PTSD: Science Deflates Politics

The New York Times report of a new study of PTSD, the NYT’s summary remarking the new study is “viewed by experts as authoritative,” knocks the air out of the Vietnam war and Vietnam veteran punching bags that stress disorders among our combatants was especially severe, long-lasting, and extraordinary. This canard is currently used to similarly undermine the U.S. war effort in Iraq, a war similarly often without clear-cut fronts and enemy.

Other qualified analysts have come to this conclusion before, such as the co-authors of One Nation Under Therapy, who critiqued earlier studies, for example, here. Another comprehensive critique by an expert on PTSD appears here.

Another take on the flip-side of PTSD, that “Some Veterans Feel Lives Enlarged by Wartime Suffering,” points out another PTSD expert’s observation:

“The whole field, in the last four years, has shifted to a certain extent [to focus on] resilience, on human potential….[studies of World War II veterans showed] Yes, I’ve suffered…but I wouldn’t have given up this experience for anything in the world….The things I experienced have made me a better man today.”

Other studies have found a similar rate of PTSD as experienced by troops in combat as among civilians experiencing severe stress in their lives, as well as among civilians experiencing terrorism attacks or among firemen.

Today’s New York Times says a “Study Finds Fewer Cases of Post-Traumatic Stress in Vietnam Veterans.” The study, containing much important detail beyond the NYT’s article, appears in the August 18 journal Science from the American Association for the Advancement of Science.

Contrary to the widely reported figure of a third of Vietnam veterans having developed PTSD, post traumatic stress disorder, this more careful study reports a, nonetheless serious, occurrence of 18.7% having temporary symptoms and 9.1% having lasting symptoms 10+ years after the end of the war. At the same time, the study points out “the majority of the veterans with high and very high MHM [military historical measure: “probable severity of exposure to war-zone stressors"] did not develop war related PTSD.”

“I’d like to think that this study would help settle the debate, and that both sides would see that this was good science,” said the report’s lead author, Dr. Bruce Dohrenwend, a psychiatric researcher at Columbia University and the New York State Psychiatric Institute.
“It’s true we found a significant reduction in the lifetime prevalence of these disorders,” he said, “but on the other hand we also found that more than 9 percent had current pathology, which is a substantial number of people.”
Richard McNally, a psychologist at Harvard who is skeptical of the earlier estimate, agreed, saying that the new study confirmed his and others’ suspicions. “It knocks the 30 percent number out of the box,” he said.
But, he added, the findings “should not be used as a justification for short-changing services that are needed to help veterans” of Iraq or Vietnam.
The new report is a reanalysis of a landmark 1988 study in which researchers tracked down 1,200 Vietnam veterans around the country and interviewed them…

The reanalysis of the data, plus additional investigations, are the result. Another notable finding in the study itself is a very low rate of compensation-seeking exaggeration.

Another notable result in the study itself is that:

T]he trajectory for most veterans with war-related PTSD that causes substantial impairment is toward amelioration or complete remission. This tendency toward improvement is present even for ~10% [approximately 10%] of veterans who still had impairing current PTSD at follow-up; the impairment most of them showed by this time [10+ years after the end of the Vietnam war] was not severe. The functioning of the veterans who had developed war-related PTSD but who no longer met criteria for the disorder at follow-up differed little from that of veterans who did not develop war-related PTSD.

Like all good studies, the conclusion calls for “investigations of other factors that may contribute to initial resilience and psychological adjustment after traumatic war experiences.” This is an important and worthwhile path of study for all of us and our lives. The traits of resilience are fundamental to our health and success, as individuals and as a nation.