There are approximately 283,000 male and 400 female Vietnam combat veterans currently living with posttraumatic stress disorder. Another 83,500 male and 150 female combat veterans have sub- threshold PTSD.
And now there’s a new generation of PTSD sufferers from the wars in Iraq and Afghanistan. It’s a significant problem for many American families.
Yet our understanding of PTSD, along with its psychological and physical ramifications, remains a work in progress. Abt Associates, a research firm in Cambridge, Mass., recently completed a new analysis of PTSD, the National Vietnam Veterans Longitudinal Study (NVVLS). This comprehensive study assessed the course of warzone-related PTSD over time and examined the relationship of PTSD with physical illnesses and depression.
Preliminary results were outlined by lead investigator William Schlenger, Ph.D., Nida Corry, Ph.D., and Norah Mulvaney-Day, Ph.D., at the American Psychological Association Convention in Washington, D.C., in early August. According to the study, 36.7 percent of Vietnam warzone veterans with warzone PTSD had severe co morbid major depression and were at far greater risk of heart disease and other chronic ailments.
“The primary focus was to examine the long-term course of PTSD among Vietnam veterans,” explains Corry. “This included assessing the long-term medical consequences of PTSD and risk factors for developing chronic or more severe symptoms of PTSD. We also looked at what services Vietnam veterans are receiving.”
The new study is a follow-up to the National Vietnam Veterans Readjustment Study (NVVRS), which surveyed 3,016 American veterans in the late 1980s. Conducted in response to a Congressional mandate, the NVVRS was hailed as a landmark undertaking in psychological and scientific circles because of the quality of the sampling and measurements.
In undertaking the National Vietnam Veterans Longitudinal Study, Abt Associates used the same sample, examining what had occurred with this population over the past 25 years.
“From a scientific standpoint, you want measures going forward in time, that reflect the current state of those individuals – as opposed to relying on retrospective measures,” says Danny G. Kaloupek, Ph.D., deputy director of the behavioral science division of the National Center for PTSD at the Veterans Affairs Boston Healthcare System.
“The NVVLS was important from a scientific standpoint and also [contributed to a greater] understanding from the VA’s perspective about what happened with these individuals. What implications does that have in terms of their health and their needs that the VA will have to address?”
The new study revealed a high correlation between veterans with PTSD and a number of physical ailments, including heart disease, cancer and musculoskeletal diseases.
“[The NVVLS] might have implications for the way mental health clinicians interact with their patients and the kind of recommendations they make, the referrals they make, recognizing that if you’re dealing with someone with a PTSD diagnosis, you know that this person is at higher risk for adverse outcomes in certain health areas,” says Kaloupek, who notes that his comments do not necessarily reflect the position of the VA.
A random subsample of the group (390 subjects) underwent a clinical diagnostic interview. Of those who had PTSD, 36.7 percent were assessed with major depression.
“That is a striking finding,” notes Corry. “It is not surprising that depression is related to PTSD but the strength of that association is of interest to us.”
Moving forward, the NVVLS not only provides a wealth of new information but also centers more attention on the issues involved with PTSD.
“There’s more of a focus on [PTSD] now,” says Sheryl LaCoursiere, Ph.D., an assistant clinical professor of nursing at UMass-Amherst and psychiatric nurse practitioner who works with PTSD-afflicted veterans at her private practice in Waterbury, Conn.
“The vets who are coming back from the Gulf area are experiencing PTSD. It’s coming more on the forefront and people in policy-making areas are able to justify putting resources towards it.”
Abt Associated will be releasing more results from the study in scientific, medical and psychological journals over the next few months.
By Howard Newman