Iraq War Clinician Guide - X. Assessment and Treatment of Anger in Combat-Related PTSD

Veterans of Operation Iraqi Freedom who suffer from symptoms of PTSD are likely to have difficulties with anger regulation given the centrality of anger in the human survival response. Research among military veterans has consistently shown that those with PTSD are higher in anger, hostility, aggression, general violence, and relationship violence and abuse than those without the disorder (e.g., Jordan et al., 1992). “Irritability and outbursts of anger” represent one of the diagnostic criteria for PTSD (American Psychiatric Association, 1994) and can have a debilitating impact across several domains. Anger dysregulation typically has a deleterious impact on the veteran’s relationships with family members and other loved ones, and may significantly interfere with other social and occupational functioning. These interpersonal difficulties may have a profound negative effect on the veteran’s social support network, which places him or her at risk for PTSD exacerbation, and possibly for cardiovascular disease and other health problems that have been associated with anger, hostility, and PTSD. Angry outbursts may also place the veteran at risk for legal problems and may lead to severe consequences for those who are exposed to these outbursts.