Enjoying the violence of war: Association with posttraumatic symptomatology in U.S. combat veterans.

Abstract

Objective

Engaging in war-related violence can have a devastating impact on military personnel, with research suggesting that injuring or killing others can contribute to posttraumatic stress disorder (PTSD), depression, and moral injury. However, there is also evidence that perpetrating violence in war can become pleasurable to a substantial number of combatants and that developing this "appetitive" form of aggression can diminish PTSD severity. Secondary analyses were conducted on data from a study of moral injury in U.S., Iraq, and Afghanistan combat veterans, to examine the impact of recognizing that one enjoyed war-related violence on outcomes of PTSD, depression, and trauma-related guilt.

Method

Three multiple regression models evaluated the impact of endorsing the item, "I came to realize during the war that I enjoyed violence" on PTSD, depression, and trauma-related guilt, after controlling for age, gender, and combat exposure.

Results

Results indicated that enjoying violence was positively associated with PTSD, β (SE) = 15.86 (3.02), p < .001, depression, β (SE) = 5.41 (0.98), p < .001, and guilt, β (SE) = 0.20 (0.08), p < .05. Enjoying violence moderated the relationship between combat exposure and PTSD symptoms, β (SE) = -0.28 (0.15), p < .05, such that there was a decrease in the strength of the relationship between combat exposure and PTSD in the presence of endorsing having enjoyed violence.

Conclusions

Implications for understanding the impact of combat experiences on postdeployment adjustment, and for applying this understanding to effectively treating posttraumatic symptomatology, are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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Citation

Published Version (Please cite this version)

10.1037/tra0001530

Publication Info

Van Voorhees, Elizabeth E, Kirsten H Dillon, Anselm Crombach, Tiffany Beaver, Katherine Kelton, Jennifer H Wortmann, undefined Visn-Mid-Atlantic Mirecc Workgroup, Jason Nieuwsma, et al. (2023). Enjoying the violence of war: Association with posttraumatic symptomatology in U.S. combat veterans. Psychological trauma : theory, research, practice and policy. 10.1037/tra0001530 Retrieved from https://hdl.handle.net/10161/28571.

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Scholars@Duke

Dillon

Kirsten H. Dillon

Adjunct Associate Professor in the Department of Psychiatry and Behavioral Sciences
Nieuwsma

Jason A Nieuwsma

Associate Professor in Psychiatry and Behavioral Sciences

Dr. Nieuwsma is a clinical psychologist whose interests are broadly related to different aspects of integrative mental health care. He has conducted work in the areas of health psychology, primary care-mental health integration, cross-cultural psychology, implementation science, and extensive work focused on integration of spirituality and health. In addition to being an Associate Professor in the Department of Psychiatry and Behavioral Sciences at Duke, Dr. Nieuwsma has served for over a decade as Associate Director for Integrative Mental Health (formerly Mental Health and Chaplaincy) in the Veterans Health Administration. He has helped lead multiple projects aimed at more effectively integrating chaplaincy and mental health care services across large healthcare systems, as well as conducting extensive work and training on moral injury, health psychology, and Acceptance and Commitment Therapy (ACT). Dr. Nieuwsma has authored over 50 peer-reviewed journal articles & book chapters; he serves on the editorial board for the APA journal Spirituality in Clinical Practice; he is Associate Editor for the Journal of Health Care Chaplaincy; and he is a co-editor and author on the books ACT for Clergy and Pastoral Counselors and Addressing Moral Injury in Clinical Practice.


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