Iraq and Afghanistan war veterans who struggle with the anger and emotional outbursts of combat trauma are more than twice as likely as other veterans to be arrested for criminal misbehavior, new research has confirmed.
The new study, published Oct. 1 in the Journal of Consulting and Clinical Psychology, for the first time draws a direct correlation between combat post-traumatic stress disorder (PTSD), the anger it can cause and criminal misbehavior.
The study of 1,388 combat veterans was completed by a group of researchers led by forensic psychologist Eric B. Elbogen of the University of North Carolina-Chapel Hill School of Medicine. The researchers found that about 23 percent of those with PTSD and high irritability had been arrested for a criminal offense. Among all of the combat veterans studied, including those with and without combat trauma, 9 percent had been arrested since their combat deployment.
The study also determined that other factors not related to military service, including growing up in a violent home and a prior history of substance abuse, also raised the risk that veterans will commit crimes.
"You often hear people say that whenever bad things happen with veterans, it has to be PTSD, but this research shows it's a lot more complicated than that," Elbogen told The Huffington Post. The experience of combat doesn't necessarily mean a veteran will commit crimes. But combat trauma in the form of PTSD, combined with the high irritability that PTSD can cause, does "significantly" raise the risk of criminal arrest, he said.
These research findings, which echo previous studies of combat veterans, underscore an increasing and critical problem. Torrents of returning combat veterans need mental health services, but the Department of Veterans Affairs (VA) -- despite increased budgets and staff -- hasn't been able to meet the demand.
The link between war and crime was detailed in a recent HuffPost story which found an estimated 223,000 veterans, mostly from the Vietnam War era, currently in prison. Recorded sexual assault crimes within the military have doubled since 2006, from 665 cases to 1,313 last year. Some 17,000 active-duty soldiers are currently in military detention or awaiting judicial proceedings, according to the Army.
Guy Garant, a prosecutor in Philadelphia's criminal court who handles a rising caseload of veterans cases, told The Huffington Post this summer that he anticipates "an epidemic" of veterans in trouble with the law.
The new research also demonstrates the need to expand local veterans courts across the country, which guide veterans into treatment rather than simply into jail.
The finding that a combination of PTSD and high irritability can lead to criminal misbehavior is important because the treatment for PTSD provided to veterans by the VA and others often doesn't include therapy designed specifically to reduce irritability, Elbogen told The Huffington Post. Apart from his work at UNC-Chapel Hill, Elbogen is a researcher and clinician at the VA's Mid-Atlantic Mental Illness Research, Education and Clinical Center in Durham, N.C.
"A lot of the interventions being done now don't address irritability," he said. Neither the cognitive behavior therapy practiced at the VA and other locations, nor exposure therapy, in which veterans are guided to re-live the trauma they experienced, deals with the irritability factor that can lead to criminal behavior, Elbogen said.
"Anger management might be useful," he said.
Most combat veterans, of course, are not afflicted with PTSD and most do not end up in prison. But many do. Previous research has shown that half of all Vietnam combat veterans with PTSD had been arrested one or more times.
A 2009 study of enlisted combat Marines with at least one deployment demonstrated that those with PTSD were six times more likely to be busted on drug charges than Marines without PTSD, and 11 times more likely to be discharged for misconduct.
The VA has sought to intervene by expanding its number of mental health therapists and services. But tens of thousands of Iraq and Afghanistan veterans still have difficulty getting help, and more have never been diagnosed or sought treatment.
A related study by Elbogen and his associates, published earlier this year, found that acts of violence by veterans were more likely to occur if the veteran was homeless, unemployed or under-employed, and had little or no social support such as a functional family. Having a stable living situation and having control over one's life significantly reduced the odds of severe violence, the study concluded.
That finding is significant as combat troops retire from the stable and supportive environment of the military into the uncertainties of civilian life. The current unemployment rate for Iraq and Afghan war veterans, for instance, is 9.7 percent, significantly above the national rate of 7.8 percent.
In the earlier 2012 study, 33 percent of a sample of 1,388 Iraq and Afghanistan war veterans had committed at least one act of non-combat-related violence or aggression toward others in the community in the past year. About 11 percent had engaged in severe violence, using a gun or knife or sexual violence against another person.
Veterans "who perceive that they have control over their future and who have greater psychological resilience" are better able to refrain from violence, the study said.
"Some of the protective factors (living stability, employment, social support, self-direction, basic needs met) are present when service members live on a military base," the study noted, "but are not necessarily present when service members return home."