Publication year
2014
Citation Title
Involvement in abusive violence among Vietnam veterans: Direct and indirect associations with substance use problems and suicidality.
Journal Name
Psychological Trauma: Theory, Research and Practice
Journal Volume
6
Issue Number
1
Page Numbers
73-82
DOI
10.1037/a0032973
Summary
A survey of Vietnam combat Veterans was conducted to test whether experiences of abusive violence toward enemies or noncombatants were directly and/or indirectly linked with drug or alcohol problems and/or suicidality via posttraumatic stress disorder (PTSD) or guilt. Forty percent of the sample witnessed and/or were directly involved in acts of abusive violence while deployed in Vietnam. These experiences were indirectly linked with substance abuse via PTSD, and both indirectly and directly linked with suicidality via PTSD.
Key Findings
Thirty-five percent of Veterans in this sample witnessed and 12% were directly involved in acts of abusive violence against civilians or noncombatants while in combat.
Of those directly involved in abusive violence perpetration, 7% reported using chemicals and bombs on villages, 5% reported terrorizing or mistreating civilians, 4% reported torturing prisoners, and 2% reported mutilating bodies.
Exposure to abusive violence during combat was related to later drug problems, alcohol problems, and suicidality; these associations were indirect (via PTSD symptoms). Exposure to abusive violence was also directly related to suicidality.
Combat exposure overall (not exposure to abusive violence) was positively linked with war-related guilt.
Implications for Program Leaders
Offer classes for Service members who have experienced abusive violence, including information about PTSD, suicidality, and drug and alcohol problems
Develop curricula to provide Service members with positive coping strategies
Recommend education for service providers around the possible effects of deployment on Service members’ families
Implications for Policy Makers
Recommend the formation of collaborative relationships between military healthcare organizations and community programs to increase referral services
Recommend professional development for program staff regarding the relationship between various mental health concerns and substance use issues, and how to encourage healthy behaviors among Service members and their families
Continue to provide support for programs that work to increase family readiness
Methods
A subsample of the randomly sampled, nationally representative National Vietnam Veterans Readjustment Study was used, including Veterans who served in Active Duty between August 5th, 1964 to May 7th, 1975.
Veterans answered a survey which contained measures of combat exposure, exposure to abusive violence toward others during combat, PTSD, drug and alcohol problems, suicidality, and guilt.
Statistical analyses were used to test abusive violence and combat exposure’s direct and indirect effects on drug problems, alcohol problems, and suicidality.
Participants
A total of 1,203 Vietnam combat theater Veterans participated (100% male) in the study.
In the sample, the mean age was 41.70 years (SD = 5.26), mean years of education was 13.47 years (SD = 3.40), and participants identified as either White (73%) or Black (27%).
Among the participants, the mean years since last deployment in Vietnam was 18 years.
No information on military branch was provided.
Limitations
All measures were self-report and collected retrospectively (average of 18 years after deployment), which increased the odds of biased or incomplete reports.
These findings may not generalize to female and non-Vietnam era Veterans.
There was no accounting for the diversity of wartime experiences of these Veterans that may have impacted the results.
Given the lag time between deployment and this study, it is possible that some of the most impacted Veterans may have already passed away; thus, these results may be skewed towards Veterans who were healthier or had higher functioning.
Avenues for Future Research
Replicate the study with Veterans of OEF/OIF/OND to determine whether similar relationships exist among variables
Gather similar data with female and more racially and ethnically diverse Veterans
Examine the relationship between experiences of life threat during deployment, mental health, and substance use/abuse over time
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Circumstances of modern wars have placed service members at risk for harming noncombatants and engaging in other possible morally injurious acts. Studying a sample of 1,203 combat veterans from the National Vietnam Veterans Readjustment Study (NVVRS), this investigation used structural equation modeling (SEM) to test (1) whether experiences of abusive violence are positively directly linked with drug or alcohol problems and suicidality when accounting for traditional combat stressors, and (2) to what extent experiences of abusive violence have positive indirect effects on these postdeployment outcomes via posttraumatic stress disorder (PTSD) and war-related guilt. Overall, 40% of the sample had witnessed or were directly involved in acts of abusive violence while deployed in Vietnam. When controlling for the effects of traditional combat stressors, SEM results revealed that exposure to acts of abusive violence in Vietnam was linked indirectly with substance abuse via PTSD symptoms and both directly and indirectly with suicidality via PTSD symptoms. There was also a significant link between atrocity exposure and war-related guilt in the model, but veterans’ remorse about behavior in Vietnam failed to uniquely predict study outcomes beyond the symptomatology of PTSD. These findings highlight the effects of disproportionate warzone violence on postdeployment mental health, while also suggesting the need for broader conceptual models of combat trauma.
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