exposure, perceived threat, atrocities exposure). However, the PTSD-positive/nonviolent group had the most childhood abuse (49%), over twice that of the other groups (21-23%). Both PTSD-positive groups both had more combat exposure than the PTSD-negative group; the PTSD-positive/partner-violent group had more exposure to combat and particularly to atrocities than the PTSD-positive/nonviolent group.

Secondary Studies

In addition to the primary studies that support the association between deployment and intimate partner violence after deployment, there are numerous supportive secondary studies. Studies that assess deployed vs nondeployed veterans are discussed first, followed by studies of intimate partner violence in veterans with and without PTSD.

McCarroll et al. (2003) surveyed a group of 313 male U.S. Army soldiers assigned to peacekeeping functions in Bosnia for 6 months from September 1998 to April 1999 and compared them with 712 male soldiers who had not deployed. The research team used the CTS to explore the incidence of intimate partner violence at two times: prior to September 1998, and April-June 1999. There were no significant demographic differences between the two groups; all participants were married, and deployed soldiers had been home from deployment for 90-113 days at the time of the survey. The rates of predeployment intimate partner violence did not differ between deployed and nondeployed soldiers (11.5% vs 10.3%) and deployment was not a significant predictor of later moderate or severe domestic violence (6.7% deployed vs 7.4% nondeployed). The strongest predictor of postdeployment domestic violence was a previous history of domestic violence (OR 4.56, 95% CI 2.60-8.00); the next-strongest was living off post (OR 2.71, 95% CI 1.39-5.32), which was followed by being nonwhite (OR 1.69, 95% CI 1.03-2.76). Although this study had a reasonably representative sample and deployment to a single area, behavior was assessed for the “honeymoon period,” which typically is not accompanied by heightened intimate partner violence, so the study may underestimate the degree of intimate partner violence that may later develop.

Several other secondary studies highlight the association between PTSD and intimate partner violence after deployment. Several of the studies of veterans with PTSD and intimate partner violence involved treatment populations; all were of Vietnam veterans, and, like the studies discussed above, many used data from the NVVRS.

Prigerson et al. (2002) used data from the 1990-1992 National Comorbidity Survey that sought to determine the prevalence of psychiatric disorders in a nationally representative sample of 2578 men 18-54 years old, of whom 1337 were currently married or cohabitating. Participants were asked about possible combat exposure and the CIDI was used to diagnose psychiatric disorders, except for PTSD, which was assessed for the previous 12 months with the DIS. The married or cohabiting men were asked about abuse of spouses or partners, and those who responded with “never” or “rarely” were counted as nonabusive. Combat exposure was associated with current spouse or partner abuse (relative risk [RR] 4.40, 95% CI 1.68-10.49, p = 0.004; adjusted for age, race, urbanicity, and low socioeconomic status in family of origin). Path analysis suggested that the effect of combat exposure on current spouse or partner abuse was indirect and mediated through PTSD.

Savarese et al. (2001) also analyzed the NSVG data on the 376 male Vietnam veterans and their female partners discussed above (Jordan et al. 1992) to examine the joint effects of drinking frequency, drinking quantity, and the severity of the hyperarousal symptoms of PTSD on marital abuse and violence. Of the 376 men, 315 (84%) indicated that they had engaged in at

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