Associations between PTSD and intimate partner and non-partner aggression among substance using veterans in specialty mental health

• Published in: Addictive behaviors 2017-01, Vol.64, p.194-199
• Main Authors: Buchholz, Katherine R., pH. D, Bohnert, Kipling M., pH. D, Sripada, Rebecca K., pH. D, Rauch, Sheila A.M., pH. D, Epstein-Ngo, Quyen M., pH. D, Chermack, Stephen T., PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aggression; Aggression - psychology; Aggressive behavior; Aggressiveness; Cannabis; Cocaine; Comorbidity; Depressive Disorder - epidemiology; Depressive Disorder - psychology; Domestic violence; Drinking behavior; Drug abuse; Drug use; Female; Health risks; Humans; Interpersonal Relations; Intimate Partner Violence - psychology; Intimate Partner Violence - statistics & numerical data; Male; Mental disorders; Mental health; Mental health care; Mental Health Services; Middle Aged; Non-partner aggression; Partner aggression; Post traumatic stress disorder; Psychiatry; PTSD; Risk Factors; Severity of Illness Index; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology; Substance use; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Surveys and Questionnaires; United States - epidemiology; Veterans; Violence; Young Adult
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2016.08.039

Abstract Background Risk factors of violence perpetration in veterans include substance use and posttraumatic stress disorder (PTSD); however, it is unknown whether these factors are associated with greater risk for partner or non-partner violence. This study investigated the associations between probable PTSD, heavy drinking, marijuana use, cocaine use, and partner and non-partner violence perpetration. Methods Self-report questionnaires assessing past-year partner and non-partner aggression (CTS2) as well as past-month substance use (SAOM) , probable PTSD (PCL C) , and probable depression (PHQ-9) were administered to 810 substance using veterans entering VA mental health treatment. Results In bivariate analyses, probable PTSD in substance using veterans was associated with violence perpetration (partner physical, χ2 = 11.46, p = 0.001, φ = 0.12; non-partner physical, χ2 = 50.64, p < 0.001, φ = 0.25; partner injury, χ2 = 6.41, p = 0.011, φ = 0.09; non-partner injury, χ2 = 42.71, p < 0.001, φ = 0.23). In multiple logistic regression analyses that adjusted for sociodemographic characteristics , probable PTSD was independently associated with non-partner physical (odds ratio [ OR ], 2.82; 95% confidence interval [CI], 1.97–4.05) and injury aggression ( OR , 3.96; CI, 2.56–6.13). Cocaine and heavy drinking were independently associated with non-partner physical and injury aggression and non-partner injury aggression respectively. Conclusions The results provide evidence that probable PTSD, heavy drinking, and cocaine use are associated with increased risk of non-partner violence perpetration in substance using veterans. These results underscore the importance of screening for PTSD symptoms and violence perpetration towards non-partners in substance using veterans presenting for treatment.