title: Vietnam veteran perceptions of delayed onset and awareness of posttraumatic stress disorder.
abstract: Although 40 years have passed since the Vietnam War, demand for treatment of posttraumatic stress disorder (PTSD) among veterans from this conflict has increased steadily. This study investigates the extent to which two factors, delayed onset or awareness of PTSD symptoms, may influence this demand. Using data from two studies of Vietnam Veterans in outpatient (n = 353) and inpatient (n = 721) PTSD treatment, this analysis examines retrospective perceptions of the time of symptom onset and awareness of the connection between symptoms and war-zone stress. The association of these two constructs with pre-war, wartime, and post-war clinical variables are analyzed. Delay in onset of symptoms was reported by 50% of outpatients and 35% of inpatients. Delay in awareness was reported by 60% of outpatients and 65% of inpatients. Onset of symptoms occurred within six years and onset of awareness within 20 years in 90% of individuals. Reported delays in onset and awareness were associated with more numerous negative life events after military service and before the onset of symptoms. Findings suggest that providers, administrators, and policy makers should be aware of the potential for protracted treatment demand among veterans from current conflicts, due in part by delay in onset and awareness of symptoms.
authors.affiliation: New England Mental Illness Research, Education, and Clinical Center, VA Connecticut Healthcare System, 900 Campbell Ave., West Haven, 06516, CT, USA, eric.hermes@yale.edu.
authors.forename: Eric
authors.initials: E
authors.lastname: Hermes
authors.forename: Alan
authors.initials: A
authors.lastname: Fontana
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
mesh_terms: D000328:Adult; D001364:Awareness / Q000502:physiology*; D003130:Combat Disorders / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology* / Q000503:physiopathology*; D013997:Time Factors; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict