Gulf War and Health Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress (2008) / Chapter Skim
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3 DEPLOYMENT-RELATED STRESSORS
3 DEPLOYMENT-RELATED STRESSORS
Pages 31-48
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report notes that depression, substance abuse or dependence, and anxiety disorders, especially posttraumatic stress disorder (PTSD) , were increased in Gulf War veterans after deployment, and that symptom severity was associated with the level of war stress (IOM 2006)
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Deployment stressors in the Persian Gulf War included being in the vicinity of a Scud missile explosion, contact with prisoners of war or dead animals, direct combat duty, witnessing the death of a person, forced sexual relations or a sexual assault, being exposed to dismembered bodies or maimed soldiers, coming under small-arms fire, having artillery close by, and having a combat-related injury (Kang et al. 2000; Unwin et al.
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(1990) asked Vietnam veterans about both war-zone stressors and traumatic events for the National Vietnam Veterans Readjustment Study (NVVRS)
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(n = 815) Being attacked or ambushed 58 89 95 Receiving incoming artillery, rocket, or mortar fire 84 86 92 Being shot at or receiving small-arms fire 66 93 97 Shooting or directing fire at the enemy 27 77 87 Being responsible for the death of an enemy combatant 12 48 65 Being responsible for the death of a noncombatant 1 14 28 Seeing dead bodies or human remains 39 95 94 Handling or uncovering human remains 12 50 57 Seeing dead or seriously injured Americans 30 65 75 Knowing someone who was seriously injured or killed 43 86 87 Participating in demining operations 16 38 34 Seeing ill or injured women or children and being 46 69 83 unable to help them Being wounded or injured 5 14 9 Having a close call, being shot or hit, but being saved Not asked 8 10 by protective gear Having a buddy shot or hit nearby Not asked 22 26 Clearing or searching homes or buildings 57 80 86 Engaging in hand-to-hand combat 3 22 9 Saving the life of a soldier or civilian 6 21 19 SOURCE: Adapted with permission from Hoge et al.
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DoD Mental Health Advisory Team surveys of both active-duty troops and reserve and National Guard soldiers deployed to Iraq during OIF in 2005 and 2006 found that the most important noncombat stressors were deployment length and family separation; deployment length was of even higher concern to soldiers who had been deployed more than once (MHAT 2006a,b)
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Australian Navy Gulf War veterans were surveyed to identify stressors in military units that were not actively engaged in combat or that had little direct combat exposure -- those troops served in blockade efforts or provided transport, supplies, or medical support (Ikin et al. 2004, 2005; McKenzie et al.
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Sexual assault includes rape, nonconsensual sodomy, indecent assault (unwanted, inappropriate sexual contact or fondling) , or attempts to commit these acts." The Army defines sexual harassment as "a form of gender discrimination that involves unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature" (U.S.
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, found that of the 11,441 Gulf War veterans who responded (4202 women and 7239 men) , 24% of the women reported having been subject to sexual harassment, and 3.3% reported sexual assault; only 0.6% of the men reported experiencing sexual harassment, and even fewer (0.2%)
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From page 39... ...
Reservists and National Guard troops may encounter more stressors going to a war zone than those faced by active-duty military personnel; many of the additional stressors were unanticipated at the time the reservists and National Guard troops signed up for service. The stressors experienced by reservists and National Guard troops might include financial concerns, such as significant loss of income due to leaving more lucrative civilian jobs for lower military
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peacekeeping forces and have performed this function in Lebanon, Sinai, Bosnia, and Somalia. The inherent conflict between being trained for active combat duty and acting in a peacekeeping capacity can lead to stress in military peacekeepers particularly if they are involved in maintaining an established peace as opposed to a more traditional combat role of establishing peace among warring parties (Litz et al.
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In World War II, almost 350,000 women served in the armed forces in a variety of health-related, clerical, and other noncombat roles. In the Korean War, 48,700 women served in support roles; and during the Vietnam War, over 7000 women served in the Vietnam Theater, most as nurses.
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There were no sex differences for most of the stressor measures; however, women reported more exposure to interpersonal stressors, such as incidents of sexual harassment, and reported that they received less postdeployment social support than men. In contrast, men reported more mission-related stressors, such as combat experiences.
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The same stressors were associated with PTSD in women; however, just being female was sufficient for a woman to be subjected to sexual harassment, regardless of whether or not she had shown fear in a combat situation. In another study of Navy health-care providers deployed to the Persian Gulf on a hospital ship days before the Gulf War, there was anticipation of large numbers of casualties and concerns for safety.
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1999. A model of war zone stressors and posttraumatic stress disorder.
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1995. Alternative representations of war zone stressors: Relationships to posttraumatic stress disorder in male and female Vietnam veterans.
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1998. Posttraumatic stress disorder and comorbidity in Australian Vietnam veterans: Risk factors, chronicity and combat.
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female Persian Gulf War military personnel. Journal of Interpersonal Violence 13(1)
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