Soldiers and veterans and PTSD

War and terrorism

Are war and terrorism risk factors for PTSD?

Exposure to at least one trauma is required for a diagnosis of PTSD. The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) determines direct traumas as threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Indirect traumas include witnessing the trauma, or learning that a relative or close friend was exposed to a trauma. Differences in trauma characteristics, along with differences in personal characteristics, may affect the risk of developing PTSD.

What is the evidence regarding war and terrorism and PTSD?

Moderate to high quality evidence finds a large effect of more post-traumatic stress symptoms in World War 2 holocaust survivors than in people with no holocaust background. The effect was largest in people who were children when exposed. There was a small effect of increased PTSD in children exposed to the Israeli-Palestinian conflict.

The prevalence of PTSD in war-affected refugees and citizens is around 31%. Rates were highest in samples exposed to recent conflict, torture, and political terror. They were highest in people from Cambodia, Bosnia, Kosovo, and Africa. The risk factors associated with increased PTSD in military personnel and veterans exposed to combat include; discharging a weapon, witnessing someone being wounded or killed, experiencing severe trauma, and having deployment-related stressors. Also, being in the army rather than other military branches, having direct combat exposure, being a non-officer, having previous adverse life events, being combat specialists, being female, having prior psychological problems, low education, longer and more deployments, being non-White, and having previous prior trauma. There were protective effects of having high unit cohesion and post-deployment support in military personnel and veterans.

There was a medium-sized increase in PTSD in people directly rather than indirectly exposed to the New York World Trade Centre attack. Rates were highest in civilians and in people who were injured during the attack.

August 2021

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Last updated at: 10:55 pm, 11th October 2021
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