The long-term psychosocial effects of trauma on survivors of human-caused extreme stress situations

Extreme stress situations that affect large collective groups, such as wars and disasters, change the lives of those affected. In the short run, survivors of such events experience significant stress. However, the long-term effects of catastrophe-generated stress are much less well understood. What are the long-term effects? Are there predisposing factors that influence long-term ability to cope with stressful life events? Are there subgroups that are more apt than others to suffer chronic problems such as posttraumatic-stress-disorder (PTSD), other manifestations of psychological distress and compromised health following a catastrophic event? The purpose of this study was to investigate the long-term psychosocial effects of trauma on survivors of military combat, to target predisposing factors that influence long-term adjustment, and to identify sub-populations that are more apt to suffer long-term problems following a catastrophic experience. This study focused on 75 male survivors of Operation Desert Storm (Persian Gulf, 1990 to 1991), who returned to Miami-Dade County and were evaluated and treated by the Miami Veterans Administration Medical Center. Hypothesized factors predicting and mediating or moderating the effects of active duty in Operation Desert Storm were grouped into six primary areas: (a) combat related stressors, (King, King, Fairbank, Keane & Adams, 1998; McCauley, Lasarev, Sticker, Rischitelli & Spencer, 2002; Riddle, Brown, Smith, Ritchie, Brix & Romano, 2003); (b) sociodemographic factors (Figley, 1985; Green, 1994; Unwin, Hotopf, Hull, Ismail, David & Wessely, 2002); (c) selected psychosocial characteristics (Aneshensel, 1992; Cohen & Wills, 1985; Figley, 1989; Shields, 2004; Taft, Stern, King & King, 1999); (d) pre-deployment history of psychiatric and substance abuse problems; abuse, economic hardship and loss as a youth; and disaster/catastrophic event experience; and (e) immediate post-return health and mental health conditions along with (f) current and past utilization of mental health and health services (Cohen, 1990; Udwin, Boyle, Yule, Bolton, O'Ryan, 2000). Long-term psychosocial and health effects of combat were specified as psychological distress, symptoms of PTSD and self reported functional and physical health status. Findings from this investigation suggest that the Persian Gulf combat veterans who participated in the study continued to experience high levels of psychological distress, manifest symptoms of PTSD and long-term emotional and physical distress years after their combat experience.