Childhood Maltreatment and Use of Aggression among Veterans with Co-occurring PTSD and Alcohol Use Disorder: The Mediating Role of Hostile Cognitions

ABSTRACT

History of childhood maltreatment is common among military veterans, particularly those with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Childhood maltreatment is associated with negative psychosocial outcomes, including use of aggression during adulthood. Prior research has identified maladaptive cognitions as a key mediating variable in the association between early life trauma and aggression. Given the high rates of comorbid PTSD and AUD among veterans and the increased risk of aggression when these conditions co-occur, it is critical to examine malleable intervention targets, such as maladaptive cognitions, for this population. The current secondary analyses examined the mediating role of hostile cognitions on the associations between childhood maltreatment and adulthood aggression in a sample of dually diagnosed veterans. Participants were veterans with co-occurring PTSD and AUD (N = 73) who were enrolled in a larger randomized controlled laboratory trial. Participants completed self-report measures of childhood maltreatment, hostile cognitions, and aggressive behavior. Three models were tested to examine the mediating effect of hostility on the associations between childhood maltreatment, abuse, and neglect on aggression. Results indicated that hostility fully mediated the effect of maltreatment on aggression and partially mediated the effect of childhood abuse on aggression. The effect of childhood neglect on aggression was nonsignificant. Hostile cognitions may be a critical intervention target for veterans with co-occurring PTSD and AUD and history of childhood maltreatment, particularly for those who have experienced higher levels of childhood abuse.

KEYWORDS:

• Childhood maltreatment
• veteran
• comorbidity
• hostility
• aggression

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ To account for the cross-sectional nature of the data, we tested three alternative models in which we entered each childhood maltreatment variable as the IV, aggression as the mediator, and hostility as the DV, controlling for PTSD symptom severity. Aggression fully mediated the associations between childhood maltreatment and hostility and between childhood abuse and hostility. Aggression did not mediate the association between childhood neglect and hostility.

Additional information

Funding

This work was funded in part by the Department of Defense under Grant W81XWH‐12‐2‐0048, the National Institute on Alcohol Abuse and Alcoholism under Grant K23AA023845, and the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment. This work does not necessarily represent the views of the Department of Veterans Affairs or the United States Government.