A causal model of the etiology of war‐related PTSD

Abstract

AbstractStructural equation modeling is used to evaluate a network of causal hypotheses concerning the relationships of premilitary vulnerabilities, military entry conditions, war zone experiences, and dissociative reactions with current symptoms of PTSD and general psychiatric distress. The analyses are directed toward resolving three general issues: (1) the relative contributions of premilitary vulnerabilities and exposure to traumatic events to the development of PTSD, (2) the features of the causal network that are distinctive to the development of PTSD as compared to general psychiatric symptoms, and (3) the major pathways mediating causation among the variables in the model. 381 Vietnam theater veterans who sought treatment from VA's new PTSD Clinical Teams Program and who provided complete data constituted the sample for the study. War zone experiences were the variables that contributed most strongly to the development of both PTSD and general psychiatric symptoms. Combat exposure, however, contributed directly to PTSD symptoms but not to general psychiatric symptoms. The overall fit of the model to the data proved to be quite satisfactory for both PTSD and general psychiatric symptoms, accounting for 59% and 60% of the variance, respectively.