Considerations of Risk, Outcomes, and Treatment for Veterans with Anger and Aggressive Behavioral Concerns

Anger and aggressive behaviors are concerns needing to be better understood to assist Veterans. Roughly 10% of active military personnel and veterans reported physically assaulting another individual, and 28% reported all types of physical aggression (e.g., fighting, threats). Physical abuse and sexual abuse during childhood and/or adulthood, combat exposure, and pre-deployment maltreatment are correlated with increased aggressive behaviors in veterans. Higher levels of anger and aggressive behaviors have been linked to a multitude of negative outcomes (e.g., medical concerns, occupational concerns, legal concerns, decreased social connectedness) for Veterans. Veterans with aggressive concerns often experience co-occurring mental health diagnoses, which can increase their experience of or difficulties coping with anger. Moreover, roughly 4.7 million veterans reside in rural areas. Rurality adds additional barriers to veteran wellbeing (e.g., lack of specialty services, provider lack of cultural sensitivity). Additionally, many social, environmental, and cultural factors intersect within military culture that can impact assessment and treatment of veterans. Specifically, with an increase in women serving in the military, more women are seeking Veterans Affairs services. However, women Veterans have reported lower satisfaction, escalated difficulties with VA staff, and perception of the VA being a male-oriented facility. While men seeking care are commonly stereotyped as weak, excessively emotional, or dependent; which can hinder Veterans seeking care. Therefore, clinicians and providers working with Veterans should continue to be mindful of unique ethical considerations and multicultural considerations while utilizing effective, evidence-based treatment protocols for individuals exhibiting aggressive concerns or comorbid mental health diagnoses to ensure overall Veteran wellbeing