hazing in the military is prevalent (17.6%), and SI is associated with serial effects of hazing, anger, and depressive symptoms with full mediation path. Findings suggest that policies that address reducing hazing and implementing clinical interventions specifically focused on symptoms of anger and depression may be important for decreasing SI in military personnel.
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Affiliation(s)
- JaeYop Kim
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - JoonBeom Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - SooKyung Park
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
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9
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Kannis-Dymand L, Salguero JM, Ramos-Cejudo J, Novaco RW. Dimensions of Anger Reactions-Revised (DAR-R): Validation of a brief anger measure in Australia and Spain. J Clin Psychol 2019; 75:1233-1248. [PMID: 30758849 DOI: 10.1002/jclp.22757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/27/2018] [Accepted: 12/27/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE A validated, brief measure of anger is needed in clinical settings to screen for problematic anger. This study examined the validity of the seven-item Dimensions of Anger Reactions-Revised (DAR-R), including a version for the Spanish population. METHOD Multiple psychometric instruments administered to 541 (76.6% female) adults in Australia and 1,115 (56.3% female) in Spain were analyzed. RESULTS A two-factor model (anger response and anger impairment) was confirmed. Concurrent, convergent, and discriminant validity were supported. Anger response items strongly correlated with established measures of anger/aggression State-Trait Anger Expression Inventory (Aggression Questionnaire), whereas anger impairment items strongly correlated with anxiety Generalized Anxiety Disorder-7 and depression Patient Health Questionnaire-9 measures. Internal consistency and test-retest reliability (3 months) were good. Cut-off scores for problematic anger were established. There were no gender differences in anger in the Spanish sample, but Australian males had higher anger scores than females. CONCLUSION Results substantiate the utility of the DAR-R as a concise, clinically informative measure of anger.
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Affiliation(s)
- Lee Kannis-Dymand
- Sunshine Coast Mind & Neuroscience-Thompson Institute, School of Social Sciences, University of the Sunshine Coast, Queensland, Australia
| | - José M Salguero
- Department of Personality, Evaluation and Psychological Treatment, School of Psychology, University of Malaga, Spain
| | - Juan Ramos-Cejudo
- Department of Social, Work and Differential Psychology, School of Psychology, Complutense University of Madrid, Spain
| | - Raymond W Novaco
- Department of Psychological Science, University of California, Irvine, California, United States
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10
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Ford JD, Grasso DJ, Greene CA, Slivinsky M, DeViva JC. Randomized clinical trial pilot study of prolonged exposure versus present centred affect regulation therapy for PTSD and anger problems with male military combat veterans. Clin Psychol Psychother 2018; 25:641-649. [DOI: 10.1002/cpp.2194] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Julian D. Ford
- Department of Psychiatry; University of Connecticut Health Center; Farmington CT USA
| | - Damion J. Grasso
- Department of Psychiatry; University of Connecticut Health Center; Farmington CT USA
| | - Carolyn A. Greene
- Department of Psychiatry; University of Connecticut Health Center; Farmington CT USA
| | - Michelle Slivinsky
- Department of Psychiatry; University of Connecticut Health Center; Farmington CT USA
| | - Jason C. DeViva
- Department of Psychology; Department of Veterans Affairs Connecticut Healthcare System and Yale School of Medicine; West Haven CT USA
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11
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The Impact of Aggression on the Relationship Between Betrayal and Belongingness Among U.S. Military Personnel. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000160] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Abstract
Studies have found that soldiers returning from combat deployment report elevated levels of anger and aggression. The present study examined the perception that anger was helpful in performing occupationally related duties and whether this perception was associated with mental health problems, somatic symptoms, and functioning. Soldiers (N = 627) completed a survey 4 months after their deployment to Afghanistan and again 3 months later. When examining anger over time, findings revealed four groups of different latent classes: low stable (resilient), high stable (chronic), decreasing over time (improved), and increasing over time (delayed problems). For two of the groups (chronic and delayed problems), perceiving anger as helpful was closely related to anger reactions. Perceiving anger as helpful was also associated with worse mental health symptoms. Further work in understanding how to mitigate this positive perception of anger in prevention initiatives may be useful in addressing anger reactions.
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13
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Vest BM, Heavey SC, Homish DL, Homish GG. Marital Satisfaction, Family Support, and Pre-Deployment Resiliency Factors Related to Mental Health Outcomes for Reserve and National Guard Soldiers. ACTA ACUST UNITED AC 2017; 5:313-323. [PMID: 30505630 DOI: 10.1080/21635781.2017.1343694] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The purpose of this study is to examine the relationship between resiliency factors and mental health outcomes among US Army Reserve and National Guard soldiers. Our results demonstrate that higher marital satisfaction is significantly associated with lower anger, depression, anxiety, and PTSD. Importantly, our results provide evidence that among the assessed resiliency factors (pre-deployment preparation, unit social support, martial satisfaction and family support), marital satisfaction has the strongest evidence for promoting resiliency. Future research should develop interventions that can be provided jointly to the soldier and his partner to facilitate stronger relationships and promote improved mental health and reintegration post-deployment.
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Affiliation(s)
- Bonnie M Vest
- Department of Family Medicine, University at Buffalo, Buffalo NY
| | - Sarah Cercone Heavey
- Department of Community Health & Health Behavior, University at Buffalo, Buffalo NY
| | - D Lynn Homish
- Department of Community Health & Health Behavior, University at Buffalo, Buffalo NY
| | - Gregory G Homish
- Department of Family Medicine, University at Buffalo, Buffalo NY.,Department of Community Health & Health Behavior, University at Buffalo, Buffalo NY
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14
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Gillikin C, Habib L, Evces M, Bradley B, Ressler KJ, Sanders J. Trauma exposure and PTSD symptoms associate with violence in inner city civilians. J Psychiatr Res 2016; 83:1-7. [PMID: 27518177 PMCID: PMC5107154 DOI: 10.1016/j.jpsychires.2016.07.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 05/12/2016] [Accepted: 07/29/2016] [Indexed: 01/10/2023]
Abstract
Understanding whether a history of psychological trauma is associated with perpetrating aggressive and violent behavior is of critical importance to public health. This relationship is especially important to study within urban areas where violence is prevalent. In this paper we examined whether a history of trauma or Post Traumatic Stress Disorder (PTSD) in inner city civilians was associated with violent behavior. Data were collected from over 1900 primary care patients at Grady Memorial Hospital in Atlanta, Georgia. Childhood trauma history was assessed with the Childhood Trauma Questionnaire (CTQ) and adult trauma history with the Traumatic Events Inventory (TEI). PTSD symptoms were measured with the PTSD Symptom Scale (PSS) and violent behaviors were measured with the Behavior Questionnaire (BQ). Using these measures we studied violent behavior in the inner city and its association with childhood or adult trauma history or PTSD. Trauma, PTSD and violence were all prevalent in this at-risk urban cohort. Perpetrating interpersonal violence was associated with a history childhood and adult trauma history, and with PTSD symptoms and diagnosis. An association between violent behavior and PTSD diagnosis was maintained after controlling for other pertinent variables such as demographics and presence of depression. Our findings point to a dysregulation of aggressive and violent behavior that may be a consequence of trauma and PTSD. These data indicate that more effective PTSD screening and treatment may help to reduce urban violence.
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Affiliation(s)
- Cynthia Gillikin
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322
| | - Leah Habib
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322
| | - Mark Evces
- Department of Psychiatry, New York University School of Medicine, 462 First Avenue, New York, NY 10016
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322,Howard Hughes Medical Institute, Chevy Chase, Maryland 20815
| | - Jeff Sanders
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 4000 Woodruff Memorial Bldg., Atlanta, GA 30322, USA.
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15
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Cassiello-Robbins C, Barlow DH. Anger: The unrecognized emotion in emotional disorders. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/cpsp.12139] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Worthen M, Rathod SD, Cohen G, Sampson L, Ursano R, Gifford R, Fullerton C, Galea S, Ahern J. Anger and Posttraumatic Stress Disorder Symptom Severity in a Trauma-Exposed Military Population: Differences by Trauma Context and Gender. J Trauma Stress 2015; 28:539-46. [PMID: 26580844 DOI: 10.1002/jts.22050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Studies have found a stronger association between anger and posttraumatic stress disorder (PTSD) severity in military populations than in nonmilitary populations. Two hypotheses have been proposed to explain this difference: Military populations are more prone to anger than nonmilitary populations, and traumas experienced on deployment create more anger than nondeployment traumas. To examine these hypotheses, we evaluated the association between anger and PTSD severity among never-deployed military service members with nondeployment traumas (n = 226) and deployed service members with deployment traumas (n = 594) using linear regression. We further examined these associations stratified by gender. Bivariate associations between anger and PTSD severity were similar for nondeployment and deployment events; however, gender modified this association. For men, the association for deployment events was stronger than for nondeployment events (β = .18, r = .53 vs. β = .16, r = .37, respectively), whereas the reverse was true for women (deployment: β = .20, r = .42 vs. nondeployment: β = .25, r = .65). Among men, findings supported the hypothesis that deployment traumas produce stronger associations between PTSD and anger and are inconsistent with hypothesized population differences. In women, however, there was not a clear fit with either hypothesis.
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Affiliation(s)
- Miranda Worthen
- Department of Health Science and Recreation, San Jose State University, San Jose, California, USA
| | - Sujit D Rathod
- Global Mental Health Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Gregory Cohen
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Laura Sampson
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Robert Ursano
- Department of Psychiatry, Uniformed Services University, School of Medicine, Bethesda, Maryland, USA
| | - Robert Gifford
- Department of Psychiatry, Uniformed Services University, School of Medicine, Bethesda, Maryland, USA
| | - Carol Fullerton
- Department of Psychiatry, Uniformed Services University, School of Medicine, Bethesda, Maryland, USA
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jennifer Ahern
- Division of Epidemiology, University of California, Berkeley, Berkeley, California, USA
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17
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Heesink L, Rademaker A, Vermetten E, Geuze E, Kleber R. Longitudinal measures of hostility in deployed military personnel. Psychiatry Res 2015; 229:479-84. [PMID: 26165965 DOI: 10.1016/j.psychres.2015.05.082] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 05/06/2015] [Accepted: 05/31/2015] [Indexed: 11/27/2022]
Abstract
Increases in anger and hostility are commonly found after military deployment. However, it is unknown how anger and hostility develop over time, and which veterans are more at risk for developing these complaints. Data of 745 veterans one month before deployment to Afghanistan and one, six, twelve and 24 months after deployment were analyzed in a growth model. Growth mixture modeling revealed four classes based on their growth in hostility. Most of the participants belonged to a low-hostile group or a mild-hostile group that remained stable over time. Two smaller groups were identified that displayed increase in hostility ratings after deployment. The first showed an immediate increase after deployment. The second showed a delayed increase between twelve and 24 months after deployment. No groups were identified that displayed a decrease of hostility symptoms over time. Multinomial logistic regression was applied to predict group membership by age, education, early trauma, deployment stressors and personality factors. This study gains more insight into the course of hostility over time, and identifies risk factors for the progression of hostility.
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Affiliation(s)
- Lieke Heesink
- Research Centre Military Mental Health Care, Ministry of Defense, Utrecht, The Netherlands; University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands.
| | - Arthur Rademaker
- Research Centre Military Mental Health Care, Ministry of Defense, Utrecht, The Netherlands; University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Eric Vermetten
- Research Centre Military Mental Health Care, Ministry of Defense, Utrecht, The Netherlands; University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands; Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands; Foundation Arq, Diemen, The Netherlands
| | - Elbert Geuze
- Research Centre Military Mental Health Care, Ministry of Defense, Utrecht, The Netherlands; University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Rolf Kleber
- Foundation Arq, Diemen, The Netherlands; Utrecht University, Department of Clinical and Health Psychology, Utrecht, The Netherlands
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18
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Risk and resilience factors associated with posttraumatic stress in ethno-racially diverse National Guard members in Hawai׳i. Psychiatry Res 2015; 227:270-7. [PMID: 25863819 DOI: 10.1016/j.psychres.2015.02.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 01/28/2015] [Accepted: 02/14/2015] [Indexed: 11/21/2022]
Abstract
This study examinedrisk and resilience factors associated with posttraumatic stress symptomatology (PTSS) in an ethno-racially diverse sample of Hawai׳i National Guard members comprised of Native Hawaiians, Filipino Americans, Japanese Americans, and European Americans. In the full sample, identifying as Japanese American and higher scores on measures of perceived social support and psychological resilience were negatively associated with PTSS, while Army Guard (vs. Air Guard) status and stronger family norms against disclosing mental health problems were positively associated with PTSS. Exploratory analyses of ethno-racial subgroups identified different patterns of within and between-group correlates of PTSS. For example, when controlling for other factors, higher psychological resilience scores were negatively associated with PTSS only among Native Hawaiian and European Americans. Overall, results of this study suggest that some risk and resilience factors associated with posttraumatic stress disorder (PTSD) may extend to military populations with high numbers of Filipino American, Japanese American, and Native Hawaiian Veterans. Results further suggest differences in risk and resilience factors unique to specific ethno-racial subgroups.
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