Transition Counseling Needed Following Exposure to Combat Situations, Yale Researcher Recommends

With the Vietnam War in the somewhat distant past, people need to be reminded about the crippling occupational, marital and psychological effects on soldiers who fight wars, says a Yale researcher who is studying veterans.

Holly Prigerson, associate professor of psychiatry and in the Department of Epidemiology and Public Health at Yale School of Medicine, this month published a study showing that men who witnessed combat, mainly in Vietnam, were at risk for a variety of current adverse outcomes.

“Wars can directly affect a man’s risk of developing a range of psychiatric problems and work and family difficulties,” she said. “Our findings have important implications for the thousands of Americans now involved in military strikes against Afghanistan.”

The article in the American Journal of Public Health was based on a national survey of more than 8,000 persons, 15-to-54-years-old, to determine the extent of psychiatric disorders and other forms of functional disability in a nationally representative sample. Slightly more than seven percent of those who responded had been in a war.

Combat exposure contributed significantly to the likelihood of current post-traumatic stress disorder, major depressive disorder, drug and alcohol abuse, unemployment, job loss, separation or divorce, and abuse of a partner or spouse. In fact, the study showed that, on a societal level, 28 percent of PTSD, 21 percent of spousal abuse, 12 percent of job loss, 8 percent of substance abuse problems, and 7.4 percent of major depression could have been averted had the men not been exposed to combat.

“The recent deployment of U.S. special operations forces and the call to active duty of thousands of American soldiers to fight the ‘war on terrorism’ reawakens a long-dormant interest in understanding the societal costs of war,” Prigerson said. “By documenting the enduring negative effects of combat exposure on the nation’s mental, social and occupational health, this report demonstrates the lasting and pernicious effects of exposing U.S. citizens to war.”

She said there is a public interest in providing quality mental health care to veterans, as well as social services such as marriage and occupational counseling, to assist them in transitioning back to life as civilians.

Co-authors of the study were Paul Maciejewski, associate research scientist, and Robert Rosenheck, M.D., professor of psychiatry and in the Department of Epidemiology and Public Health.

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