Post‐traumatic stress and associated disorders among Vietnam veterans: The significance of combat exposure and social support

Abstract

The hypothesis is tested that individuals exposed to traumatic stress who currently have lower social support have higher rates of post-traumatic stress and associated disorders. To test this, the current prevalence of five psychiatric disorders, including post-traumatic stress, generalized anxiety, depression, alcohol abuse, and drug abuse, were studied among a random sample of veterans who served in Vietnam (N = 2,490) and a random sample of "era" veterans who did not (N = 1,972). Logistic regression was used to analyze each disorder, controlling for past combat exposure, current social status, childhood delinquency, military adjustment, and current social support. Combat exposure was the best predictor of post-traumatic stress and was also associated with anxiety and depression, but not alcohol or drug abuse. Substance abuse was associated with childhood delinquency, and the best predictor of drug abuse was illicit Army drug use. Lower social support was associated with all disorders, except drug abuse. Although the causal nexus is not clear in this case, this study suggests that future research and clinical interventions should not overlook the significance of social support among victims of traumatic stress.

How does social support enhance resilience in the trauma-exposed individual?

“…For example, in the National Vietnam Veterans Readjustment Study, King and colleagues found that low level of perceived postdeployment social support was a strong mediator of risk for PTSD (King et al 1998). Vietnam veterans with high social support were shown to be 180% less likely to develop PTSD compared with Vietnam veterans with low social support (Boscarino 1995). Further, among treatment-seeking Vietnam veterans, homecoming stress (i.e., negative interpersonal interactions, shame, resentment, and social withdrawal) was a stronger predictor of current PTSD symptomatology than level of combat exposure, stressful life events, or childhood and civilian traumas (Johnson et al 1997).…”

Psychological Distress among Black and White Americans: Differential Effects of Social Support, Negative Interaction and Personal Control

“…Social support is an important predictor of mental health outcomes for victims of traumatic occurrences because it provides an emotional outlet for the trauma victim, access to significant others who will listen and empathize with them, and the opportunity to acknowledge their trauma (Boscarino 1995;Davidson et al 1991). Interactions with social networks can also be problematic in the aftermath of a traumatic event because providing and receiving support (Solomon and Smith 1994) may entail significant emotional costs, particularly for persons who are also affected by the event and may themselves be in need of support.…”

Predictive factors for alcoholic relapse in the selection of alcohol- dependent persons for hepatic transplant

“…20 However, whether this finding can be generalized is uncertain. 21,22 In this same category, anecdotal reports exist of poor postoperative compliance among women who have histories of sexual abuse and have not resolved these traumas, which often occur early in life. However, no systematic study has been done.…”