1. Intimate Partner Abuse among Iraq, Afghanistan, and Vietnam Veterans: Cohort Differences & Associations with Military Experiences Andra L. Teten, Ph.D. 1,2,3 Julie Schumacher-Coffey, Ph.D. 4 Melinda A. Stanley, Ph.D. 1,2,3,5 Donna White, Ph.D. 1,3,5 Sara D. Bailey, Ph.D. 1,2,3 Nancy Jo Dunn, Ph.D. 1,2,3 & Thomas A. Kent, MD 1,2,3 1 Michael E. DeBakey 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 OIF/OEF no PTSD (n = 17) OIF/OEF PTSD (n = 16) Vietnam PTSD (n = 19) p Age M (SD)30.41 (6.97)33.00 (6.20)59.37 (3.25)1 & 2 < 3 Married n (%)11 (65%)11 (69%)13 (68%)ns Length of Service 1 year or less 1-3 years 3-5 years 5-10 years 10-15 years 15+ years 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%) χ 2 <.05 Service Connected Disability M (SD) 12.35 (23.59)46.25 (34.03)54.74 (40.47)1 < 2 & 3 Ethnicity n (%) African American Asian American Caucasian Hispanic 6 (35%) 0 (0%) 8 (47%) 3 (18%) 3 (19%) 1 (6%) 10 (63%) 2 (12%) 9 (47%) 0 (0%) 6 (32%) 4 (21%) ns Employed n (%)10 (59%)13 (81%)0 (0%)χ 2 <.05 Branch n (%) Army Navy Marines Air Force National Guard 8 (47%) 3 (18%) 4 (24%) 1 (6%) 0 (0%) 9 (56%) 2 (13%) 3 (19%) 0 (0%) 1 (6%) 15 (79%) 0 (0%) 1 (5%) 0 (0%) ns Traumatic Brain Injury n (%) 1 (6%)3 (19%)0 (0%)ns Key Findings and Discussion Rates of Abuse and Effects of PTSD Veterans with PTSD tended to report more frequent and more severe partner abuse than those without PTSD. Most veterans in the study reported their partners perpetrated substantial abuse towards them, with OIF/OEF veterans with PTSD reporting the most partner- perpetrated aggression. Our results demonstrate rates 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). Cohort effects 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. 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 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. Method Participants Male Vietnam or OIF/OEF era veterans who completed a mental health screening (standard for all returning veterans) at the Michael E. DeBakey 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. Demographics Abstract 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: Frequency of abuse perpetrated and sustained in past year as reported by male OIF/OEF and Vietnam veterans. 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. Group and cohort differences on subtypes of premeditated and impulsive aggression, as impulsive aggression is overrepresented among trauma survivors (Miller, Hamilton, Stanford, & Kent, 2008). OIF/OEF no PTSD (n = 16) OIF/OEF PTSD (n = 16) Vietnam PTSD (n = 19) p <.05 Conflict Tactics Scale Psychological Physical Sexual 23.31 (21.77) 1.19 (3.23) 3.19 (8.33) 31.94 (39.02) 10.56 (17.28) 4.94 (8.49) 21.53 (23.73) 8.74 (22.21) 7.94 (12.86) 1 < 2 Propensity for Abusiveness Scale Total Score Trauma Borderline Childhood Anger 66.31 (16.85) 13.88 (3.52) 16.25 (5.73) 18.31 (8.17) 9.13 (2.85) 78.25 (15.90) 19.00 (4.53) 18.69 (5.31) 19.19 (7.00) 10.56 (2.58) 80.47 (18.04) 19.16 (2.97) 20.16 (5.62) 19.53 (11.15) 10.21 (2.66) 1 < 2 & 3 1 < 3 Impulsive Premeditated Aggression Scale Impulsive Premeditated 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 Crown-Marlow Social Desirability Scale16.94 (5.94)13.69 (6.46)12.58 (5.73)3 < 1 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. Percent of Veterans Who Report Perpetrating Abuse toward their Partner in the Past Year Percent of Veterans Who Report Sustaining Abuse from their Partner in Past Year Reports of Aggression and Social Desirability by Group M (SD) Implications 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.