Intimate Partner Abuse among Iraq, Afghanistan, and Vietnam Veterans: Cohort Differences & Associations with Military Experiences Andra L. Teten, 1 Michael 1, 2, 3 Ph. D. Julie Schumacher-Coffey, 4 Ph. D. 1, 2, 3, 5 Ph. D. Melinda A. Stanley, Donna White, 1, 2, 3 & Thomas A. Kent, MD 1, 3, 5 Sara Ph. D. Percent of Veterans Who Report Perpetrating Abuse toward their Partner in the Past Year Previous research (Teten, Sherman, & Han, in press) indicated an association between military trauma and partner violence. Our current study extended these findings to Iraq and Afghanistan (OIF/OEF) veterans by exploring the frequency and correlates of psychological, physical, and sexual partner violence perpetrated and sustained by male OIF/OEF veterans as compared to Vietnam veterans presenting to a VA trauma recovery program. In order to better understand partner abuse among returning veterans with and without PTSD, we examined the following: Participants Male Vietnam or OIF/OEF era veterans who completed a mental health screening (standard for all returning veterans) at the Michael E. De. Bakey VA Medical Center Trauma Recovery Program were recruited. Participants were in a heterosexual relationship for at least 3 months prior to study participation. Veterans whose treating/screening clinician identified the veteran as inappropriate for participation in research and those with a diagnosis of a psychotic disorder were not included. Traumatic Brain Injury n (%) OIF/OEF PTSD (n = 16) Vietnam PTSD (n = 19) 30. 41 (6. 97) 33. 00 (6. 20) 59. 37 (3. 25) 1&2<3 11 (65%) 11 (69%) 13 (68%) ns χ2 <. 05 1 (6%) 4 (23%) 3 (18%) 4 (23%) 0 (0%) 4 (25%) 7 (43%) 2 (13%) 3 (19%) 1 (5%) 14 (74%) 3 (16%) 0 (0%) 1 (5%) 12. 35 (23. 59) 46. 25 (34. 03) 54. 74 (40. 47) 6 (35%) 0 (0%) 8 (47%) 3 (18%) 3 (19%) 1 (6%) 10 (63%) 2 (12%) 10 (59%) 13 (81%) 0 (0%) 1<2&3 1<3 32. 81 (28. 09) 26. 04 (23. 35) 52. 34 (26. 30) 24. 48 (15. 95) 55. 92 (28. 37) 28. 07 (23. 93) 1<2&3 16. 94 (5. 94) 13. 69 (6. 46) 12. 58 (5. 73) 3<1 • Most veterans in the study reported their partners perpetrated substantial abuse towards them, with OIF/OEF veterans with PTSD reporting the most partnerperpetrated aggression. χ2 <. 05 15 (79%) 0 (0%) 1 (5%) 0 (0%) Percent of Veterans Who Report Sustaining Abuse from their Partner in Past Year • Our results demonstrates of sexual coercion in all groups were similar to that of youthful civilian samples, in which 30 -50% of men report coercive acts (Craig, 1990). • Applicability of Propensity for Abusiveness Profile to Veterans • The current study represents the first time the PAS has been applied to veteran samples. All groups scored higher on this measure than community groups of abusive men, though the effect seems to be driven by elevations on the trauma subscale. • Subtypes of Aggressive Acts ns 3 (19%) 80. 47 (18. 04) 19. 16 (2. 97) 20. 16 (5. 62) 19. 53 (11. 15) 10. 21 (2. 66) • Increased age is typically associated with decreases in partner abuse, however, the Vietnam veterans with PTSD reported rates of abuse comparable to the non-PTSD veterans in the younger cohort. These results suggest PTSD may override the protective effect of age. 9 (47%) 0 (0%) 6 (32%) 4 (21%) 1 (6%) 78. 25 (15. 90) 19. 00 (4. 53) 18. 69 (5. 31) 19. 19 (7. 00) 10. 56 (2. 58) • Cohort effects ns 9 (56%) 2 (13%) 3 (19%) 0 (0%) 1 (6%) 66. 31 (16. 85) 13. 88 (3. 52) 16. 25 (5. 73) 18. 31 (8. 17) 9. 13 (2. 85) 1<2 • Rates of Abuse and Effects of PTSD p 8 (47%) 3 (18%) 4 (24%) 1 (6%) 0 (0%) 21. 53 (23. 73) 8. 74 (22. 21) 7. 94 (12. 86) • Veterans with PTSD tended to report more frequent and more severe partner abuse than those without PTSD. OIF/OEF no PTSD (n = 17) Branch n (%) Army Navy Marines Air Force National Guard 31. 94 (39. 02) 10. 56 (17. 28) 4. 94 (8. 49) Key Findings and Discussion Demographics Employed n (%) 23. 31 (21. 77) 1. 19 (3. 23) 3. 19 (8. 33) Crown-Marlow Social Desirability Scale Method Ethnicity n (%) African American Asian American Caucasian Hispanic p <. 05 Impulsive Premeditated Aggression Scale Impulsive Premeditated • Group and cohort differences on subtypes of premeditated and impulsive aggression, as impulsive aggression is overrepresented among trauma survivors (Miller, Hamilton, Stanford, & Kent, 2008). Service Connected Disability M (SD) OIF/OEF no PTSD OIF/OEF PTSD Vietnam PTSD (n = 16) (n = 19) Propensity for Abusiveness Scale Total Score Trauma Borderline Childhood Anger • Group differences (PTSD vs. no PTSD) and cohort differences (OIF/OEF vs. Vietnam) based on correlates of abuse from Dutton's (1995) perpetrator profile of intimate abusiveness. In the model, parental warmth and rejection, borderline personality characteristics, trauma symptoms, and anger predict psychological and physical abuse of women. Length of Service 1 year or less 1 -3 years 3 -5 years 5 -10 years 10 -15 years 15+ years Reports of Aggression and Social Desirability by Group M (SD) Conflict Tactics Scale Psychological Physical Sexual • Frequency of abuse perpetrated and sustained in past year as reported by male OIF/OEF and Vietnam veterans. Married n (%) Nancy Jo Dunn, Ph. D. 1, 2, 3 E. De. Bakey VA Medical Center, 2 South Central Mental Illness Research, Education, and Clinical Center (MIRECC), 3 Baylor College of Medicine, 4 University of Mississippi Medical Center, 5 Houston Center for Quality of Care and Utilization Studies Abstract Age M (SD) D. Bailey, Ph. D. 1, 2, 3 • Given the high prevalence of impulsive aggression among veterans with PTSD (Miller, Hamilton, Stanford, & Kent, 2008), we examined aggression subtypes in this study. Veterans with PTSD reported the most impulsive aggression, which was significantly correlated with psychological abuse perpetrated and sustained. Implications ns Procedure Participants were assessed for PTSD using a semi-structured diagnostic interview administered by VA mental health professionals specializing in PTSD. All OIF/OEF veterans were assessed by doctoral-level psychologists. Participants completed a battery of self-report measures. Responses were protected by a Certificate of Confidentiality from the National Institute of Mental Health. Following completion of questionnaires, a thorough suicide/homicide assessment was administered to all participants. The current study suggests OIF/OEF veterans with PTSD, as well as Vietnam veterans with PTSD, struggle with frequent and severe relationship conflict. Given the high frequency of abuse perpetrated and sustained by these veterans, treatment for PTSD may consider addressing interpersonal violence in addition to traumatic symptoms. Acknowledgements We thank Sparkle Hamilton, MA for her assistance in data collection. This material is based upon work supported by the Office of Academic Affiliations, VA Special MIRECC Fellowship Program in Advanced Psychiatry and Psychology, Department of Veterans Affairs and a MIRECC Pilot Grant.
Скачать презентацию Intimate Partner Abuse among Iraq Afghanistan and Vietnam
93e3ec2ff8f50da2e5bb2f6efd98f465.ppt