When researchers linked a large cohort of UK military personnel to a national criminal records database they found that 11.0% (1369/12359) of them had a conviction for violent crime before, during, or after their service.

Lifetime prevalence of violent offending was particularly high in men under 30 years (521/2728; 20.6%).

Active combat (hazard ratio 1.53, 95% CI 1.15 to 2.03) and exposure to traumatic events were both associated with subsequent violent offending, even after accounting for the high prevalence of pre-service offences, poor educational attainment, younger age, and lower rank that characterised troops selected for combat roles.

Self reported alcohol misuse, aggresive behaviour, and symptoms of post-traumatic stress disorder were also associated with violent offending after return from active combat.

The researchers analysed two phases of questionnaire data from 13,856 military personnel, mostly male regulars (not reserves) serving in the army in non-officer ranks. Just over 9,000 responders were deployed to Iraq or Afghanistan during the study.

Interventions to prevent interpersonal violence in combat troops is the ultimate goal. Further exploration of the complex interactions reported in this study should take us one step closer.

Source: BMJ 2013;346:f1717.

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