title: Associations between PTSD and intimate partner and non-partner aggression among substance using veterans in specialty mental health.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), 2800 Plymouth Road, Bldg 16, Ann Arbor, MI 48109, United States; VA Ann Arbor Healthcare System, Psychiatry, (116C) 2215 Fuller Road, Ann Arbor, MI 48105, United States; Department of Psychiatry, University of Michigan Medical School, United States. Electronic address: kbuchhol@med.umich.edu.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Buchholz
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), 2800 Plymouth Road, Bldg 16, Ann Arbor, MI 48109, United States; VA Ann Arbor Healthcare System, Psychiatry, (116C) 2215 Fuller Road, Ann Arbor, MI 48105, United States; Department of Psychiatry, University of Michigan Medical School, United States.
authors.forename: Kipling M
authors.initials: KM
authors.lastname: Bohnert
authors.affiliation: VA Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), 2800 Plymouth Road, Bldg 16, Ann Arbor, MI 48109, United States; VA Ann Arbor Healthcare System, Psychiatry, (116C) 2215 Fuller Road, Ann Arbor, MI 48105, United States; Department of Psychiatry, University of Michigan Medical School, United States.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Sripada
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Dr, NE, 2nd Floor, Atlanta, GA 30329, United States; Mental Health Service Line, Atlanta VA Medical Center, (116C) 1670 Clairmont Rd, Decatur, GA 30033, United States.
authors.forename: Sheila A M
authors.initials: SA
authors.lastname: Rauch
authors.affiliation: Department of Emergency Medicine, Injury Center, University of Michigan, 2800 Plymouth Road, Suite B10-GG080, Ann Arbor, MI 48109, United States; Institute for Research on Women and Gender, University of Michigan, 1136 Lane Hall, Ann Arbor, MI 48109, United States.
authors.forename: Quyen M
authors.initials: QM
authors.lastname: Epstein-Ngo
authors.affiliation: VA Ann Arbor Healthcare System, Psychiatry, (116C) 2215 Fuller Road, Ann Arbor, MI 48105, United States; Department of Psychiatry, Addiction Research Center, University of Michigan, United States.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Chermack
mesh_terms: D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D000066511:Intimate Partner Violence / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans; D055815:Young Adult
keywords: Non-partner aggression; PTSD; Partner aggression; Substance use