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

Itsy bitsy spider: Fear of spiders and snakes is deeply embedded in us

October 19, 2017
Snakes and spiders evoke fear and disgust in many people, even in developed countries where hardly anybody comes into contact with them. Until now, there has been debate about whether this aversion is innate or learnt. Scientists ...

Inflamed support cells appear to contribute to some kinds of autism

October 18, 2017
Modeling the interplay between neurons and astrocytes derived from children with Autism Spectrum Disorder (ASD), researchers at University of California San Diego School of Medicine, with colleagues in Brazil, say innate ...

Study suggests psychedelic drugs could reduce criminal behavior

October 18, 2017
Classic psychedelics such as psilocybin (often called magic mushrooms), LSD and mescaline (found in peyote) are associated with a decreased likelihood of antisocial criminal behavior, according to new research from investigators ...

Taking probiotics may reduce postnatal depression

October 18, 2017
Researchers from the University of Auckland and Otago have found evidence that a probiotic given in pregnancy can help prevent or treat symptoms of postnatal depression and anxiety.

Schizophrenia disrupts the brain's entire communication system, researchers say

October 17, 2017
Some 40 years since CT scans first revealed abnormalities in the brains of schizophrenia patients, international scientists say the disorder is a systemic disruption to the brain's entire communication system.

Before assigning responsibility, our minds simulate alternative outcomes, study shows

October 17, 2017
How do people assign a cause to events they witness? Some philosophers have suggested that people determine responsibility for a particular outcome by imagining what would have happened if a suspected cause had not intervened.

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.