Veterans Affairs Ann Arbor Healthcare System, Mental Health Service.
Department of Psychiatry, University of Michigan.
Law Hum Behav. 2018 Apr;42(2):135-144. doi: 10.1037/lhb0000268. Epub 2017 Oct 26.
Substance misuse is prevalent among veterans entering the criminal justice system, and is related to recidivism. Research demonstrates that trauma exposure and posttraumatic stress (PTS) symptoms, which commonly co-occur with substance misuse, also increase the risk of legal involvement and recidivism. However, it is unclear whether the associations between trauma, PTS symptoms and violent and nonviolent crime may be conflated by substance use. The aim of the present study was to understand the association between PTS symptoms and criminal justice involvement (both violent and nonviolent crime) among substance-using veterans seeking Veterans Affairs (VA) specialty mental health care after accounting for substance use frequency and demographics including age, gender, and ethnicity. Further, this study examined whether specific clusters of PTS were associated with violent and nonviolent veteran offending. Participants included 697 veterans (52 women) aged 21 to 75 (M = 47.49, SD = 13.51) with a history of trauma exposure. Veterans self-reported past-month PTS symptoms, substance use, and lifetime legal charges. Logistic regression results indicated total PTS symptoms were associated with violent, but not nonviolent charges, above and beyond age, sex, race, cocaine use, and heavy alcohol use. Intrusion symptoms, in particular, were associated with violent charges. Results highlight the utility of examining PTS as a multifaceted construct and have implications for the assessment and treatment needs of justice-involved veterans. For example, the findings suggest that treatment needs appear to differ for those reporting violent or nonviolent offending, with a greater need for assessing and treating PTS for those involved with violent crime. (PsycINFO Database Record
物质滥用在进入刑事司法系统的退伍军人中很普遍，并且与累犯有关。研究表明，创伤暴露和创伤后应激（PTS）症状，这些症状通常与物质滥用同时发生，也会增加法律涉入和累犯的风险。然而，创伤、PTS 症状与暴力和非暴力犯罪之间的关联是否可能因物质使用而混淆不清尚不清楚。本研究的目的是了解在考虑物质使用频率和人口统计学因素（包括年龄、性别和种族）后，PTS 症状与寻求退伍军人事务部（VA）专业心理健康护理的物质使用退伍军人的刑事司法涉入（包括暴力和非暴力犯罪）之间的关联。此外，本研究还探讨了特定的 PTS 集群是否与暴力和非暴力退伍军人犯罪有关。参与者包括 697 名年龄在 21 至 75 岁之间（M = 47.49，SD = 13.51）、有创伤暴露史的退伍军人。退伍军人自我报告过去一个月的 PTS 症状、物质使用和终身法律指控。逻辑回归结果表明，总 PTS 症状与暴力指控有关，但与年龄、性别、种族、可卡因使用和大量饮酒无关。特别是闯入症状与暴力指控有关。结果强调了以多方面的结构来检查 PTS 的效用，并对涉及司法的退伍军人的评估和治疗需求具有影响。例如，这些发现表明，对于报告暴力或非暴力犯罪的人，治疗需求似乎有所不同，对于涉及暴力犯罪的人，评估和治疗 PTS 的需求更大。
