Why Some Soldiers Develop PTSD While Others Don't
Feb. 21, 2013
Pre-war vulnerability is just as important as combat-related trauma in predicting whether veterans' symptoms of post-traumatic stress disorder (PTSD) will be long-lasting, according to new research published in Clinical Psychological Science, a journal of the Association for Psychological Science.
It was a small study and far from a new one.
Of the soldiers who experienced any potentially traumatic combat exposures, only 31.6% developed the PTSD syndrome. When the researchers limited their analysis to the soldiers who experienced the most severe traumatic exposures, there was still a substantial proportion -- about 30% -- that did not develop the syndrome. This suggests that there were other factors and vulnerabilities involved for the minority of exposed who did end up developing the PTSD syndrome.In other words, 70% did develop it? This makes no sense at all. The long term percentage used for addressing Post Traumatic Stress Disorder has been 30%. The issue here with OEF and OIF veterans is the fact redeployments increase the risk by 50% and there have been multiple redeployments.
Age also seemed to play an important role: Men who were younger than 25 when they entered the war were seven times more likely to develop PTSD compared to older men. The researchers also found that soldiers who inflicted harm on civilians or prisoners of war were much more likely to develop PTSD.This addresses how the brain develops by, you guessed it, 25.
Maturation of the Prefrontal Cortex The prefrontal cortex, the part of the frontal lobes lying just behind the forehead, is often referred to as the “CEO of the brain.” This brain region is responsible for cognitive analysis and abstract thought, and the moderation of “correct” behavior in social situations. The prefrontal cortex takes in information from all of the senses and orchestrates thoughts and actions to achieve specific goals.1,2
The prefrontal cortex is one of the last regions of the brain to reach maturation. This delay may help to explain why some adolescents act the way they do. The so-called “executive functions” of the human prefrontal cortex include:
Focusing attention
Organizing thoughts and problem solving
Foreseeing and weighing possible consequences of behavior
Considering the future and making predictions
Forming strategies and planning
Ability to balance short-term rewards with long term goals
Shifting/adjusting behavior when situations change
Impulse control and delaying gratification
Modulation of intense emotions
Inhibiting inappropriate behavior and initiating appropriate behavior
Simultaneously considering multiple streams of information when faced with complex and challenging information
This brain region gives an individual the capacity to exercise “good judgment” when presented with difficult life situations. Brain research indicating that brain development is not complete until near the age of 25, refers specifically to the development of the prefrontal cortex.
If they developed mild PTSD before the age of 25, the likelihood of it getting worse is much greater because the primary stressor was not treated before they were hit by a series of them. The Secondary Stressors push mild PTSD into overdrive.
The combined data from all three primary factors -- combat exposure, prewar vulnerability, and involvement in harming civilians or prisoners -- revealed that PTSD syndrome onset reached an estimated 97% for veterans high on all three. While severity of combat exposure was the strongest predictor of whether the soldiers developed the syndrome, pre-war vulnerability was just as important in predicting the persistence of the syndrome over the long run.So what exactly is "prewar vulnerability" and did they factor in training itself? If they don't consider training traumatic then they have never talked to veterans about it. They are broken down emotionally, pushed to the limits physically and stressed out. Some do come out of training stronger but some realize they shouldn't have joined in the first place. Think that may be traumatic for them? Then take a look at everyone you know. Almost all of them had some kind of trauma in their lives before they were 25. Some had it worse than others. Some felt it stronger than others.
Dohrenwend and colleagues also point out that the recent conflicts in Iraq and Afghanistan, like the Vietnam War, are "wars amongst the people," and they underline the need for research examining the circumstances in which harm to civilians and prisoners is likely to occur. Such research could provide important clues for preventing such devastating violations of the rules of war.This again falls under old research since the "moral injury" has been documented for generations and yes, Vietnam, Afghanistan and Iraq involved people without uniforms on waging war, so they never did know who the enemy was.
If you come across anyone just posting this link when they pass it off as an important story, think twice about what else they missed because PTSD research began in the 70's and very little "new" research has been done even though they act as if it is new.
