Article

Intimate Partner Aggression Perpetrated and Sustained by Male Afghanistan, Iraq, and Vietnam Veterans With and Without Posttraumatic Stress Disorder

Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
Journal of Interpersonal Violence (Impact Factor: 1.64). 12/2009; 25(9):1612-30. DOI: 10.1177/0886260509354583
Source: PubMed

ABSTRACT Veterans with posttraumatic stress disorder (PTSD) consistently evidence higher rates of intimate partner aggression perpetration than veterans without PTSD, but most studies have examined rates of aggression among Vietnam veterans several years after their deployment. The primary aim of this study was to examine partner aggression among male Afghanistan or Iraq veterans who served during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) and compare this aggression to that reported by Vietnam veterans with PTSD. Three groups were recruited, OEF/OIF veterans with PTSD (n = 27), OEF/OIF veterans without PTSD (n = 31), and Vietnam veterans with PTSD (n = 28). Though only a few comparisons reached significance, odds ratios suggested that male OEF/OIF veterans with PTSD were approximately 1.9 to 3.1 times more likely to perpetrate aggression toward their female partners and 1.6 to 6 times more likely to report experiencing female perpetrated aggression than the other two groups. Significant correlations among reports of violence perpetrated and sustained suggested many men may have been in mutually violent relationships. Taken together, these results suggest that partner aggression among Iraq and Afghanistan veterans with PTSD may be an important treatment consideration and target for prevention.

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    • "Furthermore, it has been reported that at least 40% of OEF/OIF veterans indicated they have killed an enemy combatant (Maguen et al., 2010), and combat-related killings predict higher levels of PTSD, anger, alcohol abuse, suicidal ideation, and relationship problems, even after controlling for combat exposure (Maguen et al., 2010, 2011). In light of the high levels of combat exposure that may occur during deployment, it is hardly surprising that returning veterans with PTSD show greater levels of family problems (Allen et al., 2010) and intimate partner aggression than those without PTSD (Teten et al., 2010) and that their partners and children evidence more relationship distress and deploymentrelated psychological problems (Erbes, Meis, Polusny, & Compton , 2011; Gewirtz, Polusny, Degarmo, Khaylis, & Erbes, 2010; Sayers, Farrow, Ross, & Oslin, 2009). "
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    ABSTRACT: The U.S. military deployed in support to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high rates of posttraumatic stress disorder (PTSD) and relationship, partner, and parenting distress. Given the pervasive effect of combat-related PTSD on returning veterans and its effect on their loved ones, the investigators have developed a couples-based treatment, structured approach therapy (SAT), to reduce PTSD while simultaneously decreasing relationship and partner distress. This study presents treatment outcome data measuring PTSD and relationship outcomes from a randomized clinical trial (RCT) comparing SAT, a manualized 12-session novel couples-based PTSD treatment, to a manualized 12-session couples-based educational intervention (PTSD Family Education [PFE]). Data were collected from 57 returning veterans meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision; DSM-IV-TR) criteria for PTSD and their cohabiting partners; data collection was scheduled for pretreatment, posttreatment, and 3-month follow-up. Findings from an intent-to-treat analysis revealed that veterans receiving SAT showed significantly greater reductions in self-rated (PTSD Checklist; p < .0006) and Clinician-Administered PTSD Scale (CAPS)-rated PTSD (p < .0001) through the 3-month follow-up compared with veterans receiving PFE; 15 of 29 (52%) veterans receiving SAT and 2 of 28 (7%) receiving PFE no longer met DSM-IV-TR criteria for PTSD. Furthermore, SAT was associated with significant improvements in veteran relationship adjustment, attachment avoidance, and state anxiety. Partners showed significant reductions in attachment anxiety. This couples-based treatment for combat-related PTSD appears to have a strong therapeutic effect on combat-related PTSD in recently returned veterans. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
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    • "Items were summed to obtain an overall measure of IPV for the family. The CTS2 and its predecessor, the CTS (Straus 1979), are the most widely used measures of violence in research on IPV (Teten et al. 2010). Coefficient alpha for the CTS2 was 0.91, 0.91, and 0.92 at baseline, 6 months, and 12 months, respectively. "
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    ABSTRACT: This study examined whether child involvement in interparental conflict predicts child externalizing and internalizing problems in violent families. Participants were 119 families (mothers and children) recruited from domestic violence shelters. One child between the ages of 7 and 10 years in each family (50 female, 69 male) completed measures of involvement in their parents' conflicts, externalizing problems, and internalizing problems. Mothers completed measures of child externalizing and internalizing problems, and physical intimate partner violence. Measures were completed at three assessments, spaced 6 months apart. Results indicated that children's involvement in their parents' conflicts was positively associated with child adjustment problems. These associations emerged in between-subjects and within-subjects analyses, and for child externalizing as well as internalizing problems, even after controlling for the influence of physical intimate partner violence. In addition, child involvement in parental conflicts predicted later child reports of externalizing problems, but child reports of externalizing problems did not predict later involvement in parental conflicts. These findings highlight the importance of considering children's involvement in their parents' conflicts in theory and clinical work pertaining to high-conflict families.
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    • "Regarding the use of psychological aggression tactics in their relationship with a spouse/partner, veterans in the PTSD + HSU group had significantly higher levels for victimization and perpetration than did the HSU only group, but not the PTSD only group. Our findings support prior work with Iraq, Afghanistan, and Vietnam veterans indicating that veterans with PTSD displayed higher rates of psychological aggression than did veterans with no PTSD (Teten et al., 2010). Similarly, Byrne and Riggs (1996) identified PTSD as a correlate of psychological aggression perpetration among Vietnam veterans and found that perpetration was more likely when relationship problems existed. "
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    ABSTRACT: Veterans (N = 133) who were seeking treatment in either the Posttraumatic Stress Program or Substance Use Disorders Program at a Veterans Affairs Medical Center (VAMC) and, based on self-report of symptoms, met clinical norms for posttraumatic stress disorder (PTSD) or hazardous substance use (HSU) completed a survey related to relationship conflict behaviors, attachment styles, and depression severity. Participants were grouped into one of three categories on the basis of clinical norm criteria: PTSD only, HSU only, and PTSD + HSU. Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, Center for Epidemiologic Studies-Depression scale, Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test, and Psychological Aggression and Physical Violence subscales of the Conflict Tactics Scale. Most participants were male and Caucasian. Significant differences were found between groups on depression, avoidant attachment, psychological aggression perpetration and victimization, and physical violence perpetration and victimization. Post hoc analyses revealed that the PTSD + HSU group had significantly higher levels of depression, avoidant attachment, and psychological aggression than the HSU only group. The PTSD + HSU group had significantly higher levels of physical violence than did the PTSD only group, but both groups had similar mean scores on all other variables. Potential treatment implications are discussed.
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