Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland.
Deployment Health Research Department, Naval Health Research Center, San Diego, California.
JAMA Netw Open. 2022 Jul 1;5(7):e2223236. doi: 10.1001/jamanetworkopen.2022.23236.
Few studies have examined the role of problematic anger in long-term adjustment of service members transitioning out of the military.
To determine the prevalence of problematic anger during the military-to-civilian transition period and the association of problematic anger with adjustment to civilian life.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used 2 waves of survey data administered approximately 5 years apart (time 1 [T1; September 26, 2014, to August 25, 2016] and time 2 [T2; October 23, 2019, to August 31, 2021]) from the Millennium Cohort Study, a population-based military study. Participants were US active-duty service members within 24 months of separating from military service at T1. Statistical analysis was performed from September 2021 to May 2022.
Problematic anger was operationalized as scoring at least 12 points on the 5-item Dimensions of Anger Reactions scale at T1.
Behavioral and functional health (depression, posttraumatic stress disorder, problem drinking, functional limitations), relationship health (relationship quality, coping with parental demands, social support), and economic health (major financial problems, financial insecurity, homelessness, employment status) were assessed at T2. Covariates, assessed at T1, included demographics, military characteristics, mental health, problem drinking, and physical health.
Of the 3448 participants, 2625 (76.1%) were male, 217 (6.3%) were Hispanic, 293 (8.5%) were non-Hispanic Black, and 2690 (78.0%) were non-Hispanic White; the mean (SD) age was 40.1 (8.5) years; 826 (24.0%) met criteria for problematic anger. Prevalence of problematic anger was 15.9% (95% CI, 12.2%-19.7%) 24 months prior to military separation and 31.2% (95% CI, 26.2%-36.2%) 24 months following separation. After adjusting for covariates, problematic anger was associated with greater likelihood of behavioral and functional health outcomes (eg, posttraumatic stress disorder: adjusted odds ratio, 1.55, 95% CI, 1.23-1.96), relationship health difficulties (eg, low social support: aOR, 1.66; 95% CI, 1.23-2.24), and economic difficulties (eg, substantial financial insecurity: aOR, 1.64; 95% CI, 1.13-2.39) at T2.
This cohort study found an association between prevalence of problematic anger during the military-to-civilian transition and problematic anger with subsequent adjustment difficulties among US service members. These findings suggest the need to equip service members proactively with skills to identify and manage anger as a way to support them before and during this period of transition.
很少有研究探讨在从军队过渡到平民生活期间，问题性愤怒在服务人员的长期适应中的作用。
确定在军队到平民的过渡期间出现问题性愤怒的普遍性，以及问题性愤怒与适应平民生活的关联。
设计、环境和参与者：这项队列研究使用了两次相隔约 5 年的调查数据（第 1 次时间[T1；2014 年 9 月 26 日至 2016 年 8 月 25 日]和第 2 次时间[T2；2019 年 10 月 23 日至 2021 年 8 月 31 日]），来自基于人群的军事研究千年队列研究。参与者是 T1 时距离服兵役结束后 24 个月内的美国现役军人。统计分析于 2021 年 9 月至 2022 年 5 月进行。
问题性愤怒是通过在 T1 时在 5 项愤怒反应维度量表上至少得 12 分来确定的。
在 T2 时评估了行为和功能健康（抑郁、创伤后应激障碍、问题饮酒、功能限制）、关系健康（关系质量、应对父母要求、社会支持）和经济健康（重大财务问题、财务不安全、无家可归、就业状况）。在 T1 时评估的协变量包括人口统计学、军事特征、心理健康、问题饮酒和身体健康。
在 3448 名参与者中，2625 名（76.1%）为男性，217 名（6.3%）为西班牙裔，293 名（8.5%）为非西班牙裔黑人，2690 名（78.0%）为非西班牙裔白人；平均（SD）年龄为 40.1（8.5）岁；826 人（24.0%）符合问题性愤怒的标准。在军事分离前 24 个月，问题性愤怒的患病率为 15.9%（95%CI，12.2%-19.7%），在分离后 24 个月，患病率为 31.2%（95%CI，26.2%-36.2%）。在调整了协变量后，问题性愤怒与以下方面的行为和功能健康结果更有可能相关（例如，创伤后应激障碍：调整后的优势比，1.55，95%CI，1.23-1.96）、关系健康困难（例如，低社会支持：aOR，1.66；95%CI，1.23-2.24）和经济困难（例如，严重的财务不安全：aOR，1.64；95%CI，1.13-2.39）。
这项队列研究发现，在军队到平民的过渡期间，问题性愤怒的普遍性与美国服务人员随后出现的适应困难之间存在关联。这些发现表明，有必要在这一过渡期间，积极为服务人员提供识别和管理愤怒的技能，以支持他们。
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