Associations of warzone veteran mental health with partner mental health and family functioning: Family Foundations Study.

INTRODUCTION: Warzone participation is associated with increased risk of stress-related psychopathology, including posttraumatic stress disorder (PTSD) and depression. Prior research suggests that the mental health of spouses of warzone veterans (WZVs) is linked to that of their partners. Additionally, PTSD among WZVs has been associated with marital dysfunction. Less is known about the effects of depression among WZVs on partner mental health and family relationships. We sought in this study to examine associations between WZV PTSD and depression and partner mental health and relationship outcomes. METHODS: Using a nationally dispersed sample of Iraq and Afghanistan veterans and their married and unmarried intimate partners, 245 dyads completed structured psychiatric interviews and psychometric surveys assessing family functioning and relationship aggression. RESULTS: Adjusted regression analyses indicated that depression among WZVs was associated with partner depression and anxiety disorders. WZV PTSD and depression were also associated with partner-reported relationship dysfunction, dissatisfaction, and communication issues, and higher rates of intimate partner aggression victimization and perpetration. CONCLUSIONS: Mental health consequences of war extend beyond WZVs to the mental health of their intimate partners and their relationships with intimate partners.

The Role of Impulsivity in the Association Between Posttraumatic Stress Disorder Symptom Severity and Substance Use in Male Military Veterans.

High rates of posttraumatic stress disorder (PTSD) and comorbid substance use disorder (SUD) are prevalent in military veterans. However, few studies have investigated impulsivity as a risk factor for engaging in substance use behavior for individuals who are experiencing PTSD symptoms. The present study evaluated impulsivity as a moderator of the association between PTSD symptoms and alcohol/drug use. Male military veterans (N = 106) completed self-report measures of alcohol use behavior, drug use behavior, and impulsivity. Participants also completed a structured diagnostic interview to assess for PTSD. The findings indicated that impulsivity moderated the relation between total PTSD symptoms and alcohol use, B = 0.01, p = .035, along with associations between alcohol use and two of the symptom clusters: PTSD reexperiencing symptoms, B = 0.01, p = .016; and PTSD avoidance/numbing symptoms, B = 0.01, p = .029. Veterans with high levels of impulsivity were at significantly higher risk of engaging in alcohol use than veterans with low-to-average levels. Impulsivity did not potentiate the relation between PTSD hyperarousal symptoms and alcohol use nor did it moderate the association between any of the PTSD variables and drug use. Impulsivity appears to serve as a significant risk factor for alcohol use, but not drug use, for male veterans experiencing PTSD symptoms. Future studies are necessary to replicate and expand upon these findings, particularly to facilitate the development of integrated evidence-based treatments that target both alcohol use and impulsivity within the context of PTSD.

National implementation of a trauma-informed intervention for intimate partner violence in the Department of Veterans Affairs: first year outcomes.

BACKGROUND: The U.S. Department of Veterans Affairs (VA) has recently implemented a comprehensive national program to help veterans who use or experience intimate partner violence (IPV). One important component of this plan is to implement Strength at Home (SAH), a 12-week cognitive-behavioral and trauma-informed group treatment designed to reduce and end IPV use among military and veteran populations. METHOD: The present study describes initial patient and clinician findings from the first year of a training program tasked with implementing SAH at 10 VA medical centers. RESULTS: Results from 51 veterans who completed both pre- and post-treatment assessments indicate SAH was associated with significant pre- to post-treatment reductions in the proportion of veterans who reported using physical and psychological IPV toward a partner, the types of IPV used, and posttraumatic stress disorder symptoms. Overall, veterans reported high satisfaction with the quality and nature of services received, and with the program materials. In addition, 70% of sites and 34% of the 79 clinicians trained were successful in launching the program in the first year. The mean number of days between site training and initiation of the first group session was 135.86 (SD = 63.16, range 72-252). CONCLUSIONS: Results suggest that the training and implementation program was successful overall. However, average length of time between in-person training and initiation of group services was longer than desired and there were three sites that did not successfully implement the program within the first year, suggesting a need to reduce implementation barriers and enhance institutional support.

The Impact of Infidelity on Combat-Exposed Service Members.

This study examined relationships between combat-exposed Operation Enduring Freedom/Operation Iraqi Freedom veterans' experiences related to infidelity during deployment (i.e., indicating that a partner was unfaithful or reporting concern about potential infidelity) and postdeployment mental health, as well as the role of subsequent stress exposure and social support in these associations. The sample consisted of 571 individuals (338 men). There were 128 participants (22.2%) who indicated that their partners were unfaithful during their most recent deployment. Of the remaining 443 participants, 168 (37.8%) indicated that they were concerned that their partners might have been unfaithful. Individuals who indicated that their partners were unfaithful exhibited higher levels of posttraumatic stress symptomatology (ß = .08; f(2) = .18) and depression symptom severity (ß = .09; f(2) = .14), compared to individuals who did not indicate that their partners were unfaithful. For both men and women, reported infidelity was associated with mental health indirectly via postdeployment life stressors, whereas infidelity concerns were indirectly associated with mental health via postdeployment life stressors for men only. Findings suggested that infidelity can have a significant impact on combat-exposed veterans' mental health and highlight the need for additional research on this understudied topic within the military population.

Social Information Processing in Anger Expression and Partner Violence in Returning U.S. Veterans.

We examined social information processing factors that could represent pathways through which posttraumatic stress disorder (PTSD) symptoms relate to anger expression and intimate partner violence (IPV) perpetration in returning U.S. veterans. The sample included 92 male Operation Enduring Freedom/Operation Iraqi Freedom veterans, primarily Caucasian (77.4%), with smaller numbers of African American, Asian, Hispanic or Latino, American Indian or Alaskan Native, and other minority participants (9.7%, 2.2%, 2.2%, 3.2%, and 5.3% respectively). The average age was 40.37 (SD = 9.63) years. Data were collected through self-report questionnaires (PTSD Checklist, State-Trait Anger Expression Scale, Revised Conflict Tactics Scales) and the Articulated Thoughts in Simulated Situations experimental protocol. Laboratory-based assessment of cognitive biases and hostile attributions were tested as mediators of associations between PTSD symptoms and anger expression and IPV. Among the PTSD symptom clusters, hyperarousal symptoms were most strongly associated with anger expression (r = .50) and IPV perpetration (r = .27). Cognitive biases mediated associations between PTSD total scores and 3 of 4 PTSD cluster scores as well as anger expression. Hostile attribution biases were also associated with IPV perpetration (r = .23). We discuss the implications of these findings for understanding social information processing mechanisms for the relationship between PTSD symptoms and aggression.

Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans.

BACKGROUND: Violence towards others in the community has been identified as a significant problem for a subset of Iraq and Afghanistan veterans. AIMS: To investigate the extent to which post-traumatic stress disorder (PTSD) and other risk factors predict future violent behaviour in military veterans. METHOD: A national, multiwave survey enrolling a random sample of all US veterans who served in the military after 11 September 2001 was conducted. A total of 1090 veterans from 50 US states and all military branches completed two survey waves mailed 1 year apart (retention rate = 79%). RESULTS: Overall, 9% endorsed engaging in severe violence and 26% in other physical aggression in the previous year, as measured at Wave 2. Younger age, financial instability, history of violence before military service, higher combat exposure, PTSD, and alcohol misuse at Wave 1 were significantly associated with higher severe violence and other physical aggression in the past year at Wave 2. When combinations of these risk factors were present, predicted probability of violence in veterans rose sharply. Veterans with both PTSD and alcohol misuse had a substantially higher rate of subsequent severe violence (35.9%) compared with veterans with alcohol misuse without PTSD (10.6%), PTSD without alcohol misuse (10.0%) or neither PTSD nor alcohol misuse (5.3%). Using multiple regression, we found that veterans with PTSD and without alcohol misuse were not at significantly higher risk of severe violence than veterans with neither PTSD nor alcohol misuse. There was a trend for other physical aggression to be higher in veterans with PTSD without alcohol misuse. CONCLUSIONS: Co-occurring PTSD and alcohol misuse was associated with a marked increase in violence and aggression in veterans. Compared with veterans with neither PTSD nor alcohol misuse, veterans with PTSD and no alcohol misuse were not significantly more likely to be severely violent and were only marginally more likely to engage in other physical aggression. Attention to cumulative effects of multiple risk factors beyond diagnosis--including demographics, violence history, combat exposure, and veterans' having money to cover basic needs like food, shelter, transportation, and medical care--is crucial for optimising violence risk management.

Predictors of veteran attendance in an intimate partner violence intervention.

This study examined session attendance data from 2,754 veterans who participated in a national implementation of a trauma-informed intimate partner violence intervention, Strength at Home, across the Veterans Affairs Healthcare System. Potential correlates of attendance were demographic characteristics, posttraumatic stress disorder (PTSD) symptom severity, alcohol use, court involvement, current military involvement, and intervention modality (in-person vs. virtual). Given the trauma-informed nature of the intervention, it was expected that trauma-relevant risk factors, specifically PTSD symptom severity and racial minority status, would be less strongly associated with attendance than barriers related to other demographic variables and higher alcohol use, intervention modality, and court involvement. Results indicated that age, education level, employment status, retirement status, PTSD symptom severity, alcohol use, and court involvement were associated with session attendance in the expected direction at the bivariate level. Only education level, employment status, retirement status, alcohol use, and court involvement emerged as unique predictors of attendance such that more educated, employed, retired, and court-mandated veterans with less alcohol use attended more sessions. These findings suggest the importance of a trauma-informed, coordinated community response to intimate partner violence intervention and integration of motivational components surrounding problematic alcohol use to enhance compliance and mitigate barriers to attendance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Examining strength at home couples to prevent intimate partner violence on a military installation: A randomized controlled trial.

OBJECTIVES: In this study, the effectiveness of a couples-based group intervention to prevent intimate partner violence (IPV), Strength at Home Couples (SAH-C), was examined on a military installation relative to a comparison intervention, Supportive Prevention (SP). It was expected that greater reductions in use of physical, psychological, and sexual IPV behaviors, as well as reduced suicidality, would be found among service members and their partners in SAH-C relative to SP. METHOD: Participants included 138 couples randomized to SAH-C and SP through a clinical controlled trial embedded in a hybrid effectiveness implementation study which took place on a military installation. The Revised Conflict Tactics Scales and Multidimensional Measure of Emotional Abuse were used to measure IPV, and 13 Military Suicide Research Consortium common data elements were used to assess suicidality. RESULTS: Service members randomized to SAH-C evidenced greater reductions based on effect sizes across the assessment time points for all IPV variables, including use of overall physical IPV, severe physical IPV, sexual IPV, psychological IPV, and coercive control IPV relative to those randomized to SP. Partners of service members demonstrated a similar general pattern for reductions in use of IPV, but findings were not as robust as for service members. Both service members and partners demonstrated greater reductions in suicidality based on effect sizes when randomized to SAH-C relative to SP. CONCLUSIONS: Findings extend prior work demonstrating the promising effects of SAH-C delivered in the military context and highlight the possible benefits of SAH-C in preventing self-harm thoughts and behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of coping style and PTSD on family functioning after deployment in Operation Desert Shield/Storm returnees.

The relationship between military combat and postdeployment family functioning difficulties has been frequently investigated in the literature, as has the relationship between types of coping and posttraumatic stress disorder (PTSD). Few studies, however, have examined these variables together, and no studies of which we are aware have examined the effect of coping on family functioning after combat exposure. This study examined coping style measured immediately after return from deployment, and PTSD symptoms and family functioning 18-24 months after return from deployment in a sample of Operation Desert Shield/Storm veterans (N = 2,949). Structural equation models suggested that the relationships between distinct coping styles on family functioning were differentially mediated by postdeployment PTSD symptoms. Results are consistent with full mediation for avoidant coping (ßdirect = -.09, p = .07; ßindirect = -.17, p < .001) and partial mediation for approach coping (ßdirect = .16, p < .001; ßindirect = .09, p < .001). Results suggest that the strategies used to cope with a combat stress event may impact both PTSD and family functioning outcomes, and highlight the potential utility of pre- and postdeployment coping skills training.

Maladaptive dependency schemas, posttraumatic stress hyperarousal symptoms, and intimate partner aggression perpetration.

This study examined the associations between maladaptive dependency-related schemas, posttraumatic stress disorder (PTSD) hyperarousal symptoms, and intimate-partner psychological and physical aggression in a sample of court-referred men (N = 174) participating in a domestic-abuser-intervention program. The men were largely African American; average age was 33.5 years. The extent to which hyperarousal symptoms moderated the association between dependency schemas and aggression was also examined. Maladaptive dependency-related schemas were positively associated with severe psychological, and mild and severe physical aggression perpetration. Hyperarousal symptoms were positively associated with mild and severe psychological aggression, and mild physical aggression perpetration. Multiple regression analyses showed a significant interaction for mild physical aggression: For those with high levels of hyperarousal symptoms, greater endorsement of maladaptive dependency schemas was associated with the perpetration of aggression (B = 0.98, p = .001). For those with low levels of hyperarousal symptoms, there was no association between dependency schemas and aggression (B = 0.04, ns). These findings suggest that focusing on problematic dependency and PTSD-hyperarousal symptoms in domestic-abuser-intervention programs may be helpful, and that examining related variables as possible moderators between dependency schemas and intimate aggression would be a fruitful area for future research.

A dyadic analysis of the influence of trauma exposure and posttraumatic stress disorder severity on intimate partner aggression.

This study used structural equation modeling to evaluate a mediation model of the relationship between trauma exposure, posttraumatic stress disorder (PTSD) symptoms, and perpetration of intimate partner physical and psychological aggression in trauma-exposed veterans and their cohabitating spouses (n = 286 couples; 88% male veteran and female spouse, 80.8% White, non-Hispanic). Dyadic data analyses were used to simultaneously evaluate actor and partner effects using the actor-partner interdependence model (Kashy & Kenny, 2000). The primary hypothesis was that PTSD would mediate the association between trauma exposure and intimate partner physical and psychological aggression with these effects evident both within and across members of a couple (i.e., actor and partner effects). The best-fitting model included (a) equivalent actor and partner direct effects of trauma on veterans' acts of psychological aggression (ß = .17 to .20, p = .001), and (b) equivalent actor and partner indirect effects via PTSD on veterans' acts of physical aggression (ß = .08 to .10, p < .001). There were no direct or indirect effects predicting the spouses' aggression. Results suggest it is important to consider the trauma histories and possible presence of PTSD in both partners as this may be a point of intervention when treating distressed couples.

Evaluation of the Strength at Home Group Intervention for Intimate Partner Violence in the Veterans Affairs Health System.

Importance: Intimate partner violence (IPV) is a serious and prevalent public health issue that is interconnected with experiences of trauma, mental and physical health difficulties, and health disparities. Strength at Home (SAH) is a group intervention for persons using IPV in their relationships. Although previous studies have provided evidence of SAH's effectiveness in reducing IPV, its patient outcomes as implemented within organized health care have not been examined. Objective: To evaluate patient outcomes from implementation of SAH in the Department of Veterans Affairs (VA) health system. Design, Setting, and Participants: This quality improvement study evaluated patient outcomes from a national implementation and training program conducted between December 11, 2015, and September 24, 2021. Data were collected as part of treatment and submitted by clinicians at 73 VA health care facilities. Patients were 1754 veterans seeking care aimed at addressing and/or preventing their use of aggression in intimate relationships. They completed 1 pretreatment assessment and 1 follow-up assessment in the immediate weeks after group completion. Intervention: Strength at Home is a 12-week trauma-informed and cognitive behavioral group intervention to address and prevent the use of IPV in relationships. Main Outcomes and Measures: Changes in IPV were measured with the Centers for Disease Control and Prevention 2010 National Intimate Partner and Sexual Violence Survey. Changes in posttraumatic stress disorder (PTSD) symptoms were measured with the PTSD Checklist for DSM-5, and alcohol misuse was measured with the Alcohol Use Disorders Identification Test. Results: The study included 1754 participants (mean [SD] age, 44.3 [13.0] years; 1421 men [81%]), of whom 1088 (62%) were involved with the criminal legal system for IPV charges. Analyses indicate that SAH was associated with reductions in use of physical IPV (odds ratio, 3.28; percentage difference from before to after treatment, -0.17 [95% CI, -0.21 to -0.13]) and psychological IPV (odds ratio, 2.73; percentage difference from before to after treatment, -0.23 [95% CI, -0.27 to -0.19]), coercive control behaviors (odds ratio, 3.19; percentage difference from before to after treatment, -0.18 [95% CI, -0.22 to -0.14), PTSD symptoms (mean change, -4.00; 95% CI, 0.90-7.09; Hedges g = 0.10), and alcohol misuse (mean change, 2.70; 95% CI, 1.54-3.86; Hedges g = 0.24). Conclusions and Relevance: In this quality improvement study of the patient outcomes after implementation of SAH, results suggested that the program was associated with reductions in IPV behaviors, PTSD symptoms, and alcohol misuse. Results also suggest that IPV intervention in routine health care at VA health care facilities was successful; extension to other organized health care systems could be warranted.

Women's Disengagement Behaviors During Couple Conflict: Investigating Risk Indicators of Intimate Partner Violence.

Intimate partner violence (IPV) is a major public health concern, leading to prevention efforts focused on identifying risk indicators of escalating conflict between partners. Certain behaviors during conflict discussions have been uniquely linked to IPV, and there is evidence that disengagement behaviors-an emerging construct-are associated with IPV as well. However, research on disengagement and IPV has largely been limited to self-report, and available observational research is largely cross-sectional. Addressing these limitations, this study prospectively examined the association between observed disengagement behaviors during couple's conflict discussions and IPV 1 year later, using a sample of 83 heterosexual married or cohabitating partners. Behavioral coding was used to assess each partner's observed disengagement behaviors and each partner's psychological and physical IPV was assessed via questionnaire 1 year later. Linear regressions were used to investigate links between indicators of engagement (i.e., listening, questions, eye contact) and psychological and physical IPV perpetration and victimization. Less question asking and higher eye contact by women were associated with greater psychological and physical IPV perpetrated by both women and men 1 year later. Lower listening behaviors by women were associated with greater psychological (but not physical) IPV perpetrated by men 1 year later. In contrast, no disengagement behaviors displayed by men were significantly related to IPV. Applying a latent change score framework using baseline IPV data, findings indicated replicability of results, though with less consistency, suggesting that women's disengagement behaviors may reflect a larger pattern of abuse that predates and follows disengaged couple interactions. Findings suggest that a unique blend of verbal and nonverbal indicators of women's disengagement during couple conflict provides a meaningful signal of the emotional climate of the relationship.

Trauma-informed parenting intervention for veterans: A preliminary uncontrolled trial of Strength at Home-Parents.

Trauma exposure and posttraumatic stress disorder (PTSD) are highly prevalent in military and veteran populations and are associated with parenting difficulties. Unfortunately, there is a lack of accessible, trauma-informed, and evidence-based parenting support interventions within the Department of Veterans Affairs (VA). Strength at Home-Parents (SAHP) is a trauma-informed psychotherapy group that aims to improve parenting behaviors and overall parent-child and family functioning among U.S. military veterans with PTSD symptoms. SAHP was developed to maximize ease of use by VA providers and accessibility for parents. Here we report data from an uncontrolled trial of SAHP delivered using synchronous video technology in a sample of veterans using VA care (N = 53) who met the criteria for PTSD and parent-child functioning difficulties. Enrollment and retention rates met study goals and suggest feasibility and acceptability of study methods. Significant pre- to postintervention improvements were observed in measures of dysfunctional discipline, parenting stress, general family functioning, child psychosocial functioning, and parental PTSD and depression symptoms. Coupled with high satisfaction ratings, findings support further study of the intervention, including in an efficacy trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining aggression in male Vietnam veterans who receive VA services: the role of traumatic events and combat exposure.

We examined the relationship between trauma exposure and the perpetration of aggression by male Vietnam veterans (N = 1,328) using archival data from a multisite study conducted by the Cooperative Studies Program of the Department of Veteran Affairs (CSP-334) in the early 1990s. Both traumatic events in civilian life and combat exposure were examined as correlates of aggression. Results indicated that pre- and postmilitary traumatic events and combat exposure were all related to perpetration of aggression at the bivariate level; r = .07, r = .20, and r = .13, respectively. When these variables were examined simultaneously, only combat exposure (ß = .14, p < .001) and postmilitary traumatic events (ß = .20, p < .001) were associated with aggression. No interaction effects were found for civilian traumatic events and combat in relation to aggression. Results highlight the importance of attending to the psychological aftermath of exposure to traumatic events experienced during and following deployment before aggressive patterns develop.

Examining gender differences in the relationship between dating violence victimization and anger in college students.

It has been well established that dating violence victimization is associated with various mental health problems. Relatively, little is known about similarities and differences between mental health correlates of dating violence victimization for males and females. We examined the associations between physical and psychological victimization experiences and measures of anger in a sample of 200 male and female undergraduates. Results suggest that men's victimization was more strongly associated with different forms of anger than women's victimization.

An examination of general aggression and intimate partner violence in women with posttraumatic stress disorder.

Research has documented significant relationships between posttraumatic stress disorder (PTSD), aggression, and intimate partner violence (IPV). Most of these studies have focused on men and measured violence by self-report. This study examined (a) the association between PTSD and general aggression among women, (b) the association between IPV and PTSD among married and/or cohabitating couples, and (c) the concordance between self and collateral reports of IPV. One hundred twenty participants provided information about PTSD symptoms and general aggression toward others, and 43 married and/or cohabitating couples provided information about PTSD and IPV. Women with PTSD reported more general aggression, IPV perpetration, and IPV victimization. Collateral informants of those with and without PTSD did not differ significantly in their report of IPV. Concordance between participants and spouses or partners was low to moderate. These results are discussed within the context of extant IPV literature.

Does strength at home for couples prevent sexual aggression in returning veterans? Examining randomized controlled trial findings.

OBJECTIVE: Sexual aggression between intimate partners is a serious problem. This study examined this problem in returning male veterans and their female partners, and the effectiveness of an intervention for intimate partner violence (IPV) in preventing sexual aggression using data gathered during a randomized controlled trial. METHOD: Rates of sexual aggression and the effectiveness of the Strength at Home Couples (SAH-C) intervention were examined in a sample of 69 couples with a returning male veteran from Iraq/Afghanistan who participated in a randomized controlled trial for intimate partner violence (IPV) prevention. Couples were assessed at 4 timepoints: immediately prior to the intervention, immediately following the intervention, 6 months postintervention, and 12 months postintervention. RESULTS: It was found that 57% of couples reported the presence of intimate partner sexual aggression in their relationship across the assessment points, with higher rates reported at baseline than other time points and for veterans relative to their partners. The most commonly endorsed items were "I insisted on sex when my partner didn't want to" and "I made my partner have sex without a condom." Overall, couples randomized to SAH-C showed greater declines in sexual aggression than couples who were randomized to Supportive Prevention, with particularly strong differences across conditions from baseline to posttreatment. CONCLUSIONS: These data suggest that this trauma-informed couples-based intervention based on a social information processing model may assist in reducing intimate partner sexual aggression and builds on prior findings demonstrating the program be associated with the prevention of physical and psychological IPV. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pilot trial of Strength at Home Parents, a trauma-informed parenting support treatment for veterans.

PTSD is associated with compromised parenting which is not adequately addressed in available evidence-based PTSD treatments. Strength at Home - Parents (SAHP) is a trauma-informed parenting intervention which aims to improve parenting behaviors and overall parent-child functioning. Here we report pilot data obtained in a sample of veterans (N=21) with PTSD and parent-child functioning difficulties. Results support feasibility of study methods, and intervention acceptability, credibility and satisfaction. Movement on primary outcome measures suggested improved overall family functioning, a decrease in the use of dysfunctional parenting practices, an increase in positive parenting practices and a trend towards a reduction in parenting stress. Results should be interpreted with caution because of the small sample size and attrition at follow-up. Limitations withstanding, findings support further study of the intervention, which would provide insights into whether an efficacy trial is indicated.

Neurocognitive Performance Predicts Future Partner Violence Among U.S. Iraq-and Afghanistan-deployed Army Soldiers and Veterans.

Objective: Intimate partner violence (IPV) constitutes a major U.S. national health concern and disproportionately affects military families. Prior research, which has been conducted primarily in civilian populations, suggests that relative neurocognitive weaknesses may increase risk for IPV. This prospective study examined the associations between post-deployment neurocognitive performance and subsequent IPV (5-13 years later) among warzone veterans in the context of psychological health and TBI. Method: Participants were 217 warzone veterans from a nationally-dispersed sample of service members and veterans who had previously deployed to the Iraq war zone and their intimate partners. Warzone veterans had previously completed performance-based neurocognitive assessments at a post-deployment assessment. An average of eight years later, participants completed structured psychiatric interviews and psychometric surveys assessing TBI history, posttraumatic stress disorder (PTSD), depression, alcohol use, and IPV perpetration. Results: Regression analyses revealed that relatively greater psychopathology and history of TBI were significantly associated with more frequent warzone veteran IPV psychological perpetration. Further, relatively poorer post-deployment neurocognitive performance predicted higher subsequent psychological and physical IPV perpetration, adjusting for demographics, psychological health, and TBI. Conclusions: Our findings highlight the importance of identifying both psychological/behavioral and neurocognitive correlates of IPV among warzone veterans. An integrative understanding of IPV risk can help inform both IPV prevention and treatment efforts for warzone veterans.