Indiana University-Purdue University Indianapolis (IUPUI) / This study investigates differences between Veterans and non-Veterans with severe mental illness (SMI) regarding perceptions of their illness, themselves, and treatment. I compare patient interviews (using the Indiana Psychiatric Illness Interview, IPII) of Veterans (N=20) and non-Veterans (N=26). Modified grounded theory and qualitative coding software Atlas-TI were used to develop codebooks for each group, and these were compared for differences. I examined differences in both code frequency and meaning. Statistically, more Veterans were male, employed, married, had higher income, and had higher education. Statistical differences in code frequency included: more Veterans discussing boredom, regret/guilt/loss, and wanting to be “normal.” More non-Veterans had codes of pessimism and religion/spirituality, wanting a different future, bringing up mental health, family, future: no change, life goals, and relapse. Key differences in narrative themes included: (1) Veterans’ “military mindset”/discussion of anger as part of mental illness, (2) non-Veterans’ focus on mental-illness, (3) differing attitudes regarding stigma, (4) active versus passive attitudes toward treatment, and (5) degree of optimism regarding the future. Differences are described and then potential relationships and interactions are proposed. Veterans appear to have several protective factors (i.e., finances, employment, marriage). Additionally, Veterans’ military-mindset seems to encourage greater stigma-resistance, and thereby also facilitate Veterans being more active and optimistic toward treatment and recovery. By contrast, non-Veteran focus on mental illness may be related to increased self-stigma, passive and pessimistic attitudes. I propose that Veteran identity can serve as an additional protective factor against stigma, pessimism, and passivity. Veteran-identity may also be a useful framework clinically, to help promote active approaches to treatment (e.g., “fighting symptoms”). Further, Veterans emphasized issues relating to anger as important and part of their mental health. It may be that Veterans are more comfortable discussing mental health in the language of “anger,” given stigma. Finally, findings suggest that helping individuals in both groups engage in meaningful, non-mental illness-related life activities may help shape self-perception, and thereby responses to stigma, attitudes toward treatment, and hope for the future.

This study examines the phenomenon of abusive violence (AV) in the context of the American Post-9/11 Counter-terrorism and Counter-insurgency campaigns. Previous research into atrocities by states and their agents has largely come from examinations of totalitarian regimes with well-developed torture and assassination institutions. The mechanisms influencing willingness to do harm have been examined in experimental studies of obedience to authority and the influences of deindividuation, dehumanization, context and system. This study used Interpretive Phenomenological Analysis (IPA) to examine the lived experience of AV reported by fourteen American military and intelligence veterans. Participants were AV observers, objectors, or abusers. Subjects described why AV appeared sensible at the time, how methods of violence were selected, and what sense they made of their experiences after the fact. Accounts revealed the roles that frustration, fear, anger and mission pressure played to prompt acts of AV that ranged from the petty to heinous. Much of the AV was tied to a shift in mission view from macro strategic aims of CT and COIN to individual and small group survival. Routine hazing punishment soldiers received involving forced exercise and stress positions made similar acts inflicted on detainees unrecognizable as abusive. Overt and implied permissiveness from military superiors enabled AV extending to torture, and extra-judicial killings. Attempting to overcome feelings of vulnerability, powerlessness and rage, subjects enacted communal punishment through indiscriminate beatings and shooting. Participants committed AV to amuse themselves and humiliate their enemies; some killed detainees to force confessions from others, conceal misdeeds, and avoid routine paperwork. Participants realized that AV practices were unnecessary, counter-productive, and self-damaging. Several reduced or halted their AV as a result. The lived experience of AV left most respondents feeling guilt, shame, and inadequacy, whether they committed abuse or failed to stop it.