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Association of problematic anger with long-term adjustment following the military-to-civilian transition

APA Citation:

Adler, A. B., LeardMann, C. A., Villalobos, J., Jacobson, I. G., & Forbes, D. (2022). Association of problematic anger with long-term adjustment following the military-to-civilian transition. JAMA Network Open, 5(7), Article e2223236. https://doi.org/10.1001/jamanetworkopen.2022.23236

Abstract Created by REACH:

This study examined the prevalence of problematic anger (i.e., increased distress and decreased functioning) in 3,448 Service members during their transition out of the military using 2 waves of data. Participants separated from the military within 2 years before or after the baseline assessment (i.e., Time 1 [T1]) and provided data at a 5-year follow up (i.e., Time 2 [T2]). At T1, Service members/Veterans reported their anger reactions as well as their demographic (e.g., race) and military characteristics (e.g., rank, branch). At T2, they reported their mental health (e.g., depression, posttraumatic stress disorder [PTSD]), relationship health (i.e., relationship quality, coping with parental demands, and social support), and economic difficulties (e.g., employment status). Overall, those with problematic anger at T1 had a greater likelihood of experiencing mental health, relational, and economic difficulties at T2.


Mental health

Branch of Service:

Air Force
Marine Corps
Coast Guard
Multiple branches

Military Affiliation:

Active Duty

Subject Affiliation:

Active duty service member
Guard/Reserve member


Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Longitudinal Study
Quantitative Study


Adler, Amy B., LeardMann, Cynthia A., Villalobos, Javier, Jacobson, Isabel G., Forbes, David


Few studies have examined the role of problematic anger in long-term adjustment of service members transitioning out of the military.To determine the prevalence of problematic anger during the military-to-civilian transition period and the association of problematic anger with adjustment to civilian life.This cohort study used 2 waves of survey data administered approximately 5 years apart (time 1 [T1; September 26, 2014, to August 25, 2016] and time 2 [T2; October 23, 2019, to August 31, 2021]) from the Millennium Cohort Study, a population-based military study. Participants were US active-duty service members within 24 months of separating from military service at T1. Statistical analysis was performed from September 2021 to May 2022.Problematic anger was operationalized as scoring at least 12 points on the 5-item Dimensions of Anger Reactions scale at T1.Behavioral and functional health (depression, posttraumatic stress disorder, problem drinking, functional limitations), relationship health (relationship quality, coping with parental demands, social support), and economic health (major financial problems, financial insecurity, homelessness, employment status) were assessed at T2. Covariates, assessed at T1, included demographics, military characteristics, mental health, problem drinking, and physical health.Of the 3448 participants, 2625 (76.1%) were male, 217 (6.3%) were Hispanic, 293 (8.5%) were non-Hispanic Black, and 2690 (78.0%) were non-Hispanic White; the mean (SD) age was 40.1 (8.5) years; 826 (24.0%) met criteria for problematic anger. Prevalence of problematic anger was 15.9% (95% CI, 12.2%-19.7%) 24 months prior to military separation and 31.2% (95% CI, 26.2%-36.2%) 24 months following separation. After adjusting for covariates, problematic anger was associated with greater likelihood of behavioral and functional health outcomes (eg, posttraumatic stress disorder: adjusted odds ratio, 1.55, 95% CI, 1.23-1.96), relationship health difficulties (eg, low social support: aOR, 1.66; 95% CI, 1.23-2.24), and economic difficulties (eg, substantial financial insecurity: aOR, 1.64; 95% CI, 1.13-2.39) at T2.This cohort study found an association between prevalence of problematic anger during the military-to-civilian transition and problematic anger with subsequent adjustment difficulties among US service members. These findings suggest the need to equip service members proactively with skills to identify and manage anger as a way to support them before and during this period of transition.

Publisher/Sponsoring Organization:

JAMA Network

Publication Type:

REACH Publication

Author Affiliation:

Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, ABA
Deployment Health Research Department, Naval Health Research Center, CAL
Deployment Health Research Department, Naval Health Research Center, JV
Deployment Health Research Department, Naval Health Research Center, IGJ
Leidos, Inc, CAL
Leidos, Inc, JV
Leidos, Inc, IGJ
Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, DF


anger, problematic anger, military-to-civilian, adjustment

View Research Summary:

REACH Publication Type:

Research Summary


The Millennium Cohort Study is funded through the Military Operational Medicine Research Program, Defense Health Program, and Department of Veterans Affairs.

REACH Newsletter:

  January 2023

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