AGGRESSIVE BEHAVIOR Volume 00, pages 1–11 (2012) Factors Associated With Physical Aggression Among US Army Soldiers Michael Shayne Gallaway 1* , David S. Fink 1 , Amy M. Millikan 1 , and Michael R. Bell 2 1 Behavioral and Social Health Outcomes Program (BSHOP), US Army Institute of Public Health, US Army Public Health Command, Aberdeen Proving Ground, Aberdeen, Maryland 2 Uniformed Services University of Health Sciences, Bethesda, Maryland : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : There are a growing number of studies that have approximated levels of aggression and associated outcomes among combat veterans returning from Iraq and Afghanistan using brief screening assessments. However, further research to evaluate the relative role of combat exposures and overt physical behaviors is required to further elucidate potential associations between military service, combat deployment, and overt physical aggression. The purpose of the current study was to assess the prevalence of self-reported physical aggression in a sample of US Army soldiers using an adaptation of the Revised Conflict Tactics Scale (CTS2), and examine factors associated with higher levels of aggression. A population-based cross-sectional study was conducted at a single US Army Installation within a sample of active duty US Army soldiers (n = 6,128) from two large units. Anonymous surveys were collected 6 months following deployment to measure overt aggressive behaviors, posttraumatic stress disorder, anxiety, depression, traumatic brain injury, and misuse of alcohol. There were a relatively higher number of minor and severe physical overt aggressive actions reported among soldiers who previously deployed, notably highest among deployed soldiers reporting the highest levels of combat intensity. Soldiers screening positive for the misuse of alcohol were also significantly more likely to report relatively higher levels of physical aggression. This study quantified overt aggressive behaviors and associated factors, showing increasing combat exposures may result in increased physical aggression. Clinicians treating service members returning from combat may consider assessing relative levels of combat. Aggr. Behav. 00:1–11, 2012. Published 2012 Wiley Periodicals, Inc. † : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : Keywords: aggression; military; deployment, combat INTRODUCTION Operation Enduring Freedom (OEF) and Opera- tion Iraqi Freedom (OIF) represent the US military’s largest and longest lasting ground combat opera- tions since the Vietnam War. Furthermore, the sev- enth report by the Joint Mental Health Advisory Team (J-MHAT 7) released in May 2011, found cur- rent rates of combat exposure higher than ever re- ported during OEF/OIF operations [Office of the Surgeon General United States Army Medical Com- mand, 2011]. Several studies have found the combina- tion of deployment-related stressors and combat ex- posure to be significantly associated with an increase in negative behavioral and social health outcomes among OIF/OEF veterans [Cabrera et al., 2007; Hoge et al., 2007; Killgore et al., 2008; Booth-Kewley et al., 2010]. While, posttraumatic stress disorder (PTSD) and depression have been extensively studied among OEF/OIF veterans [Hoge et al., 2004, 2007, 2007; Martin, 2007; Milliken et al., 2007; Seal et al., 2007; Smith et al., 2008], comparatively little research has focused specifically on acts of aggression. As de- fined in social psychology, aggression is “any behavior The work submitted conforms to all governmental regulations and discipline appropriate professional ethical standards. This study was reviewed by the US Army Public Health Command Review Board and deemed to be Public Health Practice [Hodge and Gostin, 2004]. Army Regulation 40–5 established the US Army Public Health Command as the Army’s public health agency. Individuals did have the right to refuse to participate. The views expressed in this article are those of the authors and do not reflect official policy or position of the Department of the Army, the Department of Defense, the U.S. Government, or any of the institu- tional affiliations listed. None of these authors have any conflicts of interest to declare. Preliminary results were presented at the Force Health Protection Con- ference, Albuquerque, New Mexico, August 2009. † This article is a US government work and, as such, is in the public domain in the United States of America. ∗ Correspondence to: Michael Shayne Gallaway, Behavioral and So- cial Health Outcomes Program (BSHOP), US Army Institute of Pub- lic Health, US Army Public Health Command, Aberdeen Proving Ground, Aberdeen, MD 21010. E-mail: shayne.gallaway@us.army.mil Received 14 August 2011; Accepted 23 April 2012 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/ab.21436 Published 2012 Wiley Periodicals, Inc. †