Sunday, 30 September 2012

Researchers look into possible causes of current 'epidemic' of suicide and PTSD

Researchers look into possible causes of current 'epidemic' of suicide and PTSD

 
Because so little is known about how veterans die, comparing current mortality rates with past conflicts is a difficult task.

Forty years after the Vietnam War, there is still disagreement among researchers over the fates of combat veterans of that conflict: Although some studies found no long-term spike in suicides, overdoses or motor vehicle crashes, a 1987 U.S. Centers for Disease Control study found Vietnam veterans were indeed dying at higher rates than veterans who did not serve in Vietnam.

It’s even harder to find definitive mortality rates of veterans of World Wars I and II and Korea.
But there are isolated glimpses: B. Christopher Frueh, a post-traumatic stress disorder expert and research director at the Menninger Clinic in Houston, found that suicide rates of active-duty service members who fought in Iraq or Afghanistan are two to three times higher than those of Civil War fighters.

Frueh said explaining the difference is more difficult. “Why do we have this happening now, what are essentially epidemics of suicide and PTSD?” Frueh asked. “Were they always there, and we just did not notice or identify them, or are they something new?”

What is clearer is that the understanding of mental health issues facing soldiers and veterans has increased steadily over the past century.

Before World War I, mental health casualties were considered to be the result of poor discipline and cowardice, according to researchers Hans Pols and Stephanie Oak, who authored a 2007 study of U.S. psychiatric responses to war.

It wasn’t until World War II that mental health professionals began to understand that all normal human beings could break down under extreme conditions.

For both wars, however, the principal mental health strategy consisted of attempting to screen out vulnerable soldiers before sending them to war.

That strategy was a failure — rates of “war neurosis” (PTSD wasn’t codified as a mental health disorder until 1980) during World War II were double that of the first world war, when psychiatrists concluded that cases of “shell shock” were unacceptably high.

Prior to Vietnam, mental health officials also paid scant attention to mental health issues that emerged in veterans after war.

Such post-conflict symptoms were thought to be pre-existing conditions without a connection to war, according to Pols and Oak.

Today, it is generally acknowledged that PTSD symptoms can emerge years later and last for decades after combat.

And although mental health researchers have not been able to pinpoint exactly why the current conflicts are producing seemingly higher numbers of psychological casualties, they point to the changing nature of modern warfare. Raymond Scurfield, a professor of social work at the University of Southern Mississippi and Vietnam veteran who has written extensively about PTSD, singled out multiple deployments to Iraq and Afghanistan, which are unique in American military history.

“These repeated deployments make it that much more likely that they will be exposed to trauma and develop PTSD,” he said.

Scurfield also said the unpredictable violence and sudden bomb blasts that characterize warfare in Iraq and Afghanistan can take a toll on service members’ psyches.

“In Iraq and Afghanistan, when you go outside of the wire, you have to be alert all the time because of the prevalence of (improvised explosive devices),” he said. “You are constantly on alert, constantly on edge, constantly wondering when the next surprise is going to come.”

'Why do we have this happening now, what are essentially epidemics of suicide and PTSD? Were they always there, and we just did not notice or identify them, or are they something new?’
-- B. Christopher Frueh, a post-traumatic stress disorder expert and research director at the Menninger Clinic in Houston

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