Flanagan Julianne C, Teer Andrew, Beylotte Francis M, Killeen Therese K, Back Sudie E
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA ; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA.
Ment Health Subst Use. 2014;7(4):315-328. doi: 10.1080/17523281.2014.924986.
Aggressive behavior is strongly associated with both posttraumatic stress disorder (PTSD) and substance use disorders (SUD) among civilians. However, little research has examined correlates of aggression among Veterans with co-occurring PTSD and SUD.
This exploratory study examined the prevalence and correlates of recent (i.e., past 30 days) and lifetime aggressive behavior among a sample of U.S. Veterans (N=97) enrolled in a study examining integrated psychosocial treatment of co-occurring PTSD/SUD.
The findings revealed high rates of recent and lifetime aggressive behaviors (39.2% and 57.7%, respectively). Participants who endorsed recent aggressive behaviors were younger, had less education, more severe PTSD numbing and hyperarousal symptoms, were more likely to report recent suicidal ideation, more frequent alcohol and marijuana use, had higher rates of physical and sexual abuse, greater combat exposure, and more severe aftermath of battle experiences. Participants who endorsed lifetime aggression were younger, reported more total PTSD symptom severity, PTSD re-experiencing severity, depression severity, and fewer post-deployment stressors compared to those who did not. Logistic regression analyses indicated that education and number of drinking days were correlated with recent aggression while depression and post-deployment stressors were correlated with lifetime aggression.
The findings demonstrate high rates of aggressive behaviors among Veterans with PTSD/SUD, as well as clinically relevant correlates of aggressive behaviors. Although preliminary, the findings suggest potential targets for improving assessment and treatment of Veterans with PTSD/SUD.
在平民中，攻击性行为与创伤后应激障碍（PTSD）和物质使用障碍（SUD）都密切相关。然而，很少有研究探讨同时患有创伤后应激障碍和物质使用障碍的退伍军人中攻击行为的相关因素。
这项探索性研究调查了参与一项关于创伤后应激障碍/物质使用障碍综合心理社会治疗研究的美国退伍军人样本（N = 97）中近期（即过去30天）和终生攻击行为的患病率及相关因素。
研究结果显示近期和终生攻击行为的发生率很高（分别为39.2%和57.7%）。认可近期有攻击行为的参与者更年轻，受教育程度更低，创伤后应激障碍的麻木和过度警觉症状更严重，更有可能报告近期有自杀意念，饮酒和使用大麻更频繁，身体和性虐待发生率更高，战斗经历更多，战斗经历的后果更严重。与未认可终生攻击行为的参与者相比，认可终生攻击行为的参与者更年轻，报告的创伤后应激障碍症状总严重程度、创伤后应激障碍再次体验严重程度、抑郁严重程度更高，部署后应激源更少。逻辑回归分析表明，受教育程度和饮酒天数与近期攻击行为相关，而抑郁和部署后应激源与终生攻击行为相关。
研究结果表明，患有创伤后应激障碍/物质使用障碍的退伍军人中攻击行为的发生率很高，以及攻击行为的临床相关因素。尽管是初步的，但研究结果提示了改善对患有创伤后应激障碍/物质使用障碍退伍军人评估和治疗的潜在目标。
