Research involving military service members has shown a strong relationship between combat experiences and increased risk for posttraumatic stress disorder (PTSD) and other mental health problems. Comparatively little research has examined the relationship between combat experiences, PTSD, aggression, and unethical conduct on the battlefield, although news stories sometimes suggest links between unethical conduct and disorders such as PTSD. This study systematically examined whether unethical conduct is a proxy for aggression and whether specific combat experiences and PTSD are independently associated with unethical behavior. The results of this study indicate that aggression (β = 0.30) and specific combat experiences (particularly, witnessing war atrocities [β = 0.14] and fighting [β = 0.13]) are much more strongly associated with unethical conduct than is PTSD (β = 0.04).
[Show abstract][Hide abstract] ABSTRACT: Although types and modes of combat injury have changed over the centuries as weapons of war evolved, details about combat traumatic brain injury (TBI) date from the earliest accounts of warfare. This chapter provides a brief historical overview of combat TBI resulting from primitive blunt and penetrating head injuries to current blast-related injuries. Updated numbers of TBI events and injuring mechanisms will be considered. Brain injury causes loss or alteration of consciousness, prograde and retrograde amnesia, and immediate physical and neurological effects ranging from mild to severe. These injuries, in certain cases, cause varying chronic physical, cognitive, and behavioral issues. The most common form of brain injury, acute mild TBI or concussion (mTBI/ concussion), has multiple definitions derived from various sources. Vasterling et al. have provided a useful summary of these iterations (Vasterling, 2012). The operative definition selected for this review includes: loss or alteration consciousness for up to 30 minutes at the time of injury, a confused or disoriented state lasting less than 24 hours, memory loss lasting less than 24 hours, and normal structural brain imaging on computed tomographic scanning. Glasgow Coma Scale scores of 13–15 characterize acute mTBI, whereas lower Glasgow Coma Scale scores, 9–12, designate acute moderate TBI. Glasgow Coma Scale scores of 3–8 designate acute severe TBI (Teasdale and Jennett, 1974). Current combat or military TBI/concussions most frequently are classified as mild. Although recovery from mTBI/ concussion is said to be the norm, in about 15%, (range estimates of 10%–25%) of cases, physical disabilities and symptoms persist beyond three months to become a chronic condition, also known as post-concussion syndrome (Vasterling, 2012). Chronic sequelae of postconcussion syndrome include headache, insomnia, fatigue, sensory, balance, and other neurologic defects as well as cog-nitive and emotional disorders. Symptoms can be subtle and variable in severity and frequency over time; mTBI and concussion are often used clinically as synonyms. This chapter focuses on mTBI/concussion as a combat injury. Diagnosis of posttraumatic stress disorder (PTSD), first accepted as a formal diagnosis in 1980 (Horowitz et al., 1980), and other mental illness including depression are reportedly more common in combatants as compared with nondeployed service members during current ongoing military operations (Blakely, 2013). The methods used to obtain estimates affect data concerning numbers of cases of TBI, PTSD, and other mental disorders. Individuals usually are reported only once as a case within a category; data can be presented as the number of diagnoses (prevalence), rate of new diagnoses in a population (incidence), or total number of cases in a population. The total number of diagnoses changes in relation to population size, which for military conditions, increases over time with continued combat activities (Blakely, 2013). This chapter uses numbers available from public sources for the Department of Defense (DOD) and updated data through 2013 from the tracking tool used by the Department of Veterans Affairs (VA). PTSD results from exposure to a traumatic event with risk of serious injury or bodily harm to self or others and a response to that event involving intense fear, horror, or helplessness. Symptoms include reexperiencing of the traumatic event, including nightmares and distressing recollections, avoidance
[Show abstract][Hide abstract] ABSTRACT: Anger and aggression are among the most common issues reported by returning service members from combat deployments. However, the pathways between combat exposure and anger and aggression have not been comprehensively characterized. The present study aimed to characterize the relationship between trait anger, combat exposure, post-deployment PTSD, and aggression. U.S. Army soldiers (N = 2,420) were administered anonymous surveys assessing combat exposure, current PTSD symptoms and aggression, as well as trait anger items 3 months after returning from deployment to Afghanistan. PTSD symptom levels were related to aggression at higher levels of trait anger, but not evident among soldiers who had lower levels of trait anger. The pathway from combat exposure to PTSD, and then to aggression, was conditional upon levels of trait anger, such that the pathway was most evident at high levels of trait anger. This was the first study to our knowledge that concurrently modeled unconditional and conditional direct and indirect associations between combat exposure, PTSD, trait anger, and aggression. The findings can be helpful clinically and for developing screening protocols for combat exposed Soldiers. The results of this study suggest the importance of assessing and managing anger and aggression in soldiers returning from combat deployment. Anger is one of the most common complaints of returning soldiers and can have debilitating effects across all domains of functioning. It is imperative that future research efforts are directed toward understanding this phenomenon and developing and validating effective treatments for it. Aggr. Behav. 9999:1-10, 2015. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
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