Variables Associated with Risk of Community Violence among Subset of OEF/OIF Veterans
There has been increasing media coverage of interpersonal violence perpetrated by Iraq and Afghanistan War Veterans after returning home from military service. As more return, clinicians will need to develop evidence-based approaches for assessing and reducing post-deployment violence. Motivated by the minimal prior research, the current study investigated variables among Veterans associated with the risk of increased and decreased community violence. From an initial national cohort of 3,000 randomly selected military members who served after 9/11/2001 (funded by NIMH), the present study analyzed data from 1,388 male and female OEF/OIF Veterans from all military branches (48% Reserves or National Guard) who were alive, locatable, and responded to a survey. Measures included self-reported violence and aggression against others, as well as protective factors such as work (employment), financial status, self-care (ability to care for themselves), and living stability (not reporting homelessness). Other covariates included age, history of arrest, combat exposure, probable PTSD, and alcohol misuse.
- One-third of the OEF/OIF Veterans reported aggression against others in the previous year (e.g., kicking, slapping, using fists, fights), and 11% reported having engaged in severe acts of violence within the past year (e.g., use of a knife or gun or other lethal weapon, beat up a person).
- Risk factors in the current sample were similar to those associated with violence among Veterans from previous eras — younger age, PTSD, alcohol abuse, and past criminal arrests. When these risk factors were controlled as covariates, a stable living situation and the perception of having control over one's life were independently associated with reduced odds of severe violence.
- Positive social support and having enough money to cover basic needs were associated with reduced odds of other forms of physical aggression. Data also suggest that Veterans who perceive that they have control over their future and who have greater psychological resilience may have greater internal motivation to refrain from violence.
- Measurement of violence obtained from collateral sources may have enhanced the data, but was not feasible given the current sampling frame.
- Only 46% of the original cohort of 3,000 (56% of those who were alive and located) participated in the survey.
- The cross-sectional design of this study limits causal interpretation of data.
- 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 reducing violence risk among Veterans.
Dr. Timko is part of HSR&D's Center for Health Care Evaluation, Palo Alto, CA.
Elbogen E, Johnson S, Wagner H, Newton V, Timko C, Vasterling J, and Beckham J. Protective Factors and Risk Modification of Violence in Iraq and Afghanistan War Veterans. Journal of Clinical Psychiatry June 2012;73(6):e767-73.