Assessing the impact of combat trauma on the severity, expression, and course of posttraumatic stress disorder in justice-involved veterans.

Objective: Posttraumatic stress disorder (PTSD) is associated with criminal justice involvement in veterans, but it is unclear how trauma type influences this relationship. The present study examines the impact of combat trauma on the severity and course of PTSD and the relationship with criminogenic needs in justice-involved veterans.

Method: We conducted secondary analysis of data from 287 veterans with a criminal history admitted to mental health residential treatment. Participants completed interviews to assess PTSD symptom severity, criminal history, and criminogenic needs at the start of treatment and at 6 and 12 months. Bivariate analyses were conducted to determine differences between veterans with and without combat trauma on PTSD severity, criminal history, and criminogenic needs. Mixed-effect models were evaluated to assess changes in PTSD symptom severity over time based on trauma type.

Results: At baseline, veterans with combat-related trauma (n = 70; 24.4%) had significantly higher PTSD symptom severity (d = .29, p < .05), particularly hyperarousal symptoms (d = .42, p < .001), and higher hyperarousal scores at 12 months (d = 0.41, p < .05). While PTSD severity decreased over time for both groups, hyperarousal scores for the combat trauma group increased posttreatment from 6 to 12 months. Those with combat-related trauma scored higher on antisocial personality patterns, marked by callousness and aggression but did not differ in other measures of criminogenic needs or their criminal history.

Conclusions: The findings illustrate the need to consider trauma type in future research on the relationship between PTSD and justice involvement in veterans. (PsycInfo Database Record (c) 2025 APA, all rights reserved).