University of North Carolina-Chapel Hill School of Medicine, Forensic Psychiatry Program and Clinic, Department of Psychiatry, Chapel Hill, NC 27599, USA.
J Clin Psychiatry. 2012 Jun;73(6):e767-73. doi: 10.4088/JCP.11m07593.
After returning home, a subset of Iraq and Afghanistan War veterans report engaging in aggression toward others. This study is the first to identify variables empirically related to decreased risk of community violence among veterans.
The authors conducted a national survey from July 2009 to April 2010 in which participants were randomly drawn from over 1 million US military service members who served after September 11, 2001. Data were collected from a total of 1,388 Iraq and Afghanistan War era and theater veterans. The final sample included veterans from all 50 states and all military branches.
One-third of survey respondents self-identified committing an act of aggression toward others during the past year, mostly involving minor aggressive behavior. Younger age, criminal arrest record, combat exposure, probable posttraumatic stress disorder, and alcohol misuse were positively related to violence toward others. Controlling for these covariates, multivariate analyses showed that stable living situation and the perception of having control over one's life were associated with reduced odds of severe violence (R2 = 0.24, χ27 = 145.03, P < .0001). Greater resilience, perceiving positive social support, and having money to cover basic needs were linked to reduced odds of other physical aggression (R2 = 0.20, χ28 = 188.27, P < .0001).
The study identifies aggression as a problem for a subset of Iraq and Afghanistan War veterans who endorsed few protective factors. Analyses revealed that protective factors added incremental value to statistical modeling of violence, even when controlling for robust risk factors. The data indicate that, in addition to clinical interventions directed at treating mental health and substance abuse problems, psychosocial rehabilitation approaches aimed at improving domains of basic functioning and psychological well-being may also be effective in modifying risk and reducing violence among veterans.
一些伊拉克和阿富汗战争退伍军人回国后报告对他人采取了攻击行为。本研究首次确定了退伍军人社区暴力风险降低的相关变量。
作者于 2009 年 7 月至 2010 年 4 月进行了一项全国性调查，参与者是从 2001 年 9 月 11 日之后服役的超过 100 万美国军事人员中随机抽取的。共收集了 1388 名伊拉克和阿富汗战争时代和战区的退伍军人的数据。最终样本包括来自所有 50 个州和所有军事部门的退伍军人。
三分之一的调查受访者自我报告在过去一年中对他人实施了攻击行为，主要涉及轻微的攻击行为。年轻、被捕记录、接触过战场、可能患有创伤后应激障碍以及酗酒与对他人的暴力行为呈正相关。在控制这些协变量后，多变量分析显示，稳定的生活环境和对生活的控制感与严重暴力行为的几率降低有关（R2=0.24，χ27=145.03，P<.0001）。更强的适应力、感知到积极的社会支持以及有足够的钱来满足基本需求与降低其他身体攻击的几率有关（R2=0.20，χ28=188.27，P<.0001）。
该研究确定了攻击行为是一小部分伊拉克和阿富汗战争退伍军人的问题，他们只有很少的保护因素。分析表明，即使在控制了强大的风险因素后，保护因素也为暴力的统计模型增加了额外的价值。数据表明，除了针对心理健康和药物滥用问题的临床干预外，旨在改善基本功能和心理健康领域的心理康复方法也可能有效，从而降低退伍军人的风险并减少暴力行为。
