This continuation application proposes to extend a funded CRS&D Merit Review project investigating the role of anger and cognitive deficits and biases with respect to the association between PTSD symptom severity and intimate partner violence (IPV) perpetration among Operation Iraqi Freedom (OIF)/ Operation Enduring Freedom (OEF) veterans. In the current application, we propose to examine the contribution of traumatic brain injury (TBI) and executive functioning with respect to these relationships. The primary objective of this study is to test the hypotheses that (a) TBI and executive functioning deficits will be positively and uniquely associated with higher physical and psychological IPV severity;and (b) TBI and executive functioning deficits will moderate the impacts of PTSD symptoms and cognitive deficits/biases on the IPV outcomes. Research Design and Methodology: Participants will be 150 male OEF/OIF veterans over the age of 18 who have been married or cohabitating with a partner for at least one year. Potential participants will be excluded if (a) reading difficulties prevent valid completion of the assessment instruments, (b) the mental status of a participant precludes the completion of study procedures, such as severe organicity, active psychosis, or impaired performance on the Mini-Mental Status Exam (c) the participant has taken any medication that is thought to have significant CNS effects, or (d) the participant meets criteria for current alcohol or drug dependence, OR has been in inpatient treatment or outpatient treatment for alcohol or drug dependence (e.g., AA, NA, or methodone treatment) within the past 60 days. Participants will be drawn from three sources: (a) flyers posted in the Boston area;(b) the already established National Center for PTSD subject recruitment database;and (c) a mass mailing to those on a roster of all male OEF/OIF veterans living in Massachusetts, held by the Defense Manpower Data Center (DMDC), and shared with the VA under a data use agreement signed by DMDC and the VACO. Participation will involve a phone screening and three laboratory sessions, spaced approximately one week apart. The initial screening with the participant will entail the determination of study eligibility. Session 1 will involve informed consent procedures and the administration of the Mini-Mental Status Examination, self-report questionnaires, and diagnostic interviews for PTSD and other Axis I disorders. Session 2 will include the Articulated Thoughts in Simulated Situations (ATSS) laboratory procedure to assess cognitive deficits and biases. This methodology assesses thoughts during anger arousal, since anger- related thoughts are more likely to be accessible and reportable if assessed when angry mood states are activated and relevant contextual cues present. Session 3 will involve the assessment of TBI and the neuropsychological variables of interest. Clinical Relationships: Study findings will potentially have consequences for program modification and development, specifically for anger management and IPV perpetration. Findings may highlight the need for cognitive-behavioral anger management strategies that take into account neuropsychological deficits and history of TBI. Study findings may also elucidate marker variables for IPV and the significance of specific neuropsychological factors that are particularly relevant for understanding and treating IPV in this population. Study findings will also inform the Principal Investigator's ongoing research program focused on developing interventions for the prevention and treatment of IPV.
Relevance to Veterans Health Intimate partner violence (IPV) alienates veterans from family members and negatively impacts support networks, placing the veteran at increased risk for various psychosocial and physical health problems and poor social and occupational functioning. It is critically important that we develop a better understanding of the nature and causes of IPV in this population in order to best prevent and treat such family problems. The current investigation proposes to examine the roles of traumatic brain injury and executive functioning deficits in IPV among returning veterans, as well as their interplay with symptoms of PTSD and cognitive deficits/biases in contributing to IPV. This work will inform the Principal Investigator's current funded efforts to develop and test primary and secondary IPV prevention interventions for veterans with PTSD.