title: The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans.
abstract: This study examined the mental health impact of reported direct and indirect killing among 2,797 U.S. soldiers returning from Operation Iraqi Freedom. Data were collected as part of a postdeployment screening program at a large Army medical facility. Overall, 40% of soldiers reported killing or being responsible for killing during their deployment. Even after controlling for combat exposure, killing was a significant predictor of posttraumatic disorder (PTSD) symptoms, alcohol abuse, anger, and relationship problems. Military personnel returning from modern deployments are at risk of adverse mental health conditions and related psychosocial functioning related to killing in war. Mental health assessment and treatment should address reactions to killing to optimize readjustment following deployment.
authors.affiliation: San Francisco VA Medical Center and University of California-San Francisco, San Francisco, CA 94121, USA. Shira.Maguen@va.gov
authors.forename: Shira
authors.initials: S
authors.lastname: Maguen
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Lucenko
authors.forename: Mark A
authors.initials: MA
authors.lastname: Reger
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Gahm
authors.forename: Brett T
authors.initials: BT
authors.lastname: Litz
authors.forename: Karen H
authors.initials: KH
authors.lastname: Seal
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Knight
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006708:Homicide / Q000523:psychology*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D014728:Veterans / Q000523:psychology*; D055815:Young Adult