Epidemiology of PTSD in a national cohort of Vietnam veterans

Abstract

At age 36, Vietnam veterans in the high school class of 1963 reported significantly more problems related to nightmares, loss of control over behavior, emotional numbing, withdrawal from the external environment, hyperalertness, anxiety, and depression than did their classmates matched with them on 5 1 high school characteristics. These problems correspond closely to the disorder labeled post-traumatic stress disorder (PTSD) by the American Psychiatric Association. PTSD was associated with other family, mental health, and social interaction problems. Some environmental variables -e.g., the presence of a spouse or being a churchgoerwere associated with reduced levels of PTSD or with reductions in the degree of association between combat and PTSD. The direction of cause and effect in these associations cannot be ascertained from our data, but it seems plausible to postulate that support factors can and do help some Vietnam veterans with PTSD.

A comparison of combat's effects on PTSD scores in veterans with high and low moral development

“…His view is supported by the Jackson (1982) and Wilson (1978) findings, but seems inconsistent with Schnurr et al's (1993) report. The hypothesis that high moral standards reduce the likelihood of participation in atrocities and resulting PTSD symptoms seems consistent with the Hendin and Haas (1984) and Schnurr et al (1993) studies, and with most of the Card (1987) and Watson et al (1988) church going data, but not the Watson et al (1988) findings on reported illegal activity. Card's (1987) data on arrests seem consistent with either position.…”

“…The Vietnam Veterans Questionnaire Combat Exposure Scale (CES; Figley & Stretch, 1980), the Revised Defining Issues Test (DIT; Rest, 1979a), and the Posttraumatic Stress Disorder Interview (PTSD-I; Watson, Juba, Manifold, Kucala, and Anderson, 1991) were administered to 85 male Vietnam war veterans, all of whom reported combat experience. Seventy-three of these men were in treatment at the St.…”

“…Specifically, Schnurr, Friedman, and Rosenberg (1993) found a substantial positive relationship between premilitary MMPI Psychopathic Deviate scale scores and the presence of PTSD symptoms after combat exposure. Card (1987) also found that both arrest and felony convictions after service were more common in PTSDs than in controls, although Watson, Kucala, Manifold, Juba, and Vassar (1988) found no relationship between PTSD and reported i!legal activity during adolescence. Hendin and Haas (1984) reported that avoidance of excessively violent or guilt-producing behaviors was associated with reduced risk for PTSD after combat in Vietnam veterans.…”

“…Watson et al's (1988) PTSD patients reported significantly lower premilitary church attendance than community control veterans, although the church attendance levels reported by psychiatric patients with and without PTSD did not differ. Card (1987) also found church-going associated with a reduced incidence of PTSD in Vietnam war veterans, but because she surveyed postmilitary, not premilitary, church attendance, it is not clear that her PTSDs attended church less frequently than controls before service. While church attendance does not guarantee moral development, these studies at least suggest a relationship between level of morality and ability to avoid PTSD after combat.…”

Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm

“…However, this study suggests that the relationship between development of PTSD and level of combat exposure is not as clear as previously believed. Factors other than combat, such as childhood trauma (38,39) and preexisting personality (37,(40)(41)(42), may also play an important part in symptom development. Successful treatment of combatrelated PTSD requires a clear understanding of the relative etiologic contributions of both combat and noncombat factors.…”