Fifty Vietnam combat veterans diagnosed PTSD were compared with 50 controls, who were also combat veterans. The two groups were evaluated with a structured interview, and assessments were made of childhood and family histories, immediate preservice experiences, combat experiences, and postdischarge experiences. The two groups differed significantly in the intensity of their combat experiences and their perceptions of their homecoming experiences. Neither early history nor immediate preservice factors differentiated the two groups.
Posttraumatic Stress Disorder has been a perplexing psychiatric phenomenon since it first was noted. Although clinical descriptions have been consistent from at least the time Samuel Pepys (Daly, 1983) noted his own experiences in London, in 1666, etiological explanations have been widely divergent (Krystal, 1978; Van Putten & Emory, 1973).
Events of the 20th century have refocused attention on the delayed maladaptive sequelae of stress. At varying intervals after liberation and repatriation, many survivors of the Nazi concentration camps were reported to have developed one or more symptoms identical to those that characterize patients with posttraumatic stress disorders (Antonovsky & Eitinger, 1971;. As was the case with the holocaust survivors, controversy erupted as to the relative importance of genetic and/or predispositional psychosocial factors, as well as the nature of the interaction between premorbidity and stressful experiences in determining the course and intensity of posttraumatic stress disorders among Vietnam veterans. Debate focuses upon whether veterans who developed stress disorders were constitutionally vulnerable to the stressors of war or whether the war experiences, and/or society's reactions to the discharged veterans, were of sufficient intensity to have affected anyone, independent of prior history.
The psychopathology of posttraumatic stress disorders has been described in the clinical literature, and the etiological significance of such factors as the unique characteristics of the Vietnam war, drug usage while in Vietnam, re-entry problems, and the magnitude of combat exposure have been considered. However, few controlled studies have been conducted to determine which pre-service, in-service, and post-service variables may differ between combat veterans who develop posttraumatic stress disorders and those who do not.
Frye and Stockton (1982) used a self-assessment questionnaire to study 90 relatively affluent, well-educated combat veterans, selected from an Infantry Officer Candidate School class. Twenty-one were diagnosed as having PTSD, 19 were assessed as borderline, and 50 were judged to be free of the disorder. Preservice variables assessed were education, attitudes toward the Vietnam war, age upon entering the service, and type of entry. Included among in-service variables were level of combat, immediacy of discharge, injuries sustained, assignment in Vietnam, and duration of military assignment. The post-service variables considered were helpfulness of family upon return, talking about Vietnam, locus of control, education after return, and socioeconomic status.