The Roles of Combat Exposure, Personal Vulnerability, and Involvement in Harm to Civilians or Prisoners in Vietnam-War-Related Posttraumatic Stress Disorder

The diagnosis posttraumatic stress disorder was introduced in 1980 amid debate about the psychiatric toll of the Vietnam War. There is controversy, however, about its central assumption that potentially traumatic stressors are more important than personal vulnerability in causing the disorder. We te...

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Published inClinical psychological science Vol. 1; no. 3; pp. 223 - 238
Main Authors Dohrenwend, Bruce P., Yager, Thomas J., Wall, Melanie M., Adams, Ben G.
Format Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 01.07.2013
Sage Publications
Subjects
Adult and adolescent clinical studies
Anxiety disorders. Neuroses
Biological and medical sciences
Medical sciences
Post-traumatic stress disorder
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
United States
North America
America
harm
traumatic stressor
diagnosis
vulnerability
combat exposure
Vietnam War
posttraumatic stress disorder
Social environment
Human
Fighting
Anxiety disorder
Mental health
Male
Nosology
Posttraumatic stress disorder
Exposure
Vulnerability
Trauma
Stress
Criterion
Classification
Self involvement
Diagnosis
Veteran
Public health
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Summary:The diagnosis posttraumatic stress disorder was introduced in 1980 amid debate about the psychiatric toll of the Vietnam War. There is controversy, however, about its central assumption that potentially traumatic stressors are more important than personal vulnerability in causing the disorder. We tested this assumption with data from a rigorously diagnosed male subsample (n = 260) from the National Vietnam Veterans Readjustment Study. Combat exposure, prewar vulnerability, and involvement in harming civilians or prisoners were examined, with only combat exposure proving necessary for disorder onset. Although none of the three factors proved sufficient, estimated onset reached 97% for veterans high on all three, with harm to civilians or prisoners showing the largest independent contribution. Severity of combat exposure proved more important than prewar vulnerability in onset; prewar vulnerability was at least as important in long-term persistence. Implications for the primacy of the stressor assumption, further research, and policy are discussed.
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ISSN:2167-7026
2167-7034
DOI:10.1177/2167702612469355