Page 69 - Biobehavioral Resilence to Stress

46 Biobehavioral Resilience to Stress

Higher incident rates were reported especially during intense opera-
tions. Rosner (1944) reported that 40% of the casualties evacuated from
Guadalcanal “suffered from disabling neuromental disease” (as cited in

Marlowe, 2001, p. 49).
The Vietnam War was exceptional for many reasons; the notable fact is

that it yielded a higher rate of psychiatric casualties among those who had

been engaged in the confl ict after the period of most intense combat, which
occurred in 1968–1969 (Hyams, Wignall & Roswell, 1996; Marlowe, 2001).
Post–Vietnam War scholarship is marked by an ongoing eff ort to identify

and understand what specific economic, sociopolitical, and psychological
factors may have contributed to this phenomenon. For example, Hiley-Young
and colleagues examined data on 207 consecutively admitted veterans with
and without posttraumatic stress disorder (PTSD) and found that childhood
victimization, degree of combat exposure, and participation in war zone

abusive violence (specifically, mutilation) predicted subsequent development
of PTSD (Hiley-Young, Blake, Abueg, Rozynko & Gusman, 1995).
For most of the last half of the twentieth century, the oppressive but
comparatively stable conditions of the Cold War made it possible to main-
tain military personnel and rotation policies that fostered a fairly predict-
able career pattern for most American service members. Within reasonable
limits, personal and family concerns could be anticipated, planned, and
managed in the context of a military career that would probably not require
extended deployment or combat. With the exception of the Vietnam War,
contingencies involving combat deployment were quite brief. Early epide-
miologic studies of PTSD focused primarily on civilians but also included a

small percentage of Vietnam veterans. These studies found a 4% lifetime rate
of PTSD in nonwounded veterans but a 20% lifetime prevalence of PTSD
in veterans who had been wounded in combat (Helzer, Robins & McElvoy,
1987). Rates of psychiatric illness for nondeployed veterans have not other-
wise been extensively studied.
After the Cold War, there came a period of force reductions. From 1989

to 1999, the end-strength dropped from 2.1 to 1.4 million (Bruner, 2004).
Against this background of instability and turbulence in the force structure,
the United States deployed the largest military force since Vietnam War in

the first Persian Gulf War (1990–1991). The Gulf War period of high-intensity
combat lasted just 3 months, involving relatively low rates of stress-related
morbidity during the confl ict itself. After Vietnam War, and as distinct from

World War II, postdeployment problems were significant among Gulf War
veterans. Controversy surrounding “Gulf War syndrome” led to the develop-
ment of elaborate military physical and mental health screening programs,
which are currently in place (Marlowe, 2001). Researchers have identifi ed
several factors that likely contribute to the stress of modern military service,
including unpredictability of “tour” length (deployment period), limited

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