Persisting Posttraumatic Stress Disorder Symptoms and their Relationship to Functioning in Vietnam Veterans: A 14-Year Follow-Up
The authors examined the longitudinal association between persisting posttraumatic stress disorder (PTSD) symptoms and multiple domains of life functioning in a community sample of 1,377 American Legionnaire Vietnam veterans first assessed in 1984 and followed-up 14 years later. Almost 30 years after their return from Vietnam, 10% of veterans continued to experience severe PTSD symptoms. At all levels of combat exposure, persisting severe PTSD symptoms were associated with worse family relationships, more smoking, less life satisfaction and happiness, more mental health service use, and more nonspecific health complaints at the 14-year follow-up. Further investigation is needed to determine whether the PTSD-functioning relationship is causal and if successful treatment of PTSD is associated with improvement in functioning.
In this study, we first examine whether the association between higher combat exposure and worse functioning documented in 1984 is still evident in 1998. We then test whether persisting PTSD symptoms are associated with deficits in four important areas of current functioning: family relationships, negative health behaviors, personal well-being, and nonspecific health problems, after stratifying by combat exposure.Plus this
The association of PTSD with current smoking and nonspecific health complaints deserves further attention. A smaller proportion of veterans with persisting PTSD quit smoking between 1984 and 1998. Over 50% of veterans with PTSD in the medium and high combat groups were current smokers in 1998 compared to 30%−40% of those exposed to similar levels of combat, but who did meet criteria for severe PTSD symptoms. The significant association between combat-related PTSD and current smoking is consistent with other studies of veterans (Beckham, 1999; Eisen et al., 2004; Koenen et al., 2006; Schnurr and Spiro, 1999). Moreover, smoking has been posited as a mediator of the consistent association between PTSD and worse health and may be one reason veterans with PTSD had more nonspecific health complaints. Growing evidence suggests veterans with PTSD are at higher risk for future tobacco-related diseases including coronary heart disease and lung and other cancers (Boscarino, 2004, 2006; Kubzansky, Koenen, Spiro, Vokonas, and Sparrow, 2007). However, PTSD appears to have direct negative effects on self-reported health and coronary heart disease that are independent of the PTSD-smoking association (Kubzansky et al., 2007; Schnurr, Ford, et al., 2000; Schnurr and Spiro, 1999). In fact, path analytic studies suggest the direct effect of PTSD on health accounts for more of the variance than the indirect of PTSD through smoking (Schnurr and Spiro, 1999). Further longitudinal research aimed at clarifying the relationships among PTSD, smoking, and health problems in veterans is needed.
Remember as you read the following they have been doing research on PTSD for 40 years!
World-first study looks at PTSD's toll on Vietnam veterans' bodies
ABC Australia
By Tom Fowles
Posted about 10 hours ago
World-first research into the effects of post-traumatic stress disorder on Vietnam veterans, including Test cricketer Tony Dell, will be unveiled in Brisbane next month.
The study looked at 300 veterans, half of them with PTSD, to work out the physical impact of the disease.
Former Test cricketer and PTSD sufferer Mr Dell, who served in Vietnam in the late 1960s, was one of the first to take part in the study.
"Lots of people with PTSD actually die younger from the physical ailments that you actually become more susceptible to," he said.
He said he hoped the research provided encouragement for the Federal Government to take action against the debilitating condition.
"We hope to go back to the Prime Minister and the Defence Minister and say 'You have to do something'," Mr Dell said.
"In army terms, you've marked time for too long. It's flown under the radar. It's underfunded, it's misunderstood and here's a definite way forward for you."
The full extent of the physical toll that PTSD places on the body will be announced at the PTSD 2015 international forum in Brisbane between September 10-11.
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