Clinical assessment of post-traumatic stress disorder (PTSD) among American minorities who served in Vietnam

Abstract

This paper will review issues in clinical assessment of minority combat veterans who served in Vietnam. We will specify differences and similarities for assessing minorities within the context of evaluating the larger combat veteran population. As a way of introducing a need for specialized diagnosis and treatment, we will present data demonstrating that minorities may be characterized as a distinct group among Vietnam combat veterans; data demonstrating differential rates of PTSD and other psychological disorders; as well as differences in vocational, social, educational, physical and health adjustment along with differential rates of health services utilization. Throughout this paper, we will attempt to give a historical perspective to the role of the minority soldier before, during, and after military service in Vietnam, as well as inter-related civilian events that impacted minority veterans. We will review pertinent theories that explain higher PTSD rates among minority veterans—considering the special nature of the Vietnam War and its impact on young minority soldiers. We will frankly discuss problems we have observed about clinician prejudice that adversely affect clinical assessment and treatment. We emphasize that every combat veteran, regardless of racial background, is a unique individual with his or her own unique story to tell. We are aware, though, that cross-cultural interactions, because of factors internal to both client and clinician, can impede, if not preclude, effective therapeutic encounter. We recognize that providing information about minorities may do relatively little to alter deeply rooted prejudice of an unconscious nature. We hope to address the issues of ethnicity in ways that do not stir clinical resistance but rather that enhance clinician sensitivity, curiosity, and confidence.