In 2008 the NY Times found 121 homicides committed by OEF/OIF veterans and incorrectly concluded that our returning soldiers were bringing violence home. Better research revealed that the veterans’ homicide rate was much lower than the general population’s. But people still believe that veterans are violent. Are they wrong?
1) 94% of veterans will never commit a violent crime.
2) During 1995-2001, there were 184 homicides in the USA caused by active-duty military and new veterans. From 2001-07, there were 349, an 89% increase when there were actually fewer troops stationed in the US than before.
3) Of the homicides committed by OEF/OIF forces in the USA, one third of the victims were immediate family and one fourth were other members of the armed forces.
4) Combat veterans are responsible for almost 21% of domestic violence calls nationwide and 20% of suicide calls.
5) On the Domestic Violence Hotline, calls from military families tripled from 2006-2011, a time when abuse rates nationwide were declining.
6) In one study, over 30% of a group of veterans diagnosed with PTSD self-reported committing at least one act of aggression in the previous year– mostly minor– but almost 11% self-reported at least one seriously violent act.
7) At Fort Carson, Colorado, the number of soldiers charged with domestic violence rose more than 250% from 2006- 2009.
8) Domestic abuse in the Army rose 177% from 2003-2010.
9) A British study of Iraq and Afghanistan returning soldiers found that in those under 30 y/o, 20% had a conviction for violent offences compared with 6.7% of civilians the same age.
10) A British study found that soldiers in combat roles were 50% more likely than those in noncombat roles to commit assault or threaten violence after returning home.
There are obvious inconsistencies between these numbers, which might be reconciled by considering the socioeconomic details of each group or clarifying definitions. But even with that taken into account, there is still a trend toward violence among returning veterans. Let’s look at some studies in more detail:
Dangerous PTSD Symptoms:
A study done in 2010 by NIMH, DVA, and UNC School of Medicine (Elbogen et al. Am. J Psychiatry Sep 2010 167(9)) focused on associations between anger and aggression and specific symptoms of PTSD.
They studied 676 veterans who had served since 9/11/2001, some with and some without PTSD, and found that PTSD hyper-arousal symptoms– anger and aggressiveness, irritability, difficulty concentrating, sleep deprivation, increased startle reflex, and high anxiety– were most often associated with excessive anger and aggressive behaviors.
Also connected with anger and aggression: a history of being deployed more than 1 year, firing a weapon during their service, and having undergone family violence prior to their service.
Specifically associated with difficulty controlling anger: having a parent with a criminal history, and being married.
Specifically associated with aggressive behavior: hyper-arousal symptoms, reoccurrences of a traumatic event, a family history of mental illness, and a history of childhood abuse.
In this study, PTSD hyper-arousal symptoms had the strongest association with anger/aggression issues. This is an interesting finding because it specifies which symptoms are most problematic, a big boost for our screening programs.
If you or a loved one is suffering with hyper-arousal symptoms, check out treatments in the blog: “Treating Hyper-Arousal.”
Other Causes of Aggression:
The same author headed another study two years later (Eric B. Elbogen, et.al. UNC School of Medicine, DVA, Journal of Clinical Psychiatry, 2012).
They surveyed nearly 1400 veterans who served in Iraq and/or Afghanistan after 2001 and found factors that PREVENTED violence: employment, meeting basic needs, living stability, social support, spiritual faith, ability to care for oneself, perceived self-determination, and resilience (ability to adapt to stress). They also found that a majority (over 75%) of veterans had these factors and posed a low threat of any violence.
Factors that INCREASED veterans risk of violence included: alcohol misuse, criminal background, veterans’ lifestyle– work, social and financial circumstances — as well as PTSD hyper-arousal symptoms. Of these factors, financial status was the most important. Veterans who didn’t have enough money to cover basic needs were more likely to report aggressive behavior than veterans with PTSD.
One-third of the survey respondents self-identified an act of aggression towards other people in the previous year. Most were minor problems, but eleven-percent of the respondents self-reported severe violence.
This study clearly shows that social and economic instability is a major factor in aggression. That means helping our veterans living in poverty is just as important as treating PTSD.
Perhaps the most disturbing statistics come from studies about domestic violence. Rates among soldiers and veterans are clearly higher than those in the general population. (Marshall, et al. 2005; Sherman, et al. 2006; Tetan, Sherman and Han, 2009. Data from the Dept. of Justice, National Domestic Violence Hotline, NY Times, and Dept. of Defense.)
There are three patterns of partner violence, according to “The patterns and perceptions of interpersonal violence committed by returning veterans with PTSD” (J. of Family Violence, Vol. 25(8) 8/2010)).
1) Violence committed in anger.
2) Dissociative violence following a trigger or during a flashback.
3) Violence during sleep or upon awakening.
There were clear parallels between these categories and the veterans’ PTSD symptoms. Other studies also found a link between domestic violence and severe PTSD.
Another factor in domestic violence is the number of departures to, and returns home from deployment. These create stress in military families, and multiple transitions and deployments were significantly linked with domestic violence reports.
Added to the finding that families accounted for 1/3 of the victims of soldier and new veteran-committed homicides, this suggests an unmet need in educating and protecting the families of soldiers and returning veterans.
Treatment for flashbacks is covered in the blog: “Treating Flashbacks, Nightmares, and Intrusive Memories.” Nightmares and night terrors are often caused by hyper-arousal and usually respond to prazosin.
We don’t think of suicide as violence, but it is: violence turned against the self. The current statistics of 22 veterans a day is roughly twice the rate in the general population. The risk factors are much the same as for other types of violence, and violence against others may precede the suicide.
This number of suicides is a sad commentary on the misery many veterans have endured, and one that deserves its own blog: see Suicide, Veterans, and PTSD.
1) Most veterans are not violent.
2) Most people with PTSD are not violent.
3) Risk Factors for violence are: alcohol misuse, criminal background, PTSD hyper-arousal symptoms, and socioeconomic factors including lack of employment, poverty, and unstable living situations.
4) We can further reduce soldier and veteran violence by: 1) Providing annual screenings for substance abuse and PTSD and better access to appropriate treatment. 2) Assisting veterans who are without funds, homeless, unemployed, and have no social support. 3) Supporting military and veterans’ families through education about domestic violence, required reporting of domestic violence (already in place for child abuse), and more safe houses for endangered families.