National Nurses United

PTSD 10/11/06 1:11 AM Page 17 "I've been 18 ever since I've been in Vietnam," he told PBS NewsHour in January 2004. "Been fighting that war every day. You can be driving down the road and your wife'll say, 'Where are you at? Do you know how fast you're going!?' You say, 'I'm here.' You don't tell her, 'I just got ambushed,' or 'They just dropped bombs on me.'" For many PTSD-plagued vets, alcohol and drugs alleviate the symptoms, resulting in addiction and dependency at epidemic levels. As medical interest in PTSD grows, answers about the disorder's sometimes confounding origins are being sought. Which soldiers are most at risk? In past wars, thousands of troops endured proximity to battlefield carnage, and sometimes imprisonment and torture. Why do some return psychically ravaged, while others remain functional? Scientific explanations range from biochemical to behavioral. But part of the answer is clear: Soldiers at highest risk for PTSD are those who are "forced to kill," according to research by Dave Grossman, a former West Point psychology professor, retired Lt. Col. Army Ranger, and recent author of the Pulitzer-nominated On Killing: The Psychological Cost of Learning to Kill in War And Society. Grossman's Myers, right, hangs out with his brother, Josh Myers and his dog at his mother's house. OCTOBER 2006 sobering findings show that PTSD incidence was even higher among frontline soldiers than among poorly-treated prisoners of war in both Vietnam and WWII. Even more than fear for one's own life, Grossman says, combat-related PTSD is caused by the anxiety and guilt linked to knowledge that one will or has killed another human being. Independent Veteran's Affairs research also links PTSD prevalence to battle exposure. A 2005 VA study showed that four times as many ground troops reported PTSD symptoms as did Navy or Air Force personnel. A 1996 Journal of Traumatic Stress study revealed that PTSD incidence was in fact lower among Gulf War veterans than WWII and Vietnam vets, due to their more limited combat exposure. Shouldn't distance from battle in itself resolve symptoms of trauma? Not so, according to a 1999 study in the Journal of Consulting and Clinical Psychology. Rather than shrinking, PTSD incidence among Gulf War troops actually rose in the 18 to 24 months after their return home, from 3 to 7 percent among male GIs and from 8 to 16 percent among female vets. The post-combat rate spikes in PTSD are due to the disorder's tendency to emerge three to six months after the triggering trauma (hence "post" traumatic). But Gulf vets' limited access to health and psychological support are also responsible, the study says. W W W. C A L N U R S E S . O R G REGISTERED NURSE 17

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