PTSD Boosts Risk of Violence, Legal and Financial Problems, and More

Veterans with posttraumatic stress disorder (PTSD) were much more likely than their counterparts to be a perpetrator or victim of violence and suffer from social, legal, and financial problems, a new retrospective analysis finds.

An analysis of 62,298 matched veterans found that those newly diagnosed with PTSD were more likely to be linked to violence (adjusted odds ratio [aOR], 3.98), social problems (aOR, 2.87) legal problems (aOR, 1.75), and financial problems (aOR, 2.01), reported Ouyang et al in the November 2025 issue of the Journal of Affective Disorders.

A separate analysis of 11,758 propensity-matched veterans found that those with PTSD were more likely to experience violence (50.15% vs 11.26%), social problems (64.44% vs 25.32%), legal problems (24.84% vs 8.07%), and financial problems (48.60% vs 19.21%). 

The study does not prove that PTSD is directly linked to these problems. However, Ouyang told Federal Practitioner that the findings suggest "PTSD extends beyond psychiatric symptoms: It significantly impacts economic stability, housing security, and legal safety."

Clinicians should screen for various problems in patients with PTSD, Ouyang said, “particularly given that the risk is highest during the first year.” The study also sought to better understand the effects of PTSD over time.

“While it is established that PTSD creates serious challenges regarding employment, family dynamics, and substance use, most previous studies provided only a cross-sectional snapshot,” Ouyang said. “We aimed to understand the progression over a 10-year period.”

In addition, “previous studies relied heavily on standard diagnosis codes and missed a significant amount of unstructured data,” she said. The new study uses natural language processing, an artificial intelligence field that parses the words people use, to gain insight from clinical notes.

In the cross-sectional analysis of 62,298 veterans, including 31,149 diagnosed with PTSD in the 2011-2012 fiscal year and 31,149 without PTSD (average age 60, 91.49% male, 71.50% White and 19.27% Black), PTSD was linked to higher rates of housing instability (aOR, 1.65), barriers to care (aOR, 1.45), transitions of care (aOR, 1.58), food insecurity (aOR, 1.37), and nonspecific psychosocial needs (aOR, 1.31).

Why might PTSD be linked to violence, which was defined as perpetrated by or against the veteran?

“The primary theory centers on hyperarousal, a symptom of PTSD characterized by a state of constant high alert and anxiety,” Ouyang said. “This state creates difficulties in emotional regulation and impulse control, which can lead to aggressive reactions.”

Patients are also at risk of revictimization, Ouyang added, “where the erosion of social support networks leaves veterans more vulnerable to harm from others.”

Aspects of PTSD are also thought to contribute to problems other than violence, Ouyang said. For example, mental health struggles can make it hard to keep a job and stay financially stable “and veterans may be hesitant to seek help due to stigma until the situation becomes critical, potentially leading to housing loss.”

In terms of solutions, “clinical treatment alone is insufficient,” she said. “We recommend an integrated health care model that combines mental health treatment with referrals to social work and economic support services to address the broader determinants of well-being.”

Brian Klassen, PhD, an associate professor with the Department of Psychiatry and Behavioral Sciences at Rush University Medical Center, reviewed the study for Federal Practitioner. 

The research “underscores how problematic the diagnosis of PTSD is for folks,” said Klassen, the director of Strategic Partnership for the Road Home Program/Center for Veterans and Their Families. “It plays out in lives in trouble with relationships, work, and housing, things like that.”

How PTSD cultivates a veteran’s everyday life is important for clinicians to understand, he said. “A lot of our treatments directly target symptoms: how to help people sleep better, manage their mood. This encourages practitioners to look at the whole person,” Klassen said. “What other kind of resource needs might this person have that are related to—or maybe caused by—their PTSD diagnosis?”

These resources can “include things like job training and housing and financial assistance, maybe help to get out in the community and form relationships with people.”

The US Department of Veterans Affairs and National Institutes of Health funded the study. The study authors and Klassen have no disclosures. 

Veterans with posttraumatic stress disorder (PTSD) were much more likely than their counterparts to be a perpetrator or victim of violence and suffer from social, legal, and financial problems, a new retrospective analysis finds.

An analysis of 62,298 matched veterans found that those newly diagnosed with PTSD were more likely to be linked to violence (adjusted odds ratio [aOR], 3.98), social problems (aOR, 2.87) legal problems (aOR, 1.75), and financial problems (aOR, 2.01), reported Ouyang et al in the November 2025 issue of the Journal of Affective Disorders.

A separate analysis of 11,758 propensity-matched veterans found that those with PTSD were more likely to experience violence (50.15% vs 11.26%), social problems (64.44% vs 25.32%), legal problems (24.84% vs 8.07%), and financial problems (48.60% vs 19.21%). 

The study does not prove that PTSD is directly linked to these problems. However, Ouyang told Federal Practitioner that the findings suggest "PTSD extends beyond psychiatric symptoms: It significantly impacts economic stability, housing security, and legal safety."

Clinicians should screen for various problems in patients with PTSD, Ouyang said, “particularly given that the risk is highest during the first year.” The study also sought to better understand the effects of PTSD over time.

“While it is established that PTSD creates serious challenges regarding employment, family dynamics, and substance use, most previous studies provided only a cross-sectional snapshot,” Ouyang said. “We aimed to understand the progression over a 10-year period.”

In addition, “previous studies relied heavily on standard diagnosis codes and missed a significant amount of unstructured data,” she said. The new study uses natural language processing, an artificial intelligence field that parses the words people use, to gain insight from clinical notes.

In the cross-sectional analysis of 62,298 veterans, including 31,149 diagnosed with PTSD in the 2011-2012 fiscal year and 31,149 without PTSD (average age 60, 91.49% male, 71.50% White and 19.27% Black), PTSD was linked to higher rates of housing instability (aOR, 1.65), barriers to care (aOR, 1.45), transitions of care (aOR, 1.58), food insecurity (aOR, 1.37), and nonspecific psychosocial needs (aOR, 1.31).

Why might PTSD be linked to violence, which was defined as perpetrated by or against the veteran?

“The primary theory centers on hyperarousal, a symptom of PTSD characterized by a state of constant high alert and anxiety,” Ouyang said. “This state creates difficulties in emotional regulation and impulse control, which can lead to aggressive reactions.”

Patients are also at risk of revictimization, Ouyang added, “where the erosion of social support networks leaves veterans more vulnerable to harm from others.”

Aspects of PTSD are also thought to contribute to problems other than violence, Ouyang said. For example, mental health struggles can make it hard to keep a job and stay financially stable “and veterans may be hesitant to seek help due to stigma until the situation becomes critical, potentially leading to housing loss.”

In terms of solutions, “clinical treatment alone is insufficient,” she said. “We recommend an integrated health care model that combines mental health treatment with referrals to social work and economic support services to address the broader determinants of well-being.”

Brian Klassen, PhD, an associate professor with the Department of Psychiatry and Behavioral Sciences at Rush University Medical Center, reviewed the study for Federal Practitioner. 

The research “underscores how problematic the diagnosis of PTSD is for folks,” said Klassen, the director of Strategic Partnership for the Road Home Program/Center for Veterans and Their Families. “It plays out in lives in trouble with relationships, work, and housing, things like that.”

How PTSD cultivates a veteran’s everyday life is important for clinicians to understand, he said. “A lot of our treatments directly target symptoms: how to help people sleep better, manage their mood. This encourages practitioners to look at the whole person,” Klassen said. “What other kind of resource needs might this person have that are related to—or maybe caused by—their PTSD diagnosis?”

These resources can “include things like job training and housing and financial assistance, maybe help to get out in the community and form relationships with people.”

The US Department of Veterans Affairs and National Institutes of Health funded the study. The study authors and Klassen have no disclosures. 

Veterans with posttraumatic stress disorder (PTSD) were much more likely than their counterparts to be a perpetrator or victim of violence and suffer from social, legal, and financial problems, a new retrospective analysis finds.

An analysis of 62,298 matched veterans found that those newly diagnosed with PTSD were more likely to be linked to violence (adjusted odds ratio [aOR], 3.98), social problems (aOR, 2.87) legal problems (aOR, 1.75), and financial problems (aOR, 2.01), reported Ouyang et al in the November 2025 issue of the Journal of Affective Disorders.

A separate analysis of 11,758 propensity-matched veterans found that those with PTSD were more likely to experience violence (50.15% vs 11.26%), social problems (64.44% vs 25.32%), legal problems (24.84% vs 8.07%), and financial problems (48.60% vs 19.21%). 

The study does not prove that PTSD is directly linked to these problems. However, Ouyang told Federal Practitioner that the findings suggest "PTSD extends beyond psychiatric symptoms: It significantly impacts economic stability, housing security, and legal safety."

Clinicians should screen for various problems in patients with PTSD, Ouyang said, “particularly given that the risk is highest during the first year.” The study also sought to better understand the effects of PTSD over time.

“While it is established that PTSD creates serious challenges regarding employment, family dynamics, and substance use, most previous studies provided only a cross-sectional snapshot,” Ouyang said. “We aimed to understand the progression over a 10-year period.”

In addition, “previous studies relied heavily on standard diagnosis codes and missed a significant amount of unstructured data,” she said. The new study uses natural language processing, an artificial intelligence field that parses the words people use, to gain insight from clinical notes.

In the cross-sectional analysis of 62,298 veterans, including 31,149 diagnosed with PTSD in the 2011-2012 fiscal year and 31,149 without PTSD (average age 60, 91.49% male, 71.50% White and 19.27% Black), PTSD was linked to higher rates of housing instability (aOR, 1.65), barriers to care (aOR, 1.45), transitions of care (aOR, 1.58), food insecurity (aOR, 1.37), and nonspecific psychosocial needs (aOR, 1.31).

Why might PTSD be linked to violence, which was defined as perpetrated by or against the veteran?

“The primary theory centers on hyperarousal, a symptom of PTSD characterized by a state of constant high alert and anxiety,” Ouyang said. “This state creates difficulties in emotional regulation and impulse control, which can lead to aggressive reactions.”

Patients are also at risk of revictimization, Ouyang added, “where the erosion of social support networks leaves veterans more vulnerable to harm from others.”

Aspects of PTSD are also thought to contribute to problems other than violence, Ouyang said. For example, mental health struggles can make it hard to keep a job and stay financially stable “and veterans may be hesitant to seek help due to stigma until the situation becomes critical, potentially leading to housing loss.”

In terms of solutions, “clinical treatment alone is insufficient,” she said. “We recommend an integrated health care model that combines mental health treatment with referrals to social work and economic support services to address the broader determinants of well-being.”

Brian Klassen, PhD, an associate professor with the Department of Psychiatry and Behavioral Sciences at Rush University Medical Center, reviewed the study for Federal Practitioner. 

The research “underscores how problematic the diagnosis of PTSD is for folks,” said Klassen, the director of Strategic Partnership for the Road Home Program/Center for Veterans and Their Families. “It plays out in lives in trouble with relationships, work, and housing, things like that.”

How PTSD cultivates a veteran’s everyday life is important for clinicians to understand, he said. “A lot of our treatments directly target symptoms: how to help people sleep better, manage their mood. This encourages practitioners to look at the whole person,” Klassen said. “What other kind of resource needs might this person have that are related to—or maybe caused by—their PTSD diagnosis?”

These resources can “include things like job training and housing and financial assistance, maybe help to get out in the community and form relationships with people.”

The US Department of Veterans Affairs and National Institutes of Health funded the study. The study authors and Klassen have no disclosures.