Historic records shed light on soldiers' lifelong war scars

Study is first to demonstrate combat experiences predict lifetime post-war diseases

In the months after returning home from combat in Iraq and Afghanistan, some American soldiers report they are haunted by depression, anxiety, anger and nightmares. Now, a new study into the life and death of Civil War veterans sheds light on the lifelong effects of military combat -- both psychological and physical -- and suggests that a range of diseases and even early death plague those soldiers with the hardest wartime experiences.

"For the first time, we have objective records indicating that horrific war experiences are associated with a lifetime of increased physical disease and mental health difficulties," said Roxane Cohen Silver, UC Irvine professor of psychology and social behavior and senior researcher for the study, which is published in this month's Archives of General Psychiatry.

Looking at the Civil War, when the emotional and physical ailments affecting veterans first became known as "soldier's heart," psychologists have evaluated more than 15,000 Union veterans' military and medical records from the time of their enlistment to their post-war deaths. It is the first such study to use objective records from any war to match combat experiences to disease across a soldier's lifetime. The UCI researchers found the youth of the soldier, the extent of war horrors witnessed and prisoner-of-war experiences were linked to increased signs of cardiac, gastrointestinal and nervous disease throughout the veterans' lifetimes. In fact, the youngest soldiers who witnessed the bloodiest combat had shorter life spans, despite surviving the war itself.

"Unfortunately, it's likely that the deleterious health effects seen in a war conducted more than 130 years ago are applicable to the health and well-being of soldiers fighting wars in the 21st century," said Silver.

To measure the extent of each soldier's war trauma, researchers looked at the percentage of his comrades killed, a figure that represents a variety of stressors such as witnessing death or dismemberment, losing friends, fearing one's own imminent death and killing others. Existing studies of veterans from other wars have often relied on subjective measures of war trauma, such as a veteran's personal account of his experience.

Researchers found that in military companies with a larger percentage of soldiers killed, the veterans were 51 percent more likely to have cardiac, gastrointestinal and nervous disease. Additionally, the veterans who were youngest when they enlisted had a 93-percent increased risk of developing signs of combined physical and nervous disease, and even increased mortality. The study found that soldiers held as prisoners of war experienced increased incidence of combined physical and nervous disease later in life, too. The researchers suspect that short-term nervous system responses that help humans cope with traumatic events may have detrimental long-term health effects.

"These Civil War data represent a rare opportunity to look at medical records of war veterans over the life course, from a very young age until death," said Judith Pizarro, a graduate student in psychology and social behavior and lead author of the paper. "Not only are the data complete -- meaning all the veterans are deceased -- but the information is remarkably reliable because veterans' ailments were diagnosed by government physicians before being included in their official medical records."

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UCI research specialist and statistician JoAnn Prause is a co-author of the study. The study was funded by the National Institutes on Aging as a subgrant from the Center for Population Economics at the University of Chicago.

About the Civil War data:

For this study, researchers analyzed data from the largest, most comprehensive collection of electronic Civil War data files transcribed from their original written records from the National Archives. The transcription of military and post-war medical records was sponsored by the National Institutes of Health and the National Science Foundation. Records of veterans' ailments -- diagnosed by government physicians during the Civil War -- were transcribed using 19th and 20th century medical dictionaries, to classify diseases within modern definitions of cardiac, gastrointestinal or nervous disorders. This is the first study to link objective records of war trauma and mental and physical health over the life course of veterans.

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Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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