Objective. This paper examines the neurobiological and psychological consequences of toxic leadership in the U.S. military for service members, spouses, and children.

Method. Drawing upon neuroscience, psychology, and epidemiological data—including Department of Defense suicide reports and Family Advocacy Program statistics—this review synthesizes evidence of chronic stress, moral injury, family dysfunction, and intergenerational trauma caused by destructive command climates.

Results. Toxic leadership disrupts hypothalamic–pituitary–adrenal (HPA) axis regulation, heightens amygdala threat reactivity, reduces prefrontal control, and damages hippocampal integrity. Service members experience depression, anxiety, suicidality, and physical illness. Spouses suffer secondary traumatic stress, somatic illness, and suicide risk. Children endure disrupted attachment, altered neural development, and epigenetic vulnerability. Epidemiological data demonstrate the scope: 523 service-member suicides in 2023, 146 family-member suicides in 2022, 8,298 documented domestic abuse cases in 2023, and more than 500 intimate partner violence–related homicides and suicides between 2012 and 2022.

Conclusion. Toxic leadership is a systemic health hazard, comparable in severity to combat trauma. Addressing it requires leadership accountability, trauma-informed family support, and recognition of its intergenerational consequences.

Keywords: toxic leadership, moral injury, HPA axis, military families, neuroscience, intergenerational trauma