March 17th, 2012
08:13 AM ET

Opinion: Soldier accused of shooting rampage: Not PTSD alone

Editor's Note: Dr. Harry Croft is a former Army doctor who has evaluated more than 7,000 veterans with PTSD.  He is medical director of the San Antonio Psychiatric Research Center, has been in private practice for 35 years and just released his new book, I Always Sit With My Back to The Wall (written with coauthor, Reverend Dr. Chrys Parker).

By Harry Croft - Special to CNN

The shocking news of an American soldier allegedly going on a shooting rampage and taking the lives of 16 Afghanistan civilians has captivated the world this week. The question everyone is trying to answer: What caused him to snap and commit such a heinous act?

Details are slowly emerging, but as a former Army doctor and someone who has evaluated more than 7,000 veterans with PTSD (Post Traumatic Stress Disorder), I believe a combination of factors pushed the unnamed soldier over the edge.

This soldier was more than likely suffering from PTSD and Traumatic Brain Injury (TBI), but these conditions alone would not have caused him to go on a killing spree. Even in the most severe cases I’ve seen in my 30 years of research and treating patients, I have never seen or heard of anyone with PTSD alone doing such a thing. Yes, PTSD typically brings on symptoms of anger, irritability, and even at times, rage.  It causes a person to feel distant and detached, easily startled or hyper-vigilant. The person might be unsociable and have trouble expressing his or her emotions. But killing 16 people is not a result of combat-related PTSD alone.   

In addition to suffering with PTSD, something else is the primary reason he went out of control.  Possibly he was suffering from drug or alcohol abuse, major depression, psychosis or other conditions. He might have also had an argument with a fellow soldier or with his wife back home. Or perhaps he received some upsetting news that made him snap.

Reports also suggest that the day before the incident, the unnamed soldier witnessed a horrific event: someone close to him, possibly another soldier, becoming seriously injured. Some reports say this fellow soldier’s leg was shot off.  We don’t yet know the relationship to this injured person, but if it was someone fairly close, it could have pushed the assailant further into a depressive state.

What most non-military people don’t realize is just how strong the relationships are between fellow soldiers. Military “brothers and sisters” are constantly in life and death situations and are always watching each other’s backs. That’s why when we see soldiers with a psychiatric condition, it’s not uncommon for them to cope better with their military friends and “family” than their real family back home.  The stress these men and women are under on a daily basis is unimaginable to the average person.  And this war has added another factor: repeated deployments to the same combat areas, something unprecedented in the history of modern American warfare.

In fact, for many soldiers now serving, especially those with PTSD, even when home they are never really totally home. They are always thinking about the combat zone and what their next deployment will bring.  In the case of the unnamed soldier, we now know he didn’t want to be deployed again. This was his fourth deployment and reports are he didn’t want to go back and that doing so was a last-minute event. If he was suffering from depression, this could have potentially made that a lot worse. If he was using drugs and alcohol to cope with his PTSD, being redeployed could have made him start using even more.

The other interesting piece to the puzzle is that immediately after the killings, the accused soldier didn’t run or hide. He came back to base and turned himself in. This tells us he clearly knew what he was doing, which makes an insanity defense unlikely.

A lot of attention has also focused on this soldier’s TBI (traumatic brain injury). He apparently lost part of a foot and suffered a concussion on a past deployment. Psychiatrically speaking, although a concussion or TBI can loosen conscious control over behavior, it is unlikely that both conditions occurring in the same troop would cause something like this to happen. There had to be multiple other factors that came into play.

Some people have said perhaps where he was based played a role. This soldier was stationed at Joint Base Lewis-McChord, which houses a unit that has been under tremendous stress and saw 12 suicides this past year alone. It also has a high divorce rate among soldiers who live there. Despite any of this, it’s still not enough of an explanation - by itself - of why someone would do this.

In the coming weeks and months we will certainly learn more about this person and the incident itself. We might never know all the details, but without a doubt it will be a combination of different factors that go above and beyond just combat-related PTSD.  

The views expressed in this article are solely those of Harry Croft.  Dr. Croft has not evaluated the particular soldier in question.

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Topics: Afghanistan • Law • Military

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