title: Anger intensification with combat-related PTSD and depression comorbidity.
abstract: Anger is becoming more widely recognized for its involvement in the psychological adjustment problems of current war veterans. Recent research with combat veterans has found anger to be related to psychological distress, psychosocial functioning, and harm risk variables. Using behavioral health data for 2,077 treatment-seeking soldiers who had been deployed to Iraq and Afghanistan, this study examined whether anger disposition was intensified for those who met screen-threshold criteria for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Anger was assessed with a 7-item screening measure previously validated with the study population. The study tested the hypothesis that anger would be highest when "PTSD & MDD" were conjoined, compared with "PTSD only," "MDD only," and "no PTSD, no MDD." PTSD and depression were assessed with well-established screening instruments. A self-rated "wanting to harm others" variable was also incorporated. Age, gender, race, military component, military grade, and military unit social support served as covariates. Hierarchical multiple regression was used to test the hypothesis, which was confirmed. Anger was intensified in the PTSD & MDD condition, in which it was significantly higher than in the other 3 conditions. Convergent support was obtained for "wanting to harm others" as an exploratory index. Given the high prevalence and co-occurrence of PTSD and MDD among veterans, the results have research and clinical practice relevance for systematic inclusion of anger assessment postdeployment from risk-assessment and screening standpoints.
authors.affiliation: Department of Psychology and Social Behavior, University of California.
authors.forename: Oscar I
authors.initials: OI
authors.lastname: Gonzalez
authors.affiliation: Department of Psychology and Social Behavior, University of California.
authors.forename: Raymond W
authors.initials: RW
authors.lastname: Novaco
authors.affiliation: National Center for Telehealth and Technology, Joint Base Lewis-McChord.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Reger
authors.affiliation: National Center for Telehealth and Technology, Joint Base Lewis-McChord.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Gahm
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000786:Anger; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D000067453:War Exposure / Q000009:adverse effects*; D055815:Young Adult