Stress Reactions: What Veterans Need to Know
(PDF). From the Iraq War Clinician
The wars in
Afghanistan and Iraq are the longest combat
operations since Vietnam. Many stressors face
these Operation Enduring Freedom/Operation Iraqi
Freedom (OEF/OIF) troops.
OEF/OIF service members are at risk for death
or injury. They may see others hurt or killed.
They may have to kill or wound others. They
are on alert around the clock. These and other
factors can increase their chances of having
PTSD or other mental health problems.
For many service
members, being away from home for long periods
of time can cause problems at home or work.
These problems can add to the stress. This may
be even more so for National Guard and Reserve
troops who had not expected to be away for so
long. Almost half of those who have served in
the current wars have been Guard and Reservists.
of stress in Iraq and Afghanistan is military
sexual trauma (MST). This is sexual assault
or repeated, threatening sexual harassment that
occurs in the military. It can happen to men
and women. MST can occur during peacetime, training,
One early study
looked at the mental health of service members
in Afghanistan and Iraq. The study asked Soldiers
and Marines about war-zone experiences and about
their symptoms of distress. Soldiers and Marines
in Iraq reported more combat stressors than
Soldiers in Afghanistan.
Marines who had more combat stressors had more
mental health problems. Those who served in
Iraq had higher rates of PTSD than those who
served in Afghanistan.
has confirmed that to date, troops who served
in Iraq are more likely to report mental health
problems than troops who served in Afghanistan.
A body of research shows a strong link between
level of combat stress and PTSD.
does serving in OEF/OIF affect mental health?
Research on OEF/OIF Veterans (1) suggests that
10-18% of OEF/OIF troops are likely to have
PTSD after they return. In addition to PTSD,
OEF/OIF service members are at risk for other
mental health problems. Although studies vary
widely in terms of methods used, estimates of
depression in returning troops range from 3%
to 25%. Excessive drinking and use of tobacco
among OEF/OIF Veterans may also be problematic.
Service members also report concerns over conflicts
has looked at how the response to war stressors
changes over time. PTSD symptoms are more likely
to show up in returning OEF/OIF service members
after a delay of several months. Using a brief
PTSD screen, service members were assessed at
their return and then again six months later.
Service members were more likely to have a positive
screen - that is, they showed more PTSD symptoms
-- at the later time.
On the other
hand, many service members who screened positive
(had more PTSD symptoms) at their return showed
fewer PTSD symptoms after six months. Overall,
it should be noted that most returning service
members screened negative for PTSD at both time
increases the risk of PTSD in OEF/OIF service
Research studies have found that certain factors
make it more likely that OEF/OIF service members
will develop PTSD. These factors include:
- Longer deployment time
- More severe combat exposure,
Deployment to "forward" areas
close to the enemy
Seeing others wounded or killed
- More severe physical injury
- Traumatic brain injury
- Lower rank
- Lower level of schooling
- Low morale and poor social
support within the unit
- Not being married
- Family problems
- Member of the National
Guard or Reserves
- Prior trauma exposure
- Female gender
- Hispanic ethnic group
service members getting mental health care?
Our recent Veterans are seeking care at VA more
than ever before. VA data show that from 2002
to 2009, 1 million troops left active duty in
Iraq or Afghanistan and became eligible for
VA care. Of those troops, 46% came in for VA
services. Of those Veterans who used VA care,
48% were diagnosed with a mental health problem
Veterans with mental health problems have not
come in for services. Reasons that some Veterans
have given for not getting treatment include:
- Concern over being seen
- Concern about being treated
- Concern that others would
lose confidence in them.
- Concerns about privacy.
- They prefer to rely on
family and friends.
- They don't believe treatment
- Concerns about side effects
- Problems with access,
such as cost or location of treatment.
these concerns, VA is reaching out to OEF/OIF
Veterans. It is vital to let Veterans know that
effective treatments exist for PTSD.
are available to OEF/OIF Veterans. You can find
a list under Military
Returning from the War Zone guides
also provide help and support to returning service
members and their families.
1. This fact
sheet is based on PTSD in Service
Members and New Veterans of the Iraq and Afghanistan
Wars: A Bibliography and Critique
in PTSD Research Quarterly, 20(1).Winter 2009.
2. VA Office
of Public Health and Environmental Hazards.
(February, 2010). Analysis of VA health care
utilization among Operation Enduring Freedom
(OEF) and Operation Iraqi Freedom (OIF) veterans.
Washington, DC: Author.