Vietnam Combat Veterans Research Articles

Patterns of positive readjustment in Vietnam combat veterans

This study examines readjustment patterns in 152 Vietnam combat veterans. Subjects were nontreatment-seeking volunteers who felt that they had made an adequate life adjustment since Vietnam. Using a set of self-report instruments, data were obtained on background characteristics, military experiences (including combat), exposure to war trauma, current day PTSD symptomatology, and types of coping strategies. A subset of well-functioning veterans with substantial combat exposure was identified. Results indicated that these veterans suffered considerable distress during wartime but that they dealt with current recollections of this experience in a fashion that was significantly different from more symptomatic cohorts. Nonavoidant coping styles characterized the functioning of well-adjusted veterans; furthermore, type of coping strategy predicted current adjustment better than combat exposure. Implications of different approaches to coping are discussed, particularly as they relate to the long-term integration of traumatic war experiences.

Patterns of positive readjustment in Vietnam combat veterans

AbstractThis study examines readjustment patterns in 152 Vietnam combat veterans. Subjects were nontreatment‐seeking volunteers who felt that they had made an adequate life adjustment since Vietnam. Using a set of self‐report instruments, data were obtained on background characteristics, military experiences (including combat), exposure to war trauma, current day PTSD symptomatology, and types of coping strategies. A subset of well‐functioning veterans with substantial combat exposure was identified. Results indicated that these veterans suffered considerable distress during wartime but that they dealt with current recollections of this experience in a fashion that was significantly different from more symptomatic cohorts. Nonavoidant coping styles characterized the functioning of well‐adjusted veterans; furthermore, type of coping strategy predicted current adjustment better than combat exposure. Implications of different approaches to coping are discussed, particularly as they relate to the long‐term integration of traumatic war experiences.

Predictors of chronic stress among Vietnam veterans: Stressor exposure and intrusive recall

AbstractThe present study examined the relationship between military service during the Vietnam era and chronic stress among Vietnam combat veterans, noncombat military controls, and nonmilitary age‐mates. Psychological, behavioral, and biochemical indices of stress were assessed. Results demonstrated that exposure to combat was not associated with symptoms of chronic stress. However, reported intrusiveness of recalled imagery associated with stressful combat events was an important predictor of long‐term symptoms of stress irrespective of combat exposure. In addition, the interaction of combat exposure and intrusive thinking was significantly related to symptoms of chronic stress. These data suggest that intrusive thinking may reflect an important individual difference variable that could help predict long‐term responding to stressors.

Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans.

Early trauma in the form of childhood physical or sexual abuse has been associated with adult psychopathology. The purpose of this study was to compare rates of childhood abuse in Vietnam veterans with and without combat-related posttraumatic stress disorder (PTSD). Premilitary stressful and traumatic events including childhood abuse and other potential predisposing factors were assessed in Vietnam combat veterans who sought treatment for PTSD (N = 38) and Vietnam combat veterans without PTSD who sought treatment for medical disorders (N = 28). Stressful and traumatic events including childhood physical abuse were assessed with the Checklist of Stressful and Traumatic Events and a clinician-administered interview for the assessment of childhood abuse. Level of combat exposure was measured with the Combat Exposure Scale. Vietnam veterans with PTSD had higher rates of childhood physical abuse than Vietnam veterans without PTSD (26% versus 7%). The association between childhood abuse and PTSD persisted after controlling for the difference in level of combat exposure between the two groups. Patients with PTSD also had a significantly higher rate of total traumatic events before joining the military than patients without PTSD (mean = 4.6, SD = 4.5, versus mean = 2.8, SD = 2.9). These findings suggest that patients seeking treatment for combat-related PTSD have higher rates of childhood physical abuse than combat veterans without PTSD. Childhood physical abuse may be an antecedent to the development of combat-related PTSD in Vietnam combat veterans.

Assessment of intrusive cognition in PTSD: Use of the modified Stroop paradigm

In this article, we review research supporting the modified Stroop color-naming paradigm as a means for assessing intrusive cognition in patients with posttraumatic stress disorder (PTSD). Because Stroop interference reflects involuntary semantic activation, delayed color-naming of trauma-related words can provide an objective index of intrusive cognition that is not based on self-report. In a replication and extension of previous research, we found that Vietnam combat veterans with PTSD exhibited Stroop interference for trauma-related words but not for other threat words, positive words, or neutral words. Also, we provide reliability and validity data on the paradigm.

Treating post-traumatic stress disorder among Vietnam combat veterans: An existential perspective

In the existential therapeutic approach the traumatic event is not divorced from the totality of one's life. The authors believe that finding some degree of meaning in the traumatic event is essential and that the recovery process begins when one feels that meaning and the sense of self are congruent.

Assessment of intrusive cognition in PTSD: Use of the modified Stroop paradigm

AbstractIn this article, we review research supporting the modified Stroop color‐naming paradigm as a means for assessing intrusive cognition in patients with posttraumatic stress disorder (PTSD). Because Stroop interference reflects involuntary semantic activation, delayed color‐naming of trauma‐related words can provide an objective index of intrusive cognition that is not based on self‐report. In a replication and extension of previous research, we found that Vietnam combat veterans with PTSD exhibited Stroop interference for trauma‐related words but not for other threat words, positive words, or neutral words. Also, we provide reliability and validity data on the paradigm.

Symptom exaggeration in a PTSD inpatient population: Response set or claim for compensation

AbstractThis study examines the relationship between service‐connection (financial compensation) and exaggeration of PTSD symptoms. Sixty inpatient Vietnam combat veterans in PTSD treatment comprised three groups: those financially compensated for PTSD, those financially compensated for physical or other mental problems, and those not financially compensated. Results indicate that those veterans who are not service‐connected do not exaggerate symptoms on the MMPI F‐scale more than those who are service‐connected. Also, F scores reported for inpatient PTSD were higher than previously established cut‐off criteria found chiefly in outpatient populations. Implications for therapists' biases concerning financial compensation and symptom claims are discussed in terms of their clinical relevance.

Asian-Pacific American Vietnam Veterans:

The literature on Vietnam combat veterans suggests that ethnicity is a key variable in influencing perceptions of the war and post-war adjustment. Because they bore a physical resemblance to the Vietnamese, Asian-Pacific American (A-PA) veterans may have faced unique psychosocial conflicts. We gathered data on war-time and post-war experiences for 44 A-PA veterans in Vietnam including a strong identification with the Vietnamese and enstrangement from their white comrades in arms. Mississippi Scale scores indicated that rates of PTSD for A-PA veterans were about the same as those reported for white vets in earlier studies, but ethnic subgroups of A-PA veterans earned substantially higher scores than whites.

Negative Parenting Behavior, Combat Exposure, and PTSD Symptom Severity

The "personal characteristics" and "extreme event" hypotheses have been proposed as alternative explanations for the development of posttraumatic stress disorder (PTSD) among combat veterans. The person-event interaction model attempts to integrate both perspectives by hypothesizing that premilitary individual vulnerability characteristics play a greater role in influencing risk of PTSD or PTSD symptom severity at lower than at higher levels of exposure to traumatic combat stressors. Focusing on a sample of 57 Vietnam veterans undergoing inpatient treatment for diagnosed PTSD, we assessed this model by examining interactions between negative parenting behaviors in childhood (e.g., inconsistent love) and degree of combat exposure in predicting PTSD symptom severity. Hierarchical regression analyses supported the model, indicating that the father's negative parenting behaviors were more predictive of PTSD symptom severity at relatively lower levels of combat exposure. Implications of the findings for further research on multivariate, interactional models of PTSD etiology among Vietnam combat veterans are discussed.

Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans.

In the present study, we replicated and extended our previous findings of increased 24-hour urinary catecholamine excretion in posttraumatic stress disorder (PTSD). Dopamine, norepinephrine, and epinephrine concentrations were measured in 22 male patients with PTSD (14 inpatients and eight outpatients) and in 16 nonpsychiatric normal males. The PTSD inpatients showed significantly higher excretion of all three catecholamines compared with both outpatients with PTSD and normal controls. Dopamine and norepinephrine, but not epinephrine, levels were significantly correlated with severity of PTSD symptoms in the PTSD group as a whole. In particular, these catecholamines seemed related to intrusive symptoms. None of the catecholamines were correlated with severity of depression. The findings support the hypothesis of an enhanced sympathetic nervous system activation in PTSD, and suggest that increased sympathetic arousal may be closely linked to severity of certain PTSD symptom clusters.

Dissociation and posttraumatic stress disorder in Vietnam combat veterans

This study compared current dissociative symptoms and dissociation at the time of specific traumatic events in Vietnam combat veterans with posttraumatic stress disorder (PTSD) and Vietnam combat veterans without PTSD. Vietnam combat veterans who sought treatment for PTSD (N = 53) were compared to Vietnam combat veterans without PTSD (N = 32) who sought treatment for medical problems. Dissociative symptoms were evaluated with the Dissociative Experiences Scale. Dissociation at the time of a combat-related traumatic event was evaluated retrospectively with the modified Dissociative Experiences Questionnaire. The Combat Exposure Scale was used to measure level of combat exposure. There was a significantly higher level of dissociative symptoms, as measured by the Dissociative Experiences Scale, in patients with PTSD (mean = 27.0, SD = 18.0) than in patients without PTSD (mean = 13.7, SD = 16.0). This difference persisted when the difference in level of combat exposure was controlled with analysis of covariance. PTSD patients also reported more dissociative symptoms at the time of combat trauma, as measured retrospectively by the Dissociative Experiences Questionnaire (mean = 11.5, SD = 1.6) than non-PTSD patients (mean = 1.8, SD = 2.1). Dissociative symptoms are an important element of the long-term psychopathological response to trauma.

Exposure to atrocities and severity of chronic posttraumatic stress disorder in Vietnam combat veterans

The authors' objective was to explore aspects of trauma associated with severity of posttraumatic stress disorder (PTSD) in Vietnam veterans. Several ratings of stress exposure and symptom severity were administered to 40 patients with combat-related PTSD. A significant relationship was observed between exposure to atrocities and the impact of PTSD on veterans' lives, as measured by the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. Exposure to atrocities was also significantly correlated with current symptom severity. In contrast, combat exposure alone was not significantly associated with overall symptom severity. Both atrocity and combat exposure, however, were significantly related to reexperiencing symptoms. The data suggest that the enduring effect and severity of PTSD symptoms on an individual are associated more with exposure to brutal human death and suffering than the threat of death associated with combat.

Plasma beta-endorphin levels in post-traumatic stress disorder: a preliminary report on response to exercise-induced stress.

Post-traumatic stress disorder (PTSD) may be associated with changes in endogenous opioid peptide function. To test this hypothesis, 10 male Vietnam combat veterans with PTSD and 8 age-matched male controls underwent a standard grade-incremented exercise treadmill stress test. Plasma beta-endorphin measurements were obtained at rest and following maximal exercise. Resting plasma beta-endorphin levels were comparable between groups. Post-exercise plasma beta-endorphin levels were significantly higher than resting levels in the PTSD patients only (P less than 0.05). These pilot data suggest a differential alteration in plasma beta-endorphin response to exercise in PTSD.

Physical health complaints in combat‐related post‐traumatic stress disorder: A preliminary report

AbstractResearch has detailed the psychosocial parameters of combat‐related posttraumatic stress disorder (PTSD), but little information has been reported on it's physical health concomitants. Many aspects of the PTSD syndrome may interact to create chronic stress reactions that are related to the emergence of disease states. As part of an initial step in exploring the physical health risk associated with PTSD we examined self‐reported health problems in two matched groups of treatment‐seeking Vietnam combat veterans with and without PTSD. Overall, the PTSD group reported more current health problems, but no more physician diagnosed disorders than their non‐PTSD cohort. Possible mechanisms responsible for the report of health complaints in PTSD are discussed.

Physical health complaints in combat-related post-traumatic stress disorder: A preliminary report

Research has detailed the psychosocial parameters of combat-related posttraumatic stress disorder (PTSD), but little information has been reported on it's physical health concomitants. Many aspects of the PTSD syndrome may interact to create chronic stress reactions that are related to the emergence of disease states. As part of an initial step in exploring the physical health risk associated with PTSD we examined self-reported health problems in two matched groups of treatment-seeking Vietnam combat veterans with and without PTSD. Overall, the PTSD group reported more current health problems, but no more physician diagnosed disorders than their non-PTSD cohort. Possible mechanisms responsible for the report of health complaints in PTSD are discussed.

Military Service and Stability in the Family Course

This study explores the popular thesis that the Vietnam War had severe disruptive influences on the marriages of veterans. Analysis of life-history data from 2,303 White men who graduated from Washington State high schools in 1966 and 1967 -just before the height of the Vietnam War - shows that the Vietnam combat veterans (n = 627) were more likely to marry than were noncombat veterans who served during the Vietnam era (n = 586) or nonveterans. We found no long-term evidence of a destructive impact of Vietnam combat service on life-course sequencing or veterans' first marriages. When marital duration and other covariates were taken into account, military service reduced the probability of marital dissolution for White men. This study corroborates Card's (1983) findings for veterans who served prior to the intense combat period.

Similarities and Differences Between MMPI and MMPI-2 Applications to the Assessment of Posttraumatic Stress Disorder

The purpose of this study was to address the question: Is the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) comparable to the original MMPI in its applicability to the assessment of posttraumatic stress disorder (PTSD) among Vietnam combat veterans? The question was addressed by administering both the original MMPI and MMPI-2 to 29 subjects classified as meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; DSM-III-R) criteria for PTSD and comparing MMPI and MMPI-2 scores in terms of: degree of association, code-type congruence, diagnostic hit rates (when compared to two other clinical samples, and one normal sample), and congruence of the Keane PTSD Scale (PK). Results reveal highly significant correlations between MMPI and MMPI-2 basic scales for the PTSD sample as well as congruence in 2-point codes comparable to previous studies. The MMPI-2 was found to identify effectively PTSD subjects from the other groups. Results also showed a high degree of association between the MMPI and MMPI-2 in regard to PK scores, although minor differences were found in PK raw scores between the two tests. Overall, the findings suggest a high degree of comparability between the MMPI and MMPI-2 in the assessment of PTSD.

Chronic combat-related PTSD and concurrent substance abuse: Implications for treatment of this frequent ?dual diagnosis?

Vietnam combat veterans suffering from post-traumatic stress disorder (PTSD) who had requested treatment through a special VA-sponsored PTSD treatment program were evaluated using the Diagnostic Interview Schedule (DIS). Based on the DIS, 91.12% of the sample had a lifetime diagnosis of substance abuse or dependence and this was, by far, the most frequent co-diagnosis in the sample. The most common reason for patients not completing the treatment program was for use of illegal substances or alcohol while in the program, even though they were aware that to do so meant that they would be either discharged or transferred to another unit. The percentage of other co-diagnoses, and an estimate of currentness for all Axis I diagnoses were also presented on the sample of 102 patients. It was determined that for this population, the symptoms of substance abuse were chronic and were inextricably intertwined with PTSD symptoms and with the initial stressor (combat). Treatment process implications were discussed.

Pre-Vietnam contents of posttraumatic stress disorder veterans' service medical and personnel records

We reviewed the pre-Vietnam contents of the service medical and personnel records of 250 Vietnam combat veterans, in an attempt to identify factors predisposing to the development of posttraumatic stress disorder (PTSD). PTSD and non-PTSD veterans did not differ significantly on self-reported medical history items, sick call visits, or military efficiency and conduct ratings. There were trends for PTSD veterans to have lower arithmetic aptitude, more self-reported school difficulties, and (paradoxically) lower pulse rate at military induction.