Association of Anger and Aggression With Post-traumatic Stress Disorder and Mild Traumatic Brain Injury in U.S....

Area of Science:

• Neuroscience
• Psychiatry
• Military Health

Background:

• Anger and aggression are strongly linked to PTSD.
• The association between mild traumatic brain injury (mTBI) and anger/aggression is less understood.
• Specific anger-based aggressive behaviors in the context of PTSD, mTBI, and comorbid mTBI/PTSD require further investigation.

Purpose of the Study:

• To examine the prevalence and association of specific angry/aggressive behaviors in service members with mTBI, PTSD, or comorbid mTBI/PTSD.
• To compare the odds of reporting angry/aggressive behaviors across these groups and a control group.

Main Methods:

• Secondary analysis of the 2018 DoD Health Related Behaviors Survey data.
• Included 17,065 active component service members screened positive for mTBI, PTSD, comorbid mTBI/PTSD, or neither.
• Multivariate multinomial regression analyzed yelling, object-directed aggression, threats, and physical assault, adjusting for demographics and combat deployment.

Main Results:

• Service members with mTBI, PTSD, or both, reported higher odds of recent angry/aggressive behavior.
• PTSD (alone or comorbid) showed the strongest association with recurrent yelling (aOR=4.76).
• Comorbid mTBI/PTSD demonstrated the strongest association with recurrent object-directed aggression (aOR=7.64), suggesting additive effects.

Conclusions:

• Recent mTBI is linked to increased anger and aggression, comparable to PTSD.
• mTBI can be as strongly associated with physical aggression as PTSD.
• Clinicians should consider anger/aggression indications in mTBI and/or PTSD patients, particularly in comorbid cases.