Scholars@Duke publication: Anger mediates the relationship between changes in alcohol use and violence: A longitudinal examination among Iraq/Afghanistan-era veterans.

Anger mediates the relationship between changes in alcohol use and violence: A longitudinal examination among Iraq/Afghanistan-era veterans.

Publication , Journal Article

Miloslavich, K; Aurora, P; Beckham, JC; Elbogen, EB; Dillon, KH

Published in: Psychol Trauma

February 27, 2025

OBJECTIVE: Interpersonal violence is a common barrier to reintegration into civilian life in post-9/11 veterans. Alcohol use and anger, also common among veterans, are both risk factors for violence. The present study used longitudinal data to examine relationships between these factors. METHOD: Post-9/11-era veterans (N = 302) were assessed via clinical interviews and self-report questionnaires at baseline, 6 months, and 12 months on alcohol use, anger, violence, and posttraumatic stress disorder (PTSD) symptom severity. Multilevel structural modeling was used to compare two different mediation models across the three waves of data. RESULTS: The indirect effect of changes in alcohol use on violence via changes in anger was significant (p = .046). When covarying for PTSD symptom severity, the effects of Path A and Path B were consistent; however, the indirect effect between alcohol use and violence was no longer significant (p = .076). The indirect effect of changes in anger on violence via changes in alcohol use was not significant (p = .074). CONCLUSIONS: Alcohol use, anger, and violence are variables closely influencing one another. The association between changes in anger and subsequent violence was not mediated by changes in alcohol use. The association between changes in alcohol use and subsequent violence was mediated by changes in anger; however, this mediating effect disappeared when controlling for PTSD severity. These findings shed light on the importance of anger and PTSD as contributors to the relationship between alcohol use and violence. They suggest that assessing and treating anger may reduce violence among veterans with problematic alcohol use. (PsycInfo Database Record (c) 2025 APA, all rights reserved).