Aggression and violent behavior in the military: Self-reported conflict tactics in a sample of service members and veterans seeking treatment for posttraumatic stress disorder
Abstract: Irritability, angry outbursts, and aggression are common among individuals with posttraumatic stress disorder (PTSD). Although aggression can be a problem among many individuals with PTSD, research suggests that the relationship between PTSD and aggression might be particularly relevant among military/veteran populations as compared to civilians. The current study examined psychological and physical aggression in a large sample of treatment-seeking military service members and veterans (N = 1434) enrolled in nine PTSD clinical trials. A baseline assessment using a modified version of the Revised Conflict Tactics Scales evaluated aggression toward others in the past month. The results indicated that psychological aggression was more prevalent than physical aggression among military personnel with PTSD. Overall, 84.7% reported engaging in weekly psychological aggression, and 11.4% reported weekly physical aggression. Shouting at someone, insulting someone, and stomping off during a disagreement were the most frequent forms of psychological aggression endorsed. The findings provide a detailed account of the point prevalence and nature of various self-reported aggressive behaviors in military personnel with PTSD.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.