Friday, July 22, 2022

Anger Issues as Veterans Leave Military May Point to Future Mental Health Problems, Study Finds

American service members whose anger causes them significant distress and decreased function (problematic anger) during their transition to civilian life may have a higher risk of mental health conditions such as depression and posttraumatic stress disorder (PTSD), a study in JAMA Network Open has found. The results also suggest that service members who have problematic anger during the transition are more likely to have difficulty in their relationships and experience financial instability.

“Given problematic anger is often underrecognized and undertreated, organizations could … leverage these results by ensuring that service members are trained in healthy emotion regulation,” wrote Amy B. Adler, Ph.D., of the Walter Reed Army Institute of Research and colleagues. “Training could also target individuals at high risk for problematic anger, and screening for problematic anger could be considered prior to [accepting people into the military].”

Adler and colleagues analyzed data from 3,448 participants in two waves of the Millennium Cohort Study, which investigates health effects associated with military service. The two waves were administered approximately five years apart. Participants were U.S. active-duty service members within 24 months of separating from the military at the first wave, and they were followed for up to 24 months after separation.

Participants were considered to have problematic anger if they scored at least 12 points on the 5-item Dimensions of Anger Reactions scale (DAR-5) at the first wave. The DAR-5 measures anger frequency, intensity, duration, aggression, and interference with social functioning. Participants’ behavioral and functional health was measured with standardized assessments such as the 8-item Patient Health Questionnaire and the PTSD Checklist-Civilian Version, as well as questions about their relationships and financial health.

Overall, 24% of participants screened positive for problematic anger during the first wave. The prevalence of problematic anger was lowest at 20 to 24 months prior to separation, with 15.9% screening positive, and highest at 20 to 24 months following separation, with 31.2% screening positive.

Programs designed to promote successful military-to-civilian transition should target the period before and immediately after separation, the authors wrote. Such programs are likely also needed “even years later, given there was no observed levelling off of [problematic anger] prevalence 2 years after separation,” they added.

After adjusting for mental health, problem drinking, and physical health at the first wave, the researchers found that participants who had problematic anger had 1.77 times the odds of screening positive for depression and 1.55 times the odds of screening positive for PTSD compared with participants who did not have problematic anger. Those with problematic anger were also more likely to report lower relationship quality, difficulties with parental coping, lower social support, lower financial security, unemployment, and job seeking.

“Individuals may benefit from knowing that problematic anger may pose a risk to their well-being, important relationships, and fiscal health,” Adler and colleagues wrote. “Much like public health messaging regarding diet and exercise can encourage individuals to follow a healthier lifestyle, warning about the association of problematic anger on well-being may be similarly helpful.”

For related information, see the Psychiatric Services article “Mental Health Care Use Among U.S. Military Veterans: Results From the 2019–2020 National Health and Resilience in Veterans Study.”

(Image: iStock/Im Yeongsik)


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