This document discusses post-traumatic stress disorder (PTSD) among American military veterans. It provides statistics on the veteran population and where they served. PTSD is defined as a psychiatric disorder that can occur after witnessing or experiencing life-threatening events like military combat. Symptoms of PTSD include survivor guilt, nightmares, and hyper arousal. Risk factors include longer deployments, more combat exposure, and lower rank. While the military culture emphasizes discipline and social support, it also stigmatizes mental illness, normalizes substance abuse, and increases poverty risk, all of which can negatively impact veterans with PTSD.

1. Sean MacMillen
Lock Haven University
HLTH307
25 April 2012

2. Agenda
Veteran Population
 What is PTSD
 Symptoms of PTSD
 Risk Factors
 Positive Aspects of Culture
 Negative Aspects of Culture
 Existential Aspects of Culture

3. American Military Veterans (2010)
 21.8 million veterans
 1.6 million women veterans
 17.5 million White veterans
 2.4 million Black veterans
 203,000 Asian American veterans
 156,000 American Indian or Alaska Natives
 9 million veterans 65 or older
1.7 million were age 35 or younger

4. Where Did They Serve?
 7.6 million Vietnam veterans
 4.8 million Gulf War veterans
 2.1 million World War II veterans
 2.6 million Korean War veterans
 5.5 million veterans served during peacetime
only
 Since 2001, over 1.5 million service members
have served in Iraq or Afghanistan

5. What is PTSD?
 Psychiatric disorder than can occur following
the experience of witnessing of life
threatening events
 Military combat
 Natural disasters
 Terrorist incidents
 Serious accidents
 Violent personal attacks

6. Combat PTSD
 Following war, many veterans return home
significantly altered
 Have a changed view of the world and
themselves
 Reactions may be short lived (only a few
months)
 For others, healing may require long term
vigilance

7. Typical Symptoms
 Survivor guilt
 Fear
 Flashbacks
 Loneliness
 Revenge fantasies
 Emotionally numb
 Depression
 Frustration
 Nightmares
 Distrust
 Suicidal
 Addiction
 Hyper arousal
 Difficulty sleeping

8. Effects of PTSD
 Symptoms may not appear until months or
years after combat
 Can significantly impair a person’s daily life
 Difficulties in social or family life
 Occupational instability
 Marital problems
 Family discord
 Difficulties in parenting

9. Prevalence Rates of PTSD
 Vietnam: 15% to 31% of veterans
 Iraq and Afghanistan: 10% to 18% of veterans
 Mental health illness is 2nd largest category
for which veterans from Iraq and Afghanistan
seek treatment
 Between 2006-2007, 70% increase in veterans
seeking treatment for PTSD

10. Risk Factors
 Longer deployments
 More severe combat
exposure
 More severe physical
injury
 Traumatic Brain Injury
 Lower rank
 Lower level of
schooling
 Low unit morale
 Not married
 Family problems
 Member of National
Guard or Reserves
 Prior trauma exposure
 Female (twice as likely)
 Hispanic ethnic group

11. Positive Cultural Factors
 Improvements in access to health care
 Physical exercise
 Selfless service
 Personal courage
 Moving/relocating
 Discipline
 Social Support

12. Positive Cultural Factors
 Improvements in health care
 Iraq and Afghanistan veterans eligible for 5 years
of free health care for condition related to combat
after discharge
 Increased staffing
 Physical exercise
 Importance of exercise instilled in military
 Used to reduce stress or tension
 Distraction from difficult emotions or painful
memories

13. Positive Cultural Factors
 Moving/Relocating
 Veterans are used to changing duty stations
 May find it necessary to move to feel safe
 Living in high crime areas increases PTSD
 Discipline
 Basic foundation of the military lifestyle
 Veterans more likely to participate in treatment
program and aftercare
 More likely to take prescribed medications

14. Positive Cultural Factors
 Selfless service
 Put welfare of others before own
 Veterans likely to volunteer; feel as though they
can contribute
 Personal courage
 Ability to face, fear, danger, adversity
 Requires courage to face own mental health
issues

15. Positive Cultural Factors
 Role of social support
 Learn importance during deployments
 Helps to cope with PTSD
 Emotional support important to make veteran
feel safe and changes habits and behaviors

16. Negative Cultural Factors
 Stigma of mental illness
 Alcohol use
 Tobacco
 Poverty

17. Negative Cultural Factors
 Military structure encourages camaraderie and peer
support
 Double-edged sword; creates hidden barriers to seeking
care
 Stigma of mental illness is largest obstacle to overcome
 Perception of being weak; treated differently
 Members of unit may lose confidence in their abilities
 50% of veterans in one study showed signs of mental
illness, but refused to seek treatment due to stigma
 Media portrayal of PTSD sufferers as monsters

18. Negative Cultural Factors
 Alcohol use widely accepted in the military
 20% with PTSD also have substance abuse disorder
(SUD)
 PTSD and SUD; likely to have other health
complications
 Using drugs and alcohol can make PTSD worse
 Tobacco use rates higher than general population
 Number of veterans who smoke is double for PTSD
(about 6 in 10)
 Tobacco use creates other health concerns

19. Negative Cultural Factors
 Poverty
 More than 968,000 veterans in poverty
1 in 7 homeless adults are veterans
 1.5 million veterans at risk of homelessness to
due to poverty
 Poor diets
 May not have access to mental health care

20. Negative Cultural Factors
 Distrust in VA medical system
 Vietnam veterans treated poorly upon return
 Vietnam veterans – PTSD was not acknowledged
as a disorder until 1980
 Long waits for appointments
 Many mental health professionals in VA system
are not veterans

21. Existential Cultural Factors
Communication
 Veterans have a unique language carried over
from military service
 Military slang and acronyms used

22. “Out of suffering have emerged the strongest souls.
The most massive characters are seared with scars.”
~ Khalil Gibran