A new study has found that the incidence of post-traumatic stress disorder (PTSD) among soldiers returning from Afghanistan and Iraq is dramatically lower than predicted.
A Harvard researcher credits new efforts by the Army to prevent PTSD, as well as ensuring that those who do develop the disorder receive the best treatment available.
Early estimates suggested PTSD would affect up to 30 percent of the troops, said Harvard professor of psychology Dr. Richard J. McNally in an article that appears in the May 18 issue of Science. But current surveys show the actual rates ranging from 2.1 to 13.8 percent, he noted.
The most rigorous survey of American troops found that 4.3 percent of all American military personnel deployed to Iraq and Afghanistan developed PTSD, while 7.6 percent of those who saw combat developed the disorder, he added.
“As a society we’re much more aware of these issues than ever before,” McNally said. “That is reflected by the fact that the military and the Veteran’s Administration has established programs to ensure soldiers receive the best treatment possible. The title of my article is ‘Are We Winning the War Against Post-Traumatic Stress Disorder?’ I think a provisional answer to that is, ‘Yes, we might be.'”
The suggestion that 30 percent of troops might develop PTSD was based on the findings of the National Vietnam Veterans Readjustment Study (NVVRS), completed in 1990, which found that 30.9 percent of Vietnam veterans showed symptoms of PTSD. While later analyses brought that number down, the findings served to galvanize Army efforts to address the risk of soldiers developing the disorder, McNally said.
Part of the drop may be that today’s wars are less lethal — in a decade of war in Iraq, fewer than 5,000 American troops were killed, compared to more than 55,000 killed over a similar period in Vietnam, McNally noted. He was quick to add that new efforts by the Army to tackle the disorder sooner, and ensure soldiers receive the best treatment available, may be helping as well.
“It’s important to remember that simply being deployed carries a great deal of stress,” he said. “Soldiers miss their family, and those who stay at home essentially become a one-parent family. Difficulties with children, or school, or making ends meet — there are all kinds of stressors that have to do with separating families, let along having one member in a war zone. Fortunately, the military has taken steps to help soldiers cope with these stressors in addition to the traumatic combat stressors that can produce PTSD.”
Those steps include the Comprehensive Soldier Fitness (CSF) program, created to help soldiers build the resilience necessary to reduce their risk for PTSD before being deployed, and Battlemind training, which was created to treat those at risk of developing the disorder after they return.
“It’s not therapy per se, but a preventive intervention to help people put their experiences in perspective,” McNally said. “For example, it encourages soldiers to use the sort of emotional bonding that happens within units to reconnect with their families, and to see symptoms like hypervigilance not as symptoms of a mental disorder, but as something they need to adjust when they come home. It helps people realize that those things are part of the normal readjustment process.”
Evidence suggests the training is working, McNally said, pointing to the results of random trials that show that four months after returning home, soldiers who underwent Battlemind training showed fewer symptoms of PTSD and depression than those who underwent the Army’s standard post-deployment program. No such trials have been conducted with CSF, so it remains unclear what impact, if any, it has on the incidence of PTSD, he added.
Despite such efforts, however, some soldiers will develop PTSD, McNally said. Those who do have access to what are known to be the best treatments for the disorder, including prolonged exposure and cognitive processing therapy.
“Until this initiative, less than 10 percent of the clinical specialists in PTSD used these treatments,” McNally said. “These treatments weren’t available to veterans of the Vietnam War — they were only developed in the 1990s — and the evidence shows that the longer you have PTSD, the more likely it is that other problems will accumulate. The earlier we can get people into treatment, the quicker we can help them get their lives back together.”
Source: Harvard University