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Treatment of Co-occurring PTSD and Aggression: Current Psychotherapy and Pharmacological Approaches

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Abstract

Purpose of review

A substantial number of patients with posttraumatic stress disorder (PTSD) also experience problems with aggression; yet co-occurring PTSD and aggression have gained relatively little empirical attention. Given the functional impairment associated with both of these conditions, there is a clear need for empirically supported treatments that address both PTSD and aggression. The current review aims to summarize the existing literature on empirically supported treatments (including psychotherapy and psychopharmacology) for co-occurring PTSD and aggression.

Recent findings

Overall, a few treatments emerge as potentially effective in addressing co-occurring PTSD and aggression. Trauma-informed treatments and transdiagnostic treatments, in particular, represent promising approaches to the treatment of co-occurring aggression and PTSD; continued examination of the efficacy of these approaches is warranted. Although empirically supported treatments for PTSD lead to reductions in aggression, these reductions are similar to those seen in comparison conditions; thus, effects of empirically supported PTSD treatments may be due to common elements across psychotherapies. The current literature on pharmacological approaches suggests limited efficacy in treating co-occurring PTSD and aggression.

Summary

Taken together, the findings of this review point to a few promising treatments for co-occurring PTSD and aggression and highlight the need for continued work in this area. Researchers should work to develop novel treatments for PTSD and aggression that are grounded in a theoretical understanding of their co-occurrence.

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Acknowledgements

Dr. Krauss is supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Central Texas VA Health Care System, and the VISN 17 Center of Excellence for Returning War Veterans. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Department of Veterans Affairs or the US Government.

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Authors and Affiliations

  1. VISN 17 Center of Excellence for Research On Returning War Veterans, Central Texas Veterans Health Care System, 4800 Memorial Drive (151C), Waco, TX, 76711, USA

    Alison Krauss PhD & Suzannah K. Creech PhD

  2. Department of Psychology, Temple University, Philadelphia, PA, USA

    Michael S. McCloskey PhD

  3. Department of Psychiatry and Behavioral Sciences, Dell Medical School of the University of Texas at Austin, Austin, TX, USA

    Suzannah K. Creech PhD

  4. VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA

    Marianne Goodman MD

  5. Icahn School of Medicine at Mt. Sinai Hospital, New York, NY, USA

    Marianne Goodman MD

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  3. Suzannah K. Creech PhD
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  4. Marianne Goodman MD
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Correspondence to Alison Krauss PhD.

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Krauss, A., McCloskey, M.S., Creech, S.K. et al. Treatment of Co-occurring PTSD and Aggression: Current Psychotherapy and Pharmacological Approaches. Curr Treat Options Psych 10, 35–49 (2023). https://doi.org/10.1007/s40501-023-00282-w

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