Correlates of recent and lifetime aggression among Veterans with co-occurring PTSD and substance-use disorders

Abstract

Aggressive behavior is strongly associated with both posttraumatic stress disorder (PTSD) and substance-use disorders (SUDs) among civilians. However, little research has examined correlates of aggression among Veterans with co-occurring PTSD and SUD. This exploratory study examined the prevalence and correlates of recent (i.e. past 30 days) and lifetime aggressive behavior among a sample of US Veterans (n = 97) enrolled in a study examining integrated psychosocial treatment of co-occurring PTSD/SUD. The findings revealed high rates of recent and lifetime aggressive behaviors (39.2% and 57.7%, respectively). Participants who endorsed recent aggressive behaviors were younger, had less education, more severe PTSD numbing and hyperarousal symptoms, were more likely to report recent suicidal ideation, more frequent alcohol and marijuana use, had higher rates of physical and sexual abuse, greater combat exposure, and more severe aftermath of battle experiences. Participants who endorsed lifetime aggression were younger, reported more total PTSD symptom severity, PTSD re-experiencing severity, depression severity, and fewer post-deployment stressors compared to those who did not. Logistic regression analyses indicated that education and number of drinking days were correlated with recent aggression while depression and post-deployment stressors were correlated with lifetime aggression. The findings demonstrate high rates of aggressive behaviors among Veterans with PTSD/SUD as well as clinically relevant correlates of aggressive behaviors. Although preliminary, the findings suggest potential targets for improving assessment and treatment of Veterans with PTSD/SUD.

Keywords:

• traumatic stress
• mental health
• substance use
• aggression
• comorbidity
• Veteran

Funding

This manuscript is the result of work supported by the National Institute on Child Health and Human Development and the Office of Research on Women's Health (K12HD055885; PI: Brady, KT) and the National Institutes on Drug Abuse (R01DA030143; PI: Back, SE).