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Analysis of Violent Behavior in Vietnam Combat Veteran Psychiatric Inpatients with Posttraumatic Stress Disorder

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Journal of Traumatic Stress

Abstract

This study tested the hypothesis that male Vietnam veterans seeking inpatient treatment for PTSD (n = 228) exhibit more violent behavior compared with a mixed diagnostic group of male psychiatric Inpatients without PTSD (n = 64) and a community sample of Vietnam veterans with PTSD not undergoing inpatient treatment (n = 273). Violent acts assessed included property destruction, threats without a weapon, physical fighting, and threats with a weapon. PTSD inpatients engaged in more types of violent behavior than both comparison conditions. Correlates of violence among PTSD inpatients included PTSD symptom severity and, to a lesser degree, measures of substance abuse. These findings justify routine assessment of violent behavior among inpatients with PTSD, as well as application of specialized interventions for anger dyscontrol and aggression.

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References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Borum, R. (1996). Improving the clinical practice of violence risk assessment: Technology, guidelines, and training. American Psychologist, 51, 945–956.

    Google Scholar 

  • Chemtob, C. M., Hamada, R. S., Roitblat, H. L., & Muraoka, M. Y. (1994). Anger, impulsivity, and anger control in combat-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 62, 827–832.

    Google Scholar 

  • Chemtob, C. M., Novaco, R. W., Hamada, R. S., Gross, D. M., & Smith, G. (1997). Anger regulation deficits in combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 10, 17–36.

    Google Scholar 

  • Chemtob, C. M., Novaco, R. W., Hamada, R. S., & Gross, D. M. (1997). Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 65, 184–189.

    Google Scholar 

  • Craig, T. J. (1982). An epidemiologic study of problems associated with violence among psychiatric inpatients. American Journal of Psychiatry, 139, 1262–1266.

    Google Scholar 

  • Fisher, L. D., & van Belle, G. (1993). Biostatistics: A methodology for health sciences. New York: Wiley.

    Google Scholar 

  • Foa, E. B., Riggs, D. S., & Gershuny, B. S. (1995). Arousal, numbing, and intrusion: Symptom structure of PTSD following assault. American Journal of Psychiatry, 152, 116–120.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (1994). A short form of the Mississippi scale for measuring change in combat-related PTSD. Journal of Traumatic Stress, 7, 407–414.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (1997). Effectiveness and cost of the inpatient treatment of posttraumatic stress disorder: Comparison of three models of treatment. American Journal of Psychiatry, 154, 758–765.

    Google Scholar 

  • Fontana, A., Rosenheck, R., Spencer, H., & Gray, S. (1995). The long journey home IV: The fourth progress report on the Department of Veterans Affairs specialized PTSD programs. Unpublished manuscript, Northeast Program Evaluation Center, Veterans Affairs Medical Center, West Haven, CT.

  • Fulwiler, C., Grossman, H., Forbes, C., & Ruthazer, R. (1997). Early-onset substance abuse and community violence by outpatients with chronic mental illness. Psychiatric Services, 48, 1181–1185.

    Google Scholar 

  • Gallops, M., Laufer, R. S., & Yager, T. (1981). Revised Combat Scale. In R. S. Laufer, T. Yager, E. Frey-Wouters, & J. Donnellan (Ed.), Legacies of Vietnam: Comparative adjustments of veterans and their peers (Vol. 3, p. 125). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Hodgins, S., Mednick, S. A., Brennan, P. A., Schulsinger, F., & Engberg, M. (1996). Mental disorder and crime: Evidence from a Danish birth cohort. Archives of General Psychiatry, 53, 489–496.

    Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.

    Google Scholar 

  • Kirk, R. E. (1968). Experimental design procedures for the behavioral sciences. Monterey, CA: Brooks/Cole.

    Google Scholar 

  • Koop, C. E., & Lundberg, G. D. (1992). Violence in America: A public health emergency. Journal of the American Medical Association, 267, 3075–3076.

    Google Scholar 

  • Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1988). Contractual report of findings from the National Vietnam Veterans Readjustment Study: Vol. 1. Executive summary, description of findings, and technical appendices. Research Triangle Park, NC: Research Triangle Institute.

    Google Scholar 

  • Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1990). Trauma and the Vietnam war generation. New York: Brunner/Mazel.

    Google Scholar 

  • Lagos, J. M., Perlmutter, K., & Saexinger, H. (1977). Fear of the mentally ill: Empirical support for the common man's response. American Journal of Psychiatry, 134, 1134–1136.

    Google Scholar 

  • Lasko, N. B., Gurvits, T. V., Kuhne, A. A., Orr, S. P., & Pitman, R. K. (1994). Aggression and its correlates in Vietnam veterans with and without chronic posttraumatic stress disorder. Comprehensive Psychiatry, 35, 373–381.

    Google Scholar 

  • Marzuk, P. (1996). Violence, crime, and mental illness. Archives of General Psychiatry, 53, 481–486.

    Google Scholar 

  • McCormick, R. A., & Smith, M. (1995). Aggression and hostility in substance abusers: The relationship to abuse patterns, coping style, and relapse triggers. Addictive Behaviors, 20, 555–562.

    Google Scholar 

  • McFall, M. E., Smith, D. E., Mackay, P., & Tarver, D. J. (1990). Reliability and validity of the Mississippi scale for combat-related PTSD. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 114–121.

    Google Scholar 

  • McLellan, A. T., Parikh, G., & Bragg, A. (1990). Addiction Severity Index Manual (5th ed.). Philadelphia: University of Pennsylvania Center for the Study of Addiction.

    Google Scholar 

  • McNiel, D. E., Binder, R. L., & Greenfield, T. K. (1988). Predictors of violence in civilly committed acute psychiatric patients. American Journal of Psychiatry, 145, 965–970.

    Google Scholar 

  • Mulvey, E. P. (1994). Assessing the evidence of a link between mental illness and violence. Hospital and Community Psychiatry, 45, 663–668.

    Google Scholar 

  • Rosenberg, M. L., O'Carroll, P. W., & Powell, K. E. (1992). Let's be clear: Violence is a public health problem. Journal of the American Medical Association, 267, 3071–3072.

    Google Scholar 

  • Rossi, A. M., Jacobs, M., Monteleone, M., Olsen, R., Surber, R. W., Winkler, E. L., & Wommack, A. (1986). Characteristics of psychiatric patients who engage in assaultive or other fear-inducing behaviors. Journal of Nervous and Mental Disease, 174, 154–160.

    Google Scholar 

  • Silver, S. M., & Iacono, C. U. (1984). Factor analytic support for DSM-III's PTSD for Vietnam veterans. Journal of Clinical Psychology, 40, 5–14.

    Google Scholar 

  • Straus, M. (1979). Measuring intrafamily conflict and violence: The Conflict Tactics Scales. Journal of Marriage and the Family, 41, 75–88.

    Google Scholar 

  • Swanson, J. W., Holzer, C. E., Ganju, V. K., & Jono, R. T. (1990). Violence and psychiatric disorder in the community: Evidence from the Epidemiologic Catchment Area Surveys. Hospital and Community Psychiatry, 41, 761–770.

    Google Scholar 

  • Swett, C., & Mills, T. (1997). Use of the NOSIE to predict assaults among acute psychiatric patients. Psychiatric Services, 48, 1177–1180.

    Google Scholar 

  • Tardiff, K. (1992). The current state of psychiatry in the treatment of violent patients. Archives of General Psychiatry, 49, 493–499.

    Google Scholar 

  • Tardiff, K., & Sweillam, A. (1980). Assault, suicide, and mental illness. Archives of General Psychiatry, 37, 164–169.

    Google Scholar 

  • Volavka, J. (1995). Neurobiology of violence. Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Watson, C. G., Juba, M. P., & Anderson, P. E. D. (1989). Validities of five combat scales. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1, 98–102.

    Google Scholar 

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McFall, M., Fontana, A., Raskind, M. et al. Analysis of Violent Behavior in Vietnam Combat Veteran Psychiatric Inpatients with Posttraumatic Stress Disorder. J Trauma Stress 12, 501–517 (1999). https://doi.org/10.1023/A:1024771121189

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