Magazine article Clinical Psychiatry News

Mix of Factors Can Spark Violence in Soldiers

Magazine article Clinical Psychiatry News

Mix of Factors Can Spark Violence in Soldiers

Article excerpt

FROM A CONFERENCE ON THE COMPLEXITIES AND CHALLENGES OF PTSD AND TBI

BOSTON-A volatile mixture of individual, environmental, and social factors may cause a soldier to explode with anger and aggression toward himself or his fellows in arms, said a psychiatrist who studies suicidal behaviors and homicidal acts among U.S. service members.

"I don't want to say that every vet is a walking time bomb, but I think you need to be thinking about it all the time," said Dr. Elspeth Cameron Ritchie at the conference, which was sponsored by Massachusetts General Hospital.

Reviews of mass shootings at bases in the United States and abroad, as well as homicides among soldiers at Fort Carson, Colo., show that many factors known to heighten risk for violence in the general population are present in the military, with the addition of a key significant factor: ready access to lethal weapons.

"I don't think it's a great message when we sell weapons in PXs [post exchanges]. We have had some episodes where people have bought weapons and then shot themselves or another member, sometimes in the PX itself," said Dr. Ritchie, chief clinical officer for the District of Columbia Department of Mental Health and a retired colonel in the U.S. Army.

Army Suicide Rates Rising

Risk factors for suicide and violence toward others in the military (acute psychosis, insult-evoked reactions, drug and alcohol use/abuse, recent stressors, unstable mood/affect, mania, and severe depression) are similar to those in civilian life.

Mood and adjustment disorders and substance abuse are relatively common among Army personnel who commit suicide, but more serious psychiatric and personality disorders are less frequent, Dr. Ritchie said.

Suicides are often linked to relationship problems, legal or occupational difficulties, and chronic pain and/or disability. Recently, there has been an uptick in suicides among older service members, higher ranks, and women.

Historically, the rates of suicides among active-duty Army members had been lower than that of the general population.

But data from the National Center for Health Statistics show that while suicide rates among the general population remained flat in 2001-2006, the rate among active Army members doubled, and is expected to be about 100,000, higher than that of the age- and sex-adjusted rate in the United States of about 18 per 100,000 when the most recent data (for 2008 and 2009) become available.

A review by the Army's Epidemiology Consultant Service of suicides and homicides among active-duty soldiers in the United States reveals common themes. Dr. Ritchie explained.

Recent Cases

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