Relationship of Alcohol Use to Combat Exposure, Post-Traumatic Stress Disorder Symptoms, and Aggressive Behaviors Among Army National Guard OIF/OEF Veterans

Abstract

Previous studies have shown alcohol use to be associated with aggressive behaviors, though results have varied, in particular, when aggression is examined separately as nonphysical versus physical aggression. This topic is especially relevant for returning soldiers who report post-traumatic stress disorder (PTSD) symptoms, which often accompany postdeployment interpersonal aggression. The present study used survey data obtained from recently returning deployed Army National Guard soldiers ( N = 4,567 soldiers in 50 company-sized units) to test relationships (through structural equation modeling) among combat exposure, PTSD symptoms, alcohol use, and aggressive behaviors, both nonphysical and physical. Combat exposure had no statistically reliable association with aggression. PTSD symptoms (specifically, reexperiencing and sleep difficulty) were positively associated with aggressive behaviors. Combat exposure and PTSD symptoms showed an additional indirect effect through alcohol use on aggression, with stronger effects for nonphysical than for physical aggressive behavior. Observed differences in relationships among combat exposure, PTSD symptoms, and alcohol use for different forms of aggression may relate to the underlying psychological state (whether negative emotions or hyperaroused) varying qualitatively and quantitatively, and thus operate differently on expression of nonphysical aggression (e.g., shouting, yelling) and physical aggression (e.g., hitting, slapping). Findings have implications for preventive and clinical practice.