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- Title
Association of Problematic Anger With Long-term Adjustment Following the Military-to-Civilian Transition.
- Authors
Adler, Amy B.; LeardMann, Cynthia A.; Villalobos, Javier; Jacobson, Isabel G.; Forbes, David
- Abstract
Key Points: Question: What is the association of problematic anger with long-term adjustment following the transition of US service members to civilian life? Findings: In this cohort study of 3448 active-duty service members transitioning out of the military, the prevalence of problematic anger 2 years after separation (31.2%) was nearly double the prevalence 2 years before separation (15.9%). Problematic anger was associated with behavioral health problems, relationship health concerns, and economic difficulties approximately 5 years later. Meaning: These findings suggest that problematic anger may be a determinant of maladjustment, offering a point of intervention for emotion regulation management to improve military-to-civilian transition. This cohort study investigates the prevalence of problematic anger during the military-to-civilian transition period and the association of problematic anger with adjustment to civilian life among US military service members. Importance: Few studies have examined the role of problematic anger in long-term adjustment of service members transitioning out of the military. Objective: To determine the prevalence of problematic anger during the military-to-civilian transition period and the association of problematic anger with adjustment to civilian life. Design, Setting, and Participants: This cohort study used 2 waves of survey data administered approximately 5 years apart (time 1 [T1; September 26, 2014, to August 25, 2016] and time 2 [T2; October 23, 2019, to August 31, 2021]) from the Millennium Cohort Study, a population-based military study. Participants were US active-duty service members within 24 months of separating from military service at T1. Statistical analysis was performed from September 2021 to May 2022. Exposures: Problematic anger was operationalized as scoring at least 12 points on the 5-item Dimensions of Anger Reactions scale at T1. Main Outcomes and Measures: Behavioral and functional health (depression, posttraumatic stress disorder, problem drinking, functional limitations), relationship health (relationship quality, coping with parental demands, social support), and economic health (major financial problems, financial insecurity, homelessness, employment status) were assessed at T2. Covariates, assessed at T1, included demographics, military characteristics, mental health, problem drinking, and physical health. Results: Of the 3448 participants, 2625 (76.1%) were male, 217 (6.3%) were Hispanic, 293 (8.5%) were non-Hispanic Black, and 2690 (78.0%) were non-Hispanic White; the mean (SD) age was 40.1 (8.5) years; 826 (24.0%) met criteria for problematic anger. Prevalence of problematic anger was 15.9% (95% CI, 12.2%-19.7%) 24 months prior to military separation and 31.2% (95% CI, 26.2%-36.2%) 24 months following separation. After adjusting for covariates, problematic anger was associated with greater likelihood of behavioral and functional health outcomes (eg, posttraumatic stress disorder: adjusted odds ratio, 1.55, 95% CI, 1.23-1.96), relationship health difficulties (eg, low social support: aOR, 1.66; 95% CI, 1.23-2.24), and economic difficulties (eg, substantial financial insecurity: aOR, 1.64; 95% CI, 1.13-2.39) at T2. Conclusions and Relevance: This cohort study found an association between prevalence of problematic anger during the military-to-civilian transition and problematic anger with subsequent adjustment difficulties among US service members. These findings suggest the need to equip service members proactively with skills to identify and manage anger as a way to support them before and during this period of transition.
- Subjects
SOCIAL support; CONFIDENCE intervals; TRANSITIONAL programs (Education); SOCIAL adjustment; MENTAL health; MEDICAL screening; PSYCHOLOGY of military personnel; ANGER; ODDS ratio; LONGITUDINAL method
- Publication
JAMA Network Open, 2022, Vol 5, Issue 7, pe2223236
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2022.23236