Reckless behavior fuels ongoing stress for some with PTSD

June 14, 2017
Drunken driving and other reckless behaviors appear to be common among those with PTSD, and could in turn lead to more stress and trauma and worse PTSD symptoms, suggests a VA study. Credit: Mitch Mirkin

Researchers with the National Center for PTSD at the VA Boston Healthcare System found that engaging in risky behavior—itself a symptom of posttraumatic stress disorder—could in turn lead to worse PTSD symptoms. This sets up a pattern of repeated stressful experiences, they say, that could have harmful consequences for those with PTSD.

As Dr. Naomi Sadeh, corresponding author on the article, explains: "For individuals with PTSD, exposure to new stressful events will often prolong their symptoms and can even make them worse. So these findings suggest that treatment providers should ask trauma-exposed veterans about reckless behavior to make sure they are not engaging in harmful behaviors that could make their PTSD symptoms worse."

The results appeared in a May 2017 issue of the Journal of Traumatic Stress.

Recent research has found evidence of a link between risky behavior and PTSD. Because of this relationship, "reckless and self-destructive behavior" has been added as a of PTSD in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the handbook used to diagnose psychiatric conditions.

The new study assessed more than 200 veterans with PTSD diagnoses for both PTSD severity and reckless behavior at the beginning of the study, starting in 2006, and again four years later. Nearly three-quarters had engaged in reckless or self-destructive behavior at least once in the five years before the study.

The most common behaviors identified in this study were dangerous alcohol or drug use, drunken driving, gambling, and aggression. The researchers found a correlation between risky behavior and higher PTSD severity at both time points. The results lend further evidence that risky behavior is common among trauma-exposed veterans.

"These types of high-risk behaviors appear to be common among veterans who have experienced trauma, and put veterans in harm's way by making it more likely that they will experience stress and adversity in the future," says Sadeh.

But the study revealed more about the relationship between PTSD and risky behavior. In the time between the two tests, 82 percent of participants experienced at least one potentially traumatic event. These events included experiencing the sudden death of a friend or loved one; being threatened with or being the victim of a physical assault; being involved in a motor vehicle accident, or witnessing any severe accident; experiencing a life-threatening or disabling event affecting a loved one, or coping with a life-threatening illness.

Not only did the presence of risky behavior at baseline correlate with future PTSD symptoms, but it was also tied to the likelihood of experiencing new traumatic events. This led the researchers to suggest that risky behavior may lead to worse PTSD symptoms in the future by leading to a greater number of stressful life events. The findings suggest that many veterans with PTSD continue to experience stressful events that may prolong or worsen their PTSD symptoms, even years after the initial trauma.

The study authors write, "Driving while intoxicated, for example, increases the likelihood of experiencing a traumatic , overt aggression can elicit assaultive behavior from others, and drug use can increase exposure to drug-related crime and physical injury." In other words, risky and could lead to more trauma and, in turn, worse PSTD over time.

The results are of particular interest to VA. In addition to having much higher rates of PTSD, veterans are also more likely to engage in risky behavior. Veterans are at around 50 percent higher risk of suicide than civilians. They are also more frequently incarcerated for violent offenses and more likely to drive recklessly. Veterans also have higher rates of binge drinking and pathological gambling than their non-veteran counterparts.

VA and other health care systems need to focus on more assessment and treatment of problematic behavior in trauma-exposed individuals, say the researchers. They write, "Considering the number of veterans who have been diagnosed with PTSD and are reintegrated into society, understanding how reckless behaviors relate to the maintenance of PTSD symptoms is an important area of study."

Explore further: Sexual problems may be affected by evidence-based psychotherapy for PTSD

More information: Joanna D. Lusk et al. Reckless Self-Destructive Behavior and PTSD in Veterans: The Mediating Role of New Adverse Events, Journal of Traumatic Stress (2017). DOI: 10.1002/jts.22182

Related Stories

Sexual problems may be affected by evidence-based psychotherapy for PTSD

April 6, 2017
The National Center for Post-Traumatic Stress Disorder (PTSD) has published the research findings of a University of Kentucky researcher in its latest issue of the Clinician's Trauma Update. Assistant Professor of Psychology ...

SGA prescribing higher for veterans with PTSD / dementia

April 7, 2017
(HealthDay)—Elderly veterans with post-traumatic stress disorder (PTSD) with dementia have increased odds of being prescribed second-generation antipsychotics (SGAs) compared with those with PTSD alone, according to a study ...

Veterans with PTSD have an increased 'fight or flight' response

May 15, 2017
Young veterans with combat-related post-traumatic stress disorder (PTSD) have an increased 'fight or flight' response during mental stress, according to new findings published this week in the Journal of Physiology.

Study reveals areas of the brain impacted by PTSD

January 23, 2017
Researchers at Boston University School of Medicine (BUSM) and the VA Boston Healthcare System are one step closer to understanding the specific nature of brain changes associated with Posttraumatic Stress Disorder (PTSD).

Veterans who don't meet all PTSD criteria still at risk for depression, suicide and substance abuse

June 2, 2016
At least one in five U.S. military veterans who have experienced trauma are at greatly elevated risk for depression, suicide, or substance abuse even though they do not meet all criteria for post-traumatic stress disorder ...

PTSD may negatively affect sex life satisfaction in male and female veterans

June 3, 2016
New research reveals that posttraumatic stress disorder (PTSD) was a strong, negative predictor of sexual satisfaction in both male and female veterans who returned from warzones in recent Iraq and Afghanistan conflicts.

Recommended for you

New study rebuts the claim that antidepressants do not work

August 18, 2017
A theory that has gained considerable attention in international media, including Newsweek and the CBS broadcast 60 minutes, suggests that antidepressant drugs such as the SSRIs do not exert any actual antidepressant effect. ...

Should I stay or should I leave? Untangling what goes on when a relationship is being questioned

August 17, 2017
Knowing whether to stay in or leave a romantic relationship is often an agonizing experience and that ambivalence can have negative consequences for health and well-being.

Kids learn moral lessons more effectively from stories with humans than human-like animals

August 17, 2017
A study by researchers at the Ontario Institute for Studies in Education (OISE) at the University of Toronto found that four to six-year-olds shared more after listening to books with human characters than books with anthropomorphic ...

History of stress increases miscarriage risk, says new review

August 17, 2017
A history of exposure to psychological stress can increase the risk of miscarriage by upto 42 per cent, according to a new review.

Study finds children pay close attention to potentially threatening information, avoid eye contact when anxious

August 17, 2017
We spend a lot of time looking at the eyes of others for social cues – it helps us understand a person's emotions, and make decisions about how to respond to them. We also know that adults avoid eye contact when anxious. ...

Communicating in a foreign language takes emotion out of decision making

August 16, 2017
If you could save the lives of five people by pushing another bystander in front of a train to his death, would you do it? And should it make any difference if that choice is presented in a language you speak, but isn't your ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.