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Much has been written about the financial burden that the recent wars in Iraq and Afghanistan have caused the United States as well as the signature injuries of the wars: posttraumatic stress disorder (PTSD) and mild traumatic brain injury. An area that has gained relatively little attention is the lasting effect that prolonged combat will have on many members of the armed services and their families.

The experience of armed combat changes an individual in ways that cannot be fully predicted. Though growth can occur as a result of this experience, more commonly the effect is psychological injury that can arrest growth and cause disturbances in the person's ability to function at a normal level. Help is available to those who are identified or step forward for help, but it is widely recognized that relatively few individuals eligible for care ever enter the system. Consequently, a large population of combat veterans is facing complex and dangerous psychological insults as the result of combat, and they are doing it alone.

Symptoms of this problem include a steadily rising rate of suicide, a nearly twofold increase in the number of misdemeanors committed by soldiers (e.g., traffic infractions, driving under the influence, absence without leave), as well as more serious offenses (e.g., an increase in sexual assaults). These problems have been resistant to a dedicated effort of education and treatment because they are symptoms of a much more pervasive disease within the ranks.

Left untreated, psychological injuries are resistant to change and remain deeply ingrained within the psyche. Vietnam veterans provide a glimpse of the lasting detrimental effects of what untreated psychological combat injuries can do to an individual. There is no simple cause to the current problem faced by the military, but several causal factors have been identified to account for the rise in criminal behaviors among troops.

Admission waivers: The waiver of prior drug or other infractions (i.e., moral waivers) that were utilized in a time when recruitment goals were not being met. Some of these individuals went on to become exceptional members of the armed forces, but many others regressed back to their earlier difficulties with the law.

Stigma: Significant improvements have been made in the education of military service members on the effect of war-related psychological injuries. PTSD, traumatic brain injury, depression and suicide, and family stressors are all common knowledge to today's military members. In spite of the gains made in education, the stigma associated with seeking behavioral health care remains. Knowledge of one's difficulties is often not enough to overcome the hesitance to seek care.

Denial, depression, and escape: There remains another group of individuals who seek to address their own symptoms by whatever means are available. Alcohol is readily available and a potent means to attempt to drown out one's intrusive thoughts, guilt, anger, and so on. Excessive use can lead to fights, inability to function in one's job, DUI, and more. When alcohol is no longer sufficient to mask the psychological or physical pain, an individual may seek alternate drugs such as marijuana, cocaine, and others. This perpetuates the cycle and ultimately leads to detrimental effects on the individual and his or her family. When anger issues are combined with drugs, additional types of criminal behavior become more prevalent. This type of behavior can include crimes against people such as robbery, assault, homicide, and other actions that go against good order and discipline of the armed services.

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