The double-edged sword: Outward and inward directed aggression among war combatants.

Inspired by the two-stage model of countervailing forces, we explored the mechanism underlining inward and outward aggression among ex-combatants. Israeli veterans (N = 230) reported their partner’s violence (outward aggression), suicidal ideation (inward aggression), aggressive impulses, posttraumatic stress disorder (PTSD), paranoid ideation and guilt. Suicidal ideation was related to aggressive impulses only in the presence of PTSD, or under high guilt; whereas paranoid ideation buffered these effects. Violence towards the partner, on the other hand, was related to aggressive impulses under low guilt and in the absence of PTSD. Aggressive impulses underline both suicidal ideation and partner violence. The inter-relations between PTSD, guilt, and paranoid ideation influence the manifestation of aggression and the direction it takes.