On July 14, a 24-year-old combat veteran and Fort Hood soldier fired on Killeen police, resulting in the death of veteran police officer Robert “Bobby” Hornsby. Another police officer, Juan E. Obregon Jr., was shot in the leg. The soldier, Pfc. Dustin Billy Cole, who twice deployed to Afghanistan with the 36th Engineer Brigade, also was killed.
Although Cole’s medical records have not yet been released, his status as a combat veteran led many in the community and in the media to wonder if he suffered from post-traumatic stress disorder. Similar questions have been raised across the country about the mental health of other soldiers and veterans involved in violent run-ins with the law.
But is PTSD really to blame? Psychologists and other experts say there is no conclusive evidence that people with PTSD are prone to violence.
Tania Glenn, a psychologist who specializes in PTSD, has worked as a contractor for the Killeen Police Department since August. She said PTSD is incorrectly assumed to be the cause of violent incidents involving soldiers.
“That really is an assumption and a stereotype,” she said. “I’ve been doing this 22 years, and I’ve never been afraid of any of my military or law enforcement patients.”
Other factors in play
Other factors often come into play in violent confrontations. Drugs, alcohol or psychosis are commonly involved, Glenn said.
In Cole’s case, neighbors said he had been drinking alcohol throughout the day of the July shooting.
Glenn also noted Marine veteran Eddie Ray Routh, who shot and killed “American Sniper” Chris Kyle on Feb. 2, 2013. Shortly before the shooting, Routh had hallucinations. “Everyone assumed it was because of PTSD, but that individual was actually psychotic,” Glenn said.
While anger is a common symptom of post-traumatic stress disorder, violent or aggressive episodes in PTSD sufferers are rare, experts said. While there is a relationship between the two, PTSD does not always lead to anger and aggression.
“It’s certainly true there is an association,” said Dr. Adam Borah, chief of hospital-based behavioral health services at Fort Hood’s Carl R. Darnall Army Medical Center. “We do see more (acts) of violence among people with PTSD than those without PTSD. However, I do not feel that is a causal relationship. PTSD itself doesn’t cause violent behavior.”
Those diagnosed with the condition may be more likely to be violent if they have specific traits in their history, such as substance abuse, alcohol use, drug use, combat experience or growing up in a violent home, said Dr. Paula Schnurr, acting executive director of the National Center for PTSD in Vermont.
“Other factors are really important,” she said. “Most people with PTSD are not aggressive at all. The likelihood of aggressive violence you read about in newspapers is really quite low.”
Some show aggression
While medical experts are unable to conclusively link PTSD with violent behavior, others disagree.
Through his own experiences, Chris Leisinger, a retired cavalry scout sniper, can see where violence and aggression could rise up in a person with post-traumatic stress disorder.
“I have had anger outbursts,” he said.
Leisinger retired from the Army in 2010 due to PTSD and a traumatic brain injury stemming from his final deployment to Iraq. He served 12 years in the Army, deploying three times.
The Veterans Affairs National Center for PTSD estimates 15 percent of all veterans from the Iraq and Afghanistan wars are diagnosed with post-traumatic stress disorder. That’s nearly double the occurrence in the general population.
Leisinger’s symptoms included sensitivity to light, constant alertness that left him exhausted and trouble with short-term memory. He also went “from zero to pissed off in a matter of seconds” over small things. The breaking point for both him and his wife was the day he hit a woman with a bag of flour after she cussed at him in a grocery store.
“What bothered my wife was I continued shopping like nothing was wrong,” Leisinger said.
After that incident, he began taking treatment seriously, going to therapy, trying medications and ultimately finding success through meditation, yoga and relaxation methods, such as training his service dog, Dozer.
Despite his views on PTSD and anger, Leisinger fears media coverage of tragic situations like the 2013 shooting in Killeen will stereotype PTSD sufferers as dangerous. Stereotyping PTSD always has been a problem, he said. While he was active-duty, Leisinger thought he was treated differently post-diagnosis and felt like everyone was afraid to set him off.
Now, Leisinger doesn’t like to tell people what medical condition his service dog is for.
“When I tell people, they look at me like I grew horns ... because of that stigma,” he said.
Nearly 5,000 Fort Hood soldiers were diagnosed with PTSD through Darnall and its network in fiscal year 2013. When diagnosing and treating PTSD at Fort Hood, health professionals weigh a variety of information to mitigate danger.
“If there is a safety concern identified, it becomes the primary focus of treatment and the rest goes by the wayside,” said Borah, who thinks the Army is making a “very distinct and coordinated effort” to decrease the stigma associated with PTSD.
“When senior leaders come up and say, ‘I deployed and I had problems and I got help,’ it shows, ‘Hey, this is OK. It’s not going to negatively impact my career. It’s OK to get help,’” he said. “It’s about being fit and healthy in a bodily sense and a mental health sense.”
As more soldiers seek treatment and tell their friends, the stigma is further reduced, Borah said. Darnall averages about 9,800 behavioral health encounters with soldiers each month, according to data, and about 950 soldiers graduated from the Combat Reset Center, which reports its greatest referral source is other soldiers.
“When people engage in behavioral health care and learn what it’s about, they recognize that engaging in treatment isn’t a sign of weakness; it’s a sign of strength,” Borah said.
Just as Leisinger has felt his symptoms diminish over time with treatment, PTSD sufferers can make improvements or completely heal.
“PTSD is not a permanent diagnosis,” Borah said. “People diagnosed are diagnosed based upon a collection of specific symptoms that appear over a period of time.”
For now, Leisinger is putting his continued success in the paws of Dozer, a French mastiff he rescued from an animal shelter, and sharing his story in the hopes he can tear down the stereotype and help others learn it’s OK to ask for help.
“I talk to as many people as I can about it,” he said. “That way, guys a lot worse off than me can get help.”
Natalie Stewart contributed to this report.