Abstract
Many Vietnam War veterans who experienced military trauma still exhibit PTSD symptomatology. Little is known about how new stressful situations, like the COVID-19 pandemic, affect previously traumatized people or whether they will react differently to them. We explore whether military combat experiences in Vietnam affect veterans' perceived abilities to cope with COVID-19 and whether current PTSD symptoms and later-adulthood reengagement with trauma memories are related to coping. We examine the extent that current PTSD symptoms and trauma reengagement relate to preventive practices. Participants were part of a randomly sampled cohort of American Legionnaires who responded to two previous surveys (1984, 1998), were born 1945-1953 and deployed to Vietnam 1963-1973, thus representing an aging veteran population. A survey supplement assessed coping with the pandemic and adherence to public health guidelines. The response rate was 74% (N = 507); 422 (61.6%) completed the COVID-19 supplement. Military experiences were found to affect coping with 41.4% reporting they affected ability to cope with COVID-19. Medium- and high-combat veterans were more likely to report that military experience affected coping than low-combat (OR 2.4, 95% CI 1.51–3.96; 2.6, 95% CI 1.41–4.61, respectively). Those with high PTSD scores had 7.7-fold (95% CI 4.3–13.17) increased likelihood of reporting that their coping was affected, compared to low-PTSD scorers. Few adopted social distancing (4%), staying at home (17%), or ceasing usual activities (32%); high-combat veterans were least likely to stay home. Veterans who practiced handwashing, sanitizer use, mask-wearing, and surface disinfection had significantly higher PTSD scores than those who did not. Veterans with higher scores on the LOSS-SF scale associated more reengagement with trauma memories and were more likely to engage in personal preventive strategies. Analysis of open-ended responses supported these findings. We conclude that fifty years after returning from Vietnam, PTSD scores were high for high-combat veterans, suggestive of PTSD diagnosis. Military experiences affected coping with COVID both positively and negatively, and may have helped instill useful personal health behaviors. Veterans, especially those with PTSD symptomatology, may have special needs during stressful times, like the COVID-19 pandemic, affecting compliance with recommended practices, as well as their overall health and well-being.
Highlights
In the COVID-19 pandemic, Gerber [1], an internist and expert in veterans’ health and trauma-informed care, warned of the special burden many Vietnam veterans who had experienced military trauma could face as members of an aging population. (In 2020, the median age of Vietnam veterans was 71) [2]
The great majority were present during the period of peak combat intensity; nearly two-thirds (64.3%) experienced medium or heavy combat based on our validated combat scale
For the men in our sample, and for the great majority of those serving in United States (US) armed forces during the Vietnam Era, military service occurred in young adulthood
Summary
In the COVID-19 pandemic, Gerber [1], an internist and expert in veterans’ health and trauma-informed care, warned of the special burden many Vietnam veterans who had experienced military trauma could face as members of an aging population. (In 2020, the median age of Vietnam veterans was 71) [2]. In the COVID-19 pandemic, Gerber [1], an internist and expert in veterans’ health and trauma-informed care, warned of the special burden many Vietnam veterans who had experienced military trauma could face as members of an aging population. (In 2020, the median age of Vietnam veterans was 71) [2] She posited that a number of older veterans would view the COVID19 pandemic through the lens of their prior wartime experiences and could be retraumatized. A sizable fraction of the 6.3 million surviving American Vietnam veterans faced heavy combat during their deployment. The cohort from which the current study population was drawn, a random sample of 12,400 male American Legionnaires first assembled in 1983, includes many men who were exposed to combat: 38.1% and 19.4% of these men deployed to Vietnam experienced medium and heavy combat, respectively [3]
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