Army Spc. Ivan Lopez had been diagnosed with depression, anxiety and sleep disturbances and was being evaluated for post-traumatic stress disorder before he opened fire on fellow soldiers and then killed himself at Fort Hood on Wednesday. Now the Army is confronted once again with possible correlations between mental health disorders and violence — and how to screen for them. Tens of thousands of veterans of the wars in Iraq and Afghanistan have been diagnosed with PTSD, but only a small minority commit violent acts. It is extremely difficult to predict those who are likely to explode into violence, according to experts in mass shootings and mental illness.
The disorder alone does not make a combat veteran or anyone else more prone to premeditated violence, experts say. But it can severely strain relationships or lead to a firing or demotion at work — events that can push someone over the edge. And some conditions associated with PTSD — depression, anxiety, anger, substance abuse, suicidal thoughts — are also associated with those who commit mass shootings. “It’s easy to identify possible predictors of a rare tragic event after the fact,” Richard J. McNally, a psychology professor at Harvard University, said in an email interview. “It is much harder to predict it.”
The 34-year-old Lopez had been examined by a psychiatrist last month and was prescribed Ambien, among other drugs, while undergoing evaluation for PTSD. “We have very strong evidence that he had a medical history that indicates unstable psychiatric or psychological conditions,” Army Lt. Gen. Mark Milley, the Fort Hood commander, told reporters. Yet Lopez was not placed under any restrictions, according to the Army.
Several studies have found that combat veterans diagnosed with PTSD are two to three times more likely than other combat veterans to commit domestic violence or other violent acts, said Dr. Prakash Masand, a former Duke University psychiatrist who has studied the disorder. “The absolute numbers are small, but the association is there,” Masand said in an interview.
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