Longitudinal assessment of anger trajectories following childhood trauma and combat exposure: Associations with PTSD and alcohol use disorder symptoms

For veterans, early life stressors, such as childhood trauma and experience of combat-related events, are associated with reporting greater levels of anger. Anger, if maintained over time, can have detrimental effects on mental health such as posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Some modifiable factors, such as self-compassion and posttraumatic growth have been shown to mitigate long-term symptomology. Veterans (<i>n</i> = 1,230) completed online surveys at baseline and 9-, 12-, 18-, and 24-month follow-up. We used a latent transition model to understand how emergent classes of childhood trauma and combat experience are associated with trajectories of anger over the study period. We also explored PTSD and AUD as outcomes of emergent transitions and, further, how self-compassion and posttraumatic growth moderate transition patterns. Veterans in the <i>High severity/polytrauma exposure</i> trauma class had a transition probability (<i>Pr</i>) of 0.76 into the <i>stable high anger</i> trajectory class. Those veterans in the <i>combat exposure only</i> class had a high probability of transitioning into the <i>stable low anger</i> class (<i>Pr</i> = 0.97). Veterans in the <i>moderate childhood trauma - moderate combat</i> class had a greater probability of transitioning into the <i>stable high anger</i> class (<i>Pr</i> = 0.66). Results show that PTSD and AUD symptoms are greatest when veterans transition into the <i>stable high anger</i> class. However, this is partially mitigated by higher levels of self-compassion and posttraumatic growth. While anger and trauma are both often associated with all of these mental health conditions, they do not appear to function and interact in a similar way.