The Invisible Scars of War: The Link Between Military Explosions and Violent Behavior Revealed Years Later
- 3 days ago
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Explosions faced by military personnel can leave invisible marks on the brain. A new study suggests that repeated exposure to shockwaves is associated with a higher risk of anger, aggression, and emotional problems years after military service.
When we think about the risks faced by military personnel, we usually imagine visible physical injuries. However, scientists have been investigating another possible, less perceptible impact: the effects of shockwaves produced by repeated explosions and gunfire on the brain.
Even when they don't cause immediate serious injuries, these exposures can cause subtle neurological changes that, over time, can influence emotions, behavior, and mental health.
In this study, researchers analyzed whether military personnel who worked in roles with greater occupational exposure to explosions and impacts were more likely to develop problems related to anger, aggression, or violent behavior throughout their lives.
These exposures include routine military activities such as training with heavy weapons, artillery, explosives, and other situations where shockwaves repeatedly hit the brain.
To investigate this question, scientists used health data from 10,000 American veterans. Half of them had served in occupations considered high-risk for exposure to explosions, while the other half worked in low-risk roles. The groups were carefully matched to have similar characteristics in age, sex, and ethnicity, allowing for a fairer comparison.
One of the most innovative parts of the study was the analysis of medical records. Instead of manually reviewing millions of documents, the researchers used artificial intelligence and large language models to examine approximately 3.6 million clinical records.
The system was trained to identify reports related to intense anger, aggression, impulsivity, interpersonal conflicts, and episodes of violent behavior. Before being used on a large scale, the algorithm was compared with human assessments and achieved an accuracy of approximately 96%.
The results showed that signs of anger, aggression, or violence appeared more frequently among veterans exposed to higher levels of outbursts.
Approximately 17% of the high-risk military personnel presented records consistent with these behaviors, compared to approximately 12% in the lower-exposure group. Even after researchers accounted for other important factors, the association remained significant.
The study also revealed that other problems frequently present in military life can contribute to this risk. Exposure to combat, traumatic brain injury, and post-traumatic stress disorder were strongly associated with increased aggressive behaviors. This suggests that the effects of outbursts do not occur in isolation but can interact with physical and emotional traumas accumulated throughout a military career.
Although the study does not prove that explosions are the direct cause of aggression, the results reinforce the hypothesis that repeated exposure to shock waves can cause brain changes that affect emotional regulation.
Regions such as the prefrontal cortex, responsible for impulse control and decision-making, and the amygdala, involved in processing threats and emotions, are frequently identified as vulnerable areas in research on brain trauma.
The authors conclude that military personnel working in environments with high exposure to explosions may have a higher risk of long-term emotional and behavioral difficulties. The results highlight the importance of monitoring not only visible physical injuries, but also possible neurological and psychological consequences that may arise years after military service.
READ MORE:
When the Fuse Is Lit: Association of Military Occupational Blast Exposure With Anger, Aggression, and Violence
Eamonn Kennedy, Shashank Vadlamani, Megan Amuan, Ian J. Stewart, Shannon R. Miles, Sarah L. Martindale, Lisa A. Brenner, and Mary Jo Pugh
Military Medicine, 2026, usag217
Abstract:
Military occupational blast and impulse exposure (MOBE) is a potential risk factor for increased Anger, Aggression, or Violence (AAV). The objective of this study was to assess the association between MOBE and AAV-related content in clinical text notes in Veterans Health Administration (VHA) data. This matched cohort study investigated AAV-related content in clinical text data from Veterans across high and low-risk MOBE occupations. Veterans with documentation of high-risk MOBE occupations were sampled from a VHA population database and matched 1:1 with low-risk MOBE controls on age, sex, and race/ethnicity. An algorithm leveraging semantic similarity and large language models (LLMs) identified AAV content in millions of VHA clinical text notes. Model performance was assessed by manual review. Veteran outcomes were classified as AAV-positive or AAV-negative based on the content of their medical records. Logistic regression was used to estimate the association between MOBE and AAV. Among the MOBE cohort (n = 5,000) and matched controls (n = 5,000), 3.64 million clinical notes (Mean: 364 notes/person) were classified using an LLM pipeline that achieved 96% classification accuracy in manual review. Raw group differences were significant, with 17.2% of the MOBE cohort meeting AAV criteria, compared to 12.0% of matched controls (unadjusted Odds Ratio [OR]: 1.53 [1.37-1.71]). In adjusted models, the association between MOBE and AAV remained significant (OR: 1.22 [1.08-1.38]). Combat exposure (OR: 1.32 [1.11-1.58]) and traumatic brain injury (TBI) (OR: 1.47 [1.29-1.67]) were associated with increased AAV, while female sex was protective (OR: 0.33 [0.24-0.45]). In nested models, the OR for AAV ranged from 1.53 to 1.16 depending on the covariates considered, and posttraumatic stress disorder (PTSD) was found to be a significant confounder of the MOBE-AAV association. This matched cohort study found that individuals who served in occupations at high risk for MOBE were significantly more likely to have evidence of AAV in clinical text data. Neurological and affective changes potentially linked to MOBE may be interconnected with other military health factors, such as combat exposure, TBI, and PTSD.
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