The Non-Connection between Post Traumatic Stress Disorder (PTSD) and Violence

© Copyright 2014 by Gretchen Passantino Coburn

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As the capital murder trial of the alleged murderer of Navy SEAL “American Sniper” Chris Kyle (and his friend Chad Littlefield) begins in May, the topic will be repeatedly raised that suspect Eddie Ray Routh’s previous military service and Post Traumatic Stress Disorder (PTSD) were precipitating factors in his attacks.

This is a false assumption in popular media, a favored excuse in criminal defense, and a pathetic attempt at justification for domestic violence. No substantiated causative correlation between PTSD and violence exists. There is, however, evidence that individuals with aggression, anger, and violence in their mental health and personal history who also suffer from PTSD may be handicapped by the PTSD from better controlling their destructive behavior. As Army psychologist Col. Rebecca I. Porter observed, “We’ve asked [experts] ‘How do we predict violence in a soldier?’ and they haven’t been able to provide us with a good screen . . . .The best predictor of future behavior is past behavior.” (1)

Citing PTSD as a causative factor in violent behavior (especially premeditated criminal behavior) is not only inaccurate. It also interferes with appropriate court adjudication and/or mental health treatment. Additionally, it casts aspersions on the vast majority of those with PTSD (whether combat veterans or not), leading loved ones, friends, employers, and society at large to unreasonable fear and rejection. Perhaps most poignantly, it makes it more difficult for those with PTSD to recognize their own situations, seek appropriate treatment, and reach out to those who can be supportive and encouraging.

This Case

On February 2, 2013, former Navy Seal sniper Chris Kyle and his friend Chad Littlefield took veteran Eddie Ray Routh to a local shooting range in Texas as part of Kyle’s ongoing work with FITCO Cares Foundation, a non-profit organization benefiting veterans, veterans with disabilities, Gold Star families, and veterans suffering from PTSD. Routh, 25, is said to have opened fire on Kyle and Littlefield, killing both, before fleeing in Kyle’s truck. He was captured and arrested later the same day.

Authorities have not said what they think the motive was for the killings, although one of Routh’s family members said he wanted Kyle’s new truck, there is evidence Routh had taken illegal drugs earlier in the day, and he may have had a history of mental illness predating his military service. The Veteran’s Administration will not confirm that he was or was not diagnosed with PTSD. There were signs of anger management issues, impulsiveness, and substance abuse going back to his high school years. (Others said of him during that time period, “kinda hard to get along with,” “a standard trouble maker,” “didn’t show a whole lot of respect,” “always ready to fight,” and “had a chip on his shoulder.”) (2)

After he left the Marines, he exhibited serious signs of mental illness, including threatening to kill someone or himself, experiencing hallucinations and paranoia; and his high school heavy drinking deteriorated into extreme alcoholic binging. He was briefly hospitalized twice in the five months before the murders, both times because he had expressed an immediate threat to his own life or the life of someone else. Some mental health professionals not directly associated with his case say his symptoms and behavior may indicate schizophrenia and/or bipolar disorder instead of or in addition to PTSD. (2)

His defense team and multiple media stories are linking his alleged murderous actions to PTSD.

The Non-Causative Connection between PTSD and Violence

PTSD no more precipitated this violent criminal act than did military service. Unique factors of military service, combat experience, and PTSD instead may become unintentionally exploited by the individual’s previously existing propensities to impulsiveness, aggression, outbursts of anger, and/or acts of violence.

Someone who has uncontrolled anger & violence, whether as a component of mental illness, social aggression, or moral deficiency may well lash out repeatedly and in escalation, regardless whether he/she has ever served in the military and/or also suffers from PTSD.

While military service may make the individual more proficient at kinds of violence (more accurate shooting, for example), military service is actually designed to control & direct aggression in legal, socially sanctioned situations. And while PTSD may make the individual more prone to self-protection (maintaining vigilance, for example), PTSD is actually a mental/physiological mechanism for insulating an individual from perceived harm.

VA psychiatrist Jonathan Shay defines combat-related PTSD as “the persistence into civilian life, after danger, of the valid adaptations you made to stay alive when other people were trying to kill you.” He distinguishes between “uncomplicated” PTSD and the “complicated moral injury” that erodes the relative mental health of a PTSD sufferer to the point that he or she is unable to cope with ordinary daily life. If Routh suffers from PTSD, he might fall into this latter category. (3)

Andy O’Hara and Richard Levenson note, “The unfortunate result of this misinformation is that more and more cases are erroneously using the defense that PTSD is to blame for murders by veterans when, in fact, there were other emotional disorders and problems involved, including prior anger issues, Traumatic Brain Injury (TBI), and substance abuse, that were more likely responsible for the individual’s violent behavior.” (4)

Even the study that most strongly associates anger and violence with PTSD concludes that previous history of anger, aggression, and violence joined with substance abuse and with an irritability factor of PTSD may increase the statistical probability that an individual may act aggressively or violently, but “this research shows it’s a lot more complicated than that,” said study leader and forensic psychologist Eric B. Elbogen. (5) U. S. Public Health Captain Janet Hawkins echoes this noting, “the relationship between PTSD and interpersonal violence is not well understood” in her report on the complexities of pre-trauma behavior, the kinds of symptoms exhibited by a PTSD sufferer, and other complicating factors such as medical treatment, employment, family dynamics, etc. (6) Both reports note that the incidence of PTSD and violent acts is statistically low.

Conclusion

May this upcoming trial’s confusion of PTSD with violence and false assumption that those with PTSD are “ticking time bombs” be overcome by positive, fact-based, evidence that those with PTSD, whether from military combat or not, are deserving of our respect, encouragement, support, and acceptance in society. As O’Hara and Levenson lament, “The unfortunate consequence of this sensationalism, sadly, is to stigmatize not only veterans with PTSD, but all PTSD sufferers, as being potentially dangerous.” (4)

(For a good short treatment on respecting those with PTSD, see “Dispelling the Myths” from American’s Heroes at Work.) (7)

(1) Link Between PTSD and Violent Behavior Is Weak http://www.washingtonpost.com/national/health-science/link-between-ptsd-and-violent-behavior-is-weak/2012/03/31/gIQApYFZnS_story.html

(2) In the Crosshairs by Nicholas Schmidle (The New Yorker June 3, 2013).

http://www.newyorker.com/reporting/2013/06/03/130603fa_fact_schmidle

(3) Beyond PTSD to “Moral Injury” by Jeff Severns (On Being March 14, 2013).

http://www.onbeing.org/blog/beyond-ptsd-to-moral-injury/5069

(4) Does PTSD Cause Violence? by Andy O’Hara and Richard Levenson (The Badge of Life: Police Suicide Study).

http://www.policesuicidestudy.com/id13.html

(5) Combat Veterans with PTSD, Anger Issues More Likely to Commit Crimes: New Report by David Wood (Huffington Post October 9, 2012).

http://www.huffingtonpost.com/2012/10/09/veterans-ptsd-crime-report_n_1951338.html

(6) PTSD, Violent Behavior: What You Need to Know by Captain Janet Hawkins (Defense Centers Excellence August 29, 2013).

http://www.dcoe.mil/blog/13-08-29/PTSD_Violent_Behavior_What_You_Need_to_Know.aspx

(7) Dispelling the Myths About PTSD.

http://www.americasheroesatwork.gov/forEmployers/factsheets/dispellMyth/

(Disclosure: I am the proud wife of a USMC 2 time combat Vietnam Veteran whose PTSD has been evidence of his resilience, strength, and courage to face the abyss and not be swallowed up.)

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