Do different types of war stressors have independent relations with mental health? Findings from the Korean Vietnam Veterans Study.

Abstract

South Korea had the second largest contingent of soldiers in the Vietnam War, but little is known about their adaptation, especially in later life. Previous work in a different sample found very high rates of posttraumatic stress disorder (PTSD; 41%) among Korean Vietnam veterans (KVVs; Kang, Kim, & Lee, 2014), compared to 19-31% for American Vietnam veterans. We explored possible reasons for this high rate of PTSD, as well as anxiety and depressive symptoms, utilizing both vulnerability factors (e.g., war stressors) and protective factors (optimism, unit cohesion, and homecoming experiences). The sample included 367 male KVVs surveyed by mail (M age = 72, SD = 2.66). Using hierarchical regressions controlling for demographics, we examined the relative contributions of different types of war stressors and then the protective factors. Combat exposure was significantly associated with the three types of negative psychological symptoms, but their associations became nonsignificant when "subjective" war stressors (malevolent environments, perceived threat, and moral injury) were added. In the final models, malevolent environments were the strongest predictor for all three outcomes. In addition, moral injury was independently associated with PTSD symptoms, while perceived threat was marginally associated with depressive and anxiety symptoms. Among psychosocial factors, only optimism was negatively associated with the mental health outcomes. KVVs had very high rates of combat exposure, but malevolent environments played a more important role in their mental health in later life. These findings suggest the importance of considering adverse environmental factors in understanding PTSD in future studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).