2005 August 28 Sunday
Stress Of War Exacts Long Term Health Costs

Soldiers who suffer from Post Traumatic Stress Disorder (PTSD) have much higher rates of death from a large range of causes.

But now Joseph Boscarino of the New York Academy of Medicine has re-analysed the 1985 data to assess which men were suffering from the condition. That analysis, to be published in Annals of Epidemiology, reveals stark differences in death rates persisting 30 years after the end of the Vietnam conflict. All men with PTSD, whether from combat experience or not, were more likely to die from "external causes" such as accidents, drugs or suicide. But men who developed PTSD as a consequence of combat were also more likely to die of heart disease and, surprisingly, various kinds of cancer.

Boscarino finds lowered cortisol levels in soldiers proportionate to the amount of combat exposure they experienced.

Israeli researchers found the same pattern with veterans of the fighting in Lebanon.

In March this year Yael Benyamini and colleagues at Tel Aviv University in Israel reported that among Israeli veterans of fighting in Lebanon in 1982, those who developed PTSD are now twice as likely to have high blood pressure, ulcers and diabetes, and five times as likely to have heart disease and headaches, as those who did not develop the disorder (Social Science and Medicine, vol 61, p 1267). "PTSD is the key mechanism that leads from the trauma to poorer health," they say.

Because of advances in medical technology a much higher percentage of injured soldiers survive. Therefore the death rates understate the extent of the damage done to soldiers in Iraq.

A modest proposal to any folks reading this who work in policy making positions in the US Defense Department: Do a study on stress levels of soldiers in Iraq to track stress levels on soldiers in the field by minute or by some other high rate of sampling. Use electrodes or give soldiers small devices (PDAs?) where they can record when they feel high levels of stress. Use blood sampling to check how long stress levels remain high after combat operations. Find out exactly which situations cause stress and whether any tactical changes can reduce the percentage of the time that soldiers are in stressful situations.

For example, if soldiers who are about to break down a door feel a lot of stress would they feel less stress in such an operation if they could use a mechanical device to punch a hole through the door and extend a pole with a camera to see what is inside an apartment or house before entering?

Also, do stress levels in soldiers on long operations rise when they lack sleep? Does Provigil (modafinil) prevent some of the stress response to sleep deprivation or does it make the stress response higher?

Also, what base designs would best reduce stress levels of soldiers between combat operations? Would natural scenic vistas or paintings of forests or fields or perhaps ocean views best reduce stress? Does golf course architecture offer lessons for lowering soldier stress while in bases?

An even more effective way to stop the stress would be total withdrawal of US forces. But the American public haven't yet learned enough to make that a possibility.

Share |      By Randall Parker at 2005 August 28 02:39 PM  Mideast Iraq Costs

Engineer-Poet said at August 29, 2005 6:57 AM:

Now would be a very good time to start testing beta blockers as ways to halt PTSD.  If they can also prevent the knock-on effects of PTSD it could save enormous amounts of suffering, not to mention money.

Bob Badour said at August 29, 2005 4:54 PM:

Beta-blockers block the production of adrenaline and halt anger reactions. I wonder whether halting the stress response is appropriate for soldiers at war. After all, it seems to me the species evolved the stress response precisely for such times of danger.

playrink said at August 30, 2005 10:14 AM:

experts (immune from accountability) routinely tinker with the neurochemistry of pre-teens, ignorance of the intricacies of the human mind be damned. War-zone denizens deserve at least so much concern.

edit: experts held accountable enrich pers inj shysters, my bad, god bless merka & the latest fashions.

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