Steven Stellman - Post-traumatic stress disorder among American Legionnaires in relation to combat experience in Vietnam: associated and contributing factors

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      Publication Details (including relevant citation   information):

      Snow, B. R., Stellman, J. M., Stellman, S. D., Sommer, J. F., Jr.   47 (2) 175-92-

      Abstract: The relationship between combat   stress, DSM-III-defined post-traumatic stress disorder (PTSD),   and a variety of behavioral factors was examined in a large   nonclinical population. A total of 2858 randomly selected   American Legion members who had served in Southeast Asia   completed a questionnaire which elicited information on military   service, personal health, and a variety of mental health   outcomes. The data confirm the utility of the PTSD diagnosis as a   distinct clinical entity. The frequency of PTSD and the extent of   symptoms developed varied with the severity of criteria used for   determining the extent of traumatic exposure. The PTSD rate   ranged from 1.8 to 15.0% of the total sample, depending on   whether "exposure" to combat was defined relatively narrowly or   broadly. A distinct linear dose-response relationship between   combat stress and a quantitative measure of PTSD intensity was   observed. The frequency of PTSD diagnosis was not affected by the   presence of either physical or mental health problems which   predated military service. A strong, stable relationship was   found between combat stress and PTSD intensity for cohorts with   differing intervals since the experience of combat trauma, which   persisted up to 20 years after discharge from the military. The   data thus support a broader approach to defining traumatic events   which recognizes individual differences in response to combat, as   well as the existence of other behavioral outcomes as residual   effects of combat. Implications of these findings and the   importance of treating veterans with varying presentations of   PTSD are discussed.

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