Regular Article/Psychological Consequences of the Wars in Iraq and Afghanistan

The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans†

  1. Shira Maguen1,*,
  2. Barbara A. Lucenko2,
  3. Mark A. Reger3,
  4. Gregory A. Gahm3,
  5. Brett T. Litz4,
  6. Karen H. Seal5,
  7. Sara J. Knight5,
  8. Charles R. Marmar5

Article first published online: 26 JAN 2010

DOI: 10.1002/jts.20434

Issue

Journal of Traumatic Stress

Journal of Traumatic Stress

Special Issue: Psychological Consequences of the Wars in Iraq and Afghanistan

Volume 23, Issue 1, pages 86–90, February 2010

Additional Information

How to Cite

Maguen, S., Lucenko, B. A., Reger, M. A., Gahm, G. A., Litz, B. T., Seal, K. H., Knight, S. J. and Marmar, C. R. (2010), The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans. J. Traum. Stress, 23: 86–90. doi: 10.1002/jts.20434

Author Information

  1. 1

    San Francisco VA Medical Center and University of California-San Francisco, San Francisco, CA

  2. 2

    Madigan Army Medical Center, Tacoma, WA

  3. 3

    National Center for Telehealth & Technology, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Tacoma, WA

  4. 4

    National Center for PTSD, Department of Veterans Affairs Boston Healthcare System and Massachusetts Veterans Epidemiological Research and Information Center, and Boston University School of Medicine, Boston, MA

  5. 5

    San Francisco VA Medical Center and University of California-San Francisco, San Francisco, CA

*San Francisco VA Medical Center, PTSD Program (116-P), 4150 Clement St., San Francisco, CA, 94121

  1. †

    This study was funded by a VA Health Services Research and Development Career Development Award. The authors would like to thank Jeane Bosch and Sabra Inslicht for their assistance with this manuscript. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or representing the views of the Department of the Army or the Department of Defense. Preliminary results were presented at The International Society of Traumatic Stress Studies, Chicago, November 13–15, 2008.

Publication History

  1. Issue published online: 18 FEB 2010
  2. Article first published online: 26 JAN 2010

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Abstract

This study examined the mental health impact of reported direct and indirect killing among 2,797 U.S. soldiers returning from Operation Iraqi Freedom. Data were collected as part of a postdeployment screening program at a large Army medical facility. Overall, 40% of soldiers reported killing or being responsible for killing during their deployment. Even after controlling for combat exposure, killing was a significant predictor of posttraumatic disorder (PTSD) symptoms, alcohol abuse, anger, and relationship problems. Military personnel returning from modern deployments are at risk of adverse mental health conditions and related psychosocial functioning related to killing in war. Mental health assessment and treatment should address reactions to killing to optimize readjustment following deployment.

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