Treatment-seeking veterans of Iraq and Afghanistan: comparison with veterans of previous wars.
Differences in the characteristics and mental health needs of veterans of the Iraq/Afghanistan war when compared with those of veterans who served in the Persian Gulf war and in the Vietnam war may have important implications for Veterans Affairs (VA) program and treatment planning. Subjects were drawn from administrative data bases of veterans who sought treatment from specialized VA programs for treatment of posttraumatic stress disorder (PTSD). Current Iraq/Afghanistan veterans were compared with 4 samples of outpatient and inpatient Persian Gulf and Vietnam veterans whose admission to treatment was either contemporaneous or noncontemporaneous with their admission. A series of analyses of covariance was used hierachically to control for program site and age. In analyses of contemporaneous veterans uncontrolled for age, Iraq/Afghanistan veterans differed most notably from Vietnam veterans by being younger, more likely to be female, less likely to be either married or separated/divorced, more often working, less likely to have ever been incarcerated, and less likely to report exposure to atrocities in the military. Regarding clinical status, Iraq/Afghanistan veterans were less often diagnosed with substance abuse disorders, manifested more violent behavior, and had lower rates of VA disability compensation because of PTSD. Differences are more muted in comparisons with Persian Gulf veterans, particularly in those involving noncontemporaneous samples, or those that controlled for age differences. Among recent war veterans with PTSD, social functioning has largely been left intact. There is a window of opportunity, therefore, for developing and focusing on treatment interventions that emphasize the preservation of these social assets.
Fontana
Alan
A
New England Mental Illness Research, Education and Clinical Center, West Haven, Connecticut, USA. alan.fontana@va.gov
Rosenheck
Robert
R
D000328:Adult; D000346:Afghanistan; D000367:Age Factors; D015331:Cohort Studies; D003130:Combat Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007493:Iraq; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D018923:Persian Gulf Syndrome / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D012919:Social Behavior; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict; D014857:Warfare