Post-Traumatic Stress Disorder and Killing in Combat: A Review of Existing Literature

Background: Killing during combat is a unique experience and, for the majority, is limited to military service.
For those working with military and veteran populations, it is essential to be able to understand this experience and any psychological ramifications.
Purpose: This review provides a synthesis of existing literature, addressing the specific question: what is known about the relationship between post-traumatic stress disorder and killing in combat? It summarises what is known of the relationship between these variables and the clinical implications of these findings.
Method: A search of existing literature was conducted in a systematic manner in 2017 using electronic databases. A critical appraisal tool was used to inform data extraction and guide the literature review.
Results: The literature suggests that those who kill during combat are more likely to report symptoms of PTSD; however, disparity exists as to the statistical significance of this relationship. Factors such as gender and victim characteristics may be influencing factors.
Conclusion: The impact of killing during combat must be considered when working therapeutically with military and veteran populations. Future research should aim to recruit military participants from different populations and address some of the difficulties with recruitment—ensuring samples are representative and generalisable.
Key words: Post-traumatic stress, combat, killing, military, veteran