Managing anger and aggression in patients with posttraumatic stress disorder

Posttraumatic stress disorder was categorized as a clinical entity in 1980 in response to assertions by trauma survivors (particularly Vietnam veterans) and their clinicians that existing diagnostic categories failed to adequately describe their symptoms. The diagnostic features of the current DSM-IV diagnosis have been expanded, and the concept of the disorder is still evolving. Posttraumatic stress disorder rarely occurs in "pure" form, and individuals suffering from the disorder commonly meet criteria for Axis I and Axis II disorders. Research is now emerging that supports the prevalence of aggression in posttraumatic stress disorder. Treatment approaches vary, but pharmacotherapy aimed at targeting individual symptoms or clusters can promote mood stabilization. This article discusses the evolving concept of posttraumatic stress disorder as a clinical entity, the association of anger and aggression with the disorder, and the psychopharmacologic approaches to treatment.