Anger Among UK Veterans During the COVID-19 Pandemic: Results from the Veterans-CHECK Study

Anger is a basic human emotion that is experienced as a reaction to the unwanted or unexpected behaviour of others and often occurs after traumatic experiences, frustrations, and stressful situations. Research from the United States suggests up to a fifth of military serving and ex-serving personnel (i.e. veterans) experience difficulties with anger and aggression, with prevalence estimates for the UK Armed Forces reported at approximately 29% for all types of physical aggression, 13% for violent behaviour and 10% for physical assault.

Previous research has reported associations between intensity and frequency of exposure to combat trauma and an increase in violence. Anger is also associated with younger age, male sex and adverse childhood experiences (i.e. highly stressful events or situations that occur during childhood or adolescence, such as physical abuse, exposure to domestic violence and parental substance misuse).

Given the associations between anger and psychological distress among veterans, it was important to explore the impact of the COVID-19 pandemic on anger among this population. The novel coronavirus disease (COVID-19) was declared a global pandemic in March 2020. Despite being necessary to protect public health, the lockdowns and social distancing measures associated with the pandemic which aimed to slow the spread of infection had several negative social, economic, health and wellbeing consequences.

There remains little research regarding the ongoing impacts of the COVID-19 pandemic on the health and wellbeing of veterans, particularly in relation to anger difficulties. By better understanding the needs of veterans during the pandemic, treatment services and support can be re-evaluated to better align with their needs and begin to improve engagement and outcomes.

Aims of this study

To investigate the levels of anger difficulties among UK veterans during the COVID-19 pandemic.
To explore reported changes in anger difficulties compared to pre-pandemic levels.
To identify sociodemographic characteristics, military characteristics, COVID-19 experiences and stressors associated with anger difficulties.

What did we do?

The data was collected as part of a wider study of the mental health and wellbeing of veterans during the COVID-19 pandemic, Veterans-CHECK. Individuals were invited to complete an online survey between June and September 2020. The questionnaire was made up of three main sections: 1) sociodemographic and military characteristics, 2) COVID-19 experiences and stressors, and 3) current mental health and wellbeing. We assessed anger difficulties using a self-report anger measure and asked participants to rate how their feelings of anger had changed since before the pandemic from much worse to much better.

Who took part in Veterans-CHECK?

Participants were eligible if they:

Had completed the questionnaire at Phase 3 of the KCMHR Health and Wellbeing Study.
Had left the UK Armed Forces (i.e. were a veteran).
Had served as a Regular.
Were living in the UK.
Had consented to further contact and provided an email address.

Overall, 1,499 individuals completed the anger questions in the questionnaire.

What did we find?

We found that 14.4% of veterans reported anger difficulties during the COVID-19 pandemic, 24.8% felt that their anger had worsened during the pandemic compared to pre-pandemic levels, and these were influenced by several factors. Sociodemographic characteristics, such as certain age groups (i.e. younger age groups), living arrangements (i.e. living alone), and employment status (i.e. being economically inactive), all impacted on a higher likelihood of veterans reporting anger difficulties. Military characteristics, such as rank, were associated with the levels of anger, where Officers were less likely to report anger difficulties than lower ranks.

COVID-19 experiences, such as having moved out of home during the pandemic, having extra or new caring responsibilities during the pandemic, and knowing someone who died from COVID-19 were also associated with higher likelihood of anger difficulties. The most common COVID-19 stressors included difficulties with family/social relationships, boredom, and work difficulties, but experiencing any of the COVID-19 stressors was associated with higher likelihood of anger difficulties. The likelihood of anger difficulties increased around one and a half times for each additional COVID-19 stressor reported.

Conclusions

Our study identifies that specific COVID-19 experiences and stressors had an impact on veterans’ anger outcomes during the pandemic. This knowledge can be adopted by clinicians to ensure support is targeted at veterans who are at risk and provided in a timely manner especially as the impact of the COVID-19 pandemic may be ongoing. By developing our understanding of the impacts of the pandemic, we can be better equipped to support veterans into the future.

Want to know more?

You can read the research article here:

Williamson C, Jones M, Palmer L, Dighton G, Burdett H, Sharp M-L & Fear NT (2023). Anger Among UK Ex-Service Personnel During the COVID-19 Pandemic. Journal of Nervous and Mental Disease. [doi: 10.1097/NMD.0000000000001681]

To find out more about the findings from the Veterans-CHECK study you can read this blog post or research article.

For updates on this study and other work being conducted at KCMHR please follow @kcmhr on Twitter and take a look at our most recent blog posts.

Funding

The Veterans-CHECK study was funded by the Office for Veterans’ Affairs, Cabinet Office, UK Government, but was conducted by KCMHR which is a fully independent research group.