No abstract

Most Vietnamese young adults who experienced the American War were exposed to war-related violence, which can exert a lifelong impact. We analyze survey data collected among northern and central Vietnamese older adults in the 2018 Vietnam Health and Aging Study (N = 2,447) to examine the association between various war traumas, psychological distress, and suicidal ideation. Informed by life course and stress process perspectives, we use structural equation models with multiple mediators to analyze the relationship between mental health outcomes and five types of wartime stress exposure: loss of family and friends, witnessing death, malevolent living conditions, life threat, and moral injury. Our findings reveal enduring mental health impacts of war among survivors. Wartime stress exposure’s influence on mental health is mediated by recent comorbidities and stressful life events. Loss of family members, witnessing death, and malevolent living conditions during war are particularly salient risks for psychological distress.

Growing numbers of women in militaries worldwide, coupled with vast segments of women within war-affected populations globally, raise questions about gender as it structures trauma exposure, posttraumatic stress disorder (PTSD), and other mental health consequences of war. In this study, we investigate the gendered associations between early-life wartime stress exposures and PTSD symptoms in older adulthood using data from the 2018 Vietnam Health and Aging Study, a unique data set documenting multiple dimensions of health and wartime stress exposures within a sample of older adults who occupied diverse roles during the American war in Vietnam. Our results indicate that the severity of recent PTSD symptoms is significantly and positively associated with the severity of wartime stress exposure among both men and women. Vietnamese men’s social positions, particularly their predominance in combat, exposed them to more numerous war-related stressors. However, Vietnamese women experience a greater PTSD penalty associated with some wartime stress exposures, likely due to the burden of protecting family in wartime and incorporation into military and paramilitary roles with lesser preparation, training, and support than men. We conclude that women who survive major wars, both as soldiers and civilians, bear a significant burden of armed conflict’s lasting toll upon mental health.