Advertisement

Complicated Postcombat Disorders in Vietnam Veterans

Comprehensive Diagnosis and Treatment in the VA System
  • Roland M. Atkinson
  • Michael E. Reaves
  • Michael J. Maxwell
Part of the The Springer Series on Stress and Coping book series (SSSO)

Abstract

Postcombat adjustment of Vietnam veterans is highly variable (Egendorf, Kadushin, Laufer, Rothbart, & Sloan, 1981; Wilson, 1978). Most workers would agree with Egendorf (1982) that among persons exposed to the war, there is probably a spectrum of stress response problems varying from subtle forms to severe, chronic disorders. Although accurate prevalence data are not yet at hand, certainly only a portion of these veterans would meet the DSM-III (American Psychiatric Association, 1980) criteria for post-traumatic stress disorder (PTSD), and an even smaller proportion would be expected to show, in addition, features justifying other psychiatric diagnoses.

Keywords

Personality Disorder Substance Abuse Treatment Community Psychiatry Vietnam Veteran Combat Veteran 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington DC: American Psychiatric Association.Google Scholar
  2. Arnold, A. L. (1985). Diagnosis of post-traumatic stress disorder in Vietnam veterans. In S. M. Sonnenberg, A. S. Blank, Jr., & J. A. Talbott, (Eds.), The trauma of war: Stress and recovery in Vietnam veterans (pp. 99–123). Washington DC: American Psychiatric Press.Google Scholar
  3. Atkinson, R. M., Henderson, R. G., Sparr, L. F., & Deale, S. (1982). Assessment of Vietnam veterans for posttraumatic stress disorder in Veterans Administration disability claims. American Journal of Psychiatry, 139, 1118–1121.PubMedGoogle Scholar
  4. Atkinson, R. M., Sparr, L. F., Sheff, A. G., White, R. A. F., & Fitzsimmons, J. T. (1984). Diagnosis of posttraumatic stress disorder in Vietnam veterans: Preliminary findings. American Journal of Psychiatry, 141, 694–696.PubMedGoogle Scholar
  5. Atkinson, R. M., Callen, K. E., Reaves, M. E., & Drummond, D. J. (1985). VA mental health services for Vietnam veterans. VA Practitioner, 2(5), 72–74, 77.Google Scholar
  6. Berman, S., Price, S., & Gusman, F. (1982). An inpatient program for Vietnam combat veterans in a Veterans Administration hospital. Hospital and Community Psychiatry, 33, 919–922.PubMedGoogle Scholar
  7. Blanchard, E. B., Kolb, L. C., Pallmeyer, T. P., & Gerardi, R. J. (1982). A psychophysiological study of post traumatic stress disorder in Vietnam veterans. Psychiatric Quarterly, 54, 220–229.PubMedCrossRefGoogle Scholar
  8. Blank, A. S., Jr. (1982a). Apocalypse terminable and interminable: Operation outreach for Vietnam veterans. Hospital and Community Psychiatry, 33, 913–918.PubMedGoogle Scholar
  9. Blank, A. S., Jr. (1982b). Stresses of war: The example of Vietnam. In L. Goldberger & S. Breznitz (Eds.), Handbook of stress (pp. 631–643). New York: Free Press/Macmillan.Google Scholar
  10. Blank, A. S., Jr. (1985). The Veterans Administration’s Vietnam veterans outreach and counseling centers. In S. M. Sonnenberg, A. S. Blank, Jr., & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans (pp. 227–261). Washington DC: American Psychiatric Press.Google Scholar
  11. Boulanger, G. (1986). Predisposition to posttraumatic stress disorder. In G. Boulanger & C. Kadushin (Eds.), The Vietnam veteran redefined: Fact and fiction (pp. 37–50). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  12. Boulanger, G., Kadushin, C., Rindskopf, D. M., & Carey, M. A. (1986). Posttraumatic stress disorder: A valid diagnosis? In G. Boulanger & C. Kadushin (Eds.), The Vietnam veteran redefined: Fact and fiction (pp. 23–35). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  13. Breslau, N., & Davis, G. C. (1987). Post traumatic stress disorder: The etiologic specificity of wartime Stressors. American Journal of Psychiatry, 144, 578–583.PubMedGoogle Scholar
  14. Buffalo VA Medical Center. (1984). Proposal for a multiservice center for Vietnam veterans with post traumatic stress disorder. Unpublished manuscript.Google Scholar
  15. Callen, K. E., Reaves, M. E., Maxwell, M. J., & McFarland, B. H. (1985). Vietnam veterans in the general hospital. Hospital and Community Psychiatry, 36, 150–153.PubMedGoogle Scholar
  16. Card, J. J. (1983). Lives after Vietnam. Lexington, MA: Lexington Books.Google Scholar
  17. DeFazio, V. J. (1978). Dynamic perspectives on the nature and effects of combat stress. In C. R. Figley (Ed.), Stress disorders among Vietnam veterans: Theory, research and treatment (pp. 23–42). New York: Brunner/Mazel.Google Scholar
  18. Domash, M. D., & Sparr, L. F. (1982). Post-traumatic stress disorder masquerading as paranoid schizophrenia: Case report. Military Medicine, 147, 772–774.PubMedGoogle Scholar
  19. Dwyer, J., & Pentland, B. (1983). Vietnam veterans liaison unit. West Los Angeles VA Medical Center. Various unpublished materials.Google Scholar
  20. Egendorf, A. (1982). The postwar healing of Vietnam veterans: Recent research. Hospital and Community Psychiatry, 33, 901–908.PubMedGoogle Scholar
  21. Egendorf, A., Kadushin, C., Laufer, R. S., Rothbart, G., & Sloan, L. (1981). Legacies of Vietnam: Comparative adjustment of veterans and their peers (Publication No. V 101 134P-630). Washington, DC: U.S. Government Printing Office.Google Scholar
  22. Escobar, J. I., Randolph, E. T., Puente, G., Spiwak, F., Asamen, J. K., Hill, M., & Hough, R. L. (1983). Post-traumatic stress disorder in Hispanic Vietnam veterans. The Journal of Nervous and Mental Disease, 171, 585–596.PubMedCrossRefGoogle Scholar
  23. Fairbank, J. A., & Keane, T. M. (1982). Flooding for combat-related stress disorders: Assessment of anxiety reduction across traumatic memories. Behavior Therapy, 13, 499–510.CrossRefGoogle Scholar
  24. Fairbank, J. A., Keane, T. M., & Malloy, P. F. (1983). Some preliminary data on the psychological characteristics of Vietnam veterans with posttraumatic stress disorders. Journal of Consulting and Clinical Psychology, 51, 912–919.PubMedCrossRefGoogle Scholar
  25. Fairbank, J. A., McCaffrey, R. J., & Keane, T. M. (1985). Psychometric detection of fabricated symptoms of posttraumatic stress disorder. American Journal of Psychiatry, 142, 501–503.PubMedGoogle Scholar
  26. Fox, R. P. (1974). Narcissistic rage and the problem of combat aggression. Archives of General Psychiatry, 31, 807–811.PubMedCrossRefGoogle Scholar
  27. Foy, D. W., Sipprelle, R. C., Rueger, D. B., Carroll, E. M. (1984). Etiology of posttraumatic stress disorder in Vietnam veterans: Analysis of premilitary, military and combat exposure influences. Journal of Consulting and Clinical Psychology, 52, 79–87.PubMedCrossRefGoogle Scholar
  28. Frick, R., & Bogart, L. (1982). Transference and countertransference in group therapy with Vietnam veterans. Bulletin of the Menninger Clinic, 46, 429–444.PubMedGoogle Scholar
  29. Friedman, M. J. (1981). Post-Vietnam syndrome: Recognition and management. Psychosomatics, 22, 931–943.PubMedGoogle Scholar
  30. Frye, J. S., & Stockton, R. A. (1982). Discriminant analysis of post-traumatic stress disorder among a group of Vietnam veterans. American Journal of Psychiatry, 139, 52–56.PubMedGoogle Scholar
  31. Green, B. L., Lindy, J. D., & Grace, M. C. (1985). Posttraumatic stress disorder: Toward DSM-IV. The Journal of Nervous and Mental Disease, 173, 406–411.PubMedCrossRefGoogle Scholar
  32. Green, B. L., Wilson, J. P., & Lindy, J. D. (1985). Conceptualizing post-traumatic stress disorder: A psychosocial framework. In C. R. Figley, (Ed.), Trauma and its wake: The study and treatment of post-traumatic stress disorder (pp. 53–69). New York: Brunner/Mazel.Google Scholar
  33. Harris, M. J., & Fisher, B. S. (1985). Group therapy in the treatment of female partners of Vietnam veterans. Journal for Specialists in Group Work, 10, 44–50.CrossRefGoogle Scholar
  34. Heizer, J. E. (1981). Methodological issues in the interpretations of the consequences of extreme situations. In B. S. Dohrenwend & B. P. Dohrenwend (Eds.), Stressful life events and their contexts (pp. 108–129). New York: Neale Watson Academic Publications.Google Scholar
  35. Heizer, J. E., Robins, L. N., Wish, E., & Hesselbrock, M. (1979). Depression in Vietnam veterans and civilian controls. American Journal of Psychiatry, 136, 526–529.Google Scholar
  36. Hendin, H., Pollinger, A., Singer, P., & Ulman, R. B. (1981). Meanings of combat and the development of post-traumatic stress disorder. American Journal of Psychiatry, 138, 1490–1493.PubMedGoogle Scholar
  37. Hendin, H., Pollinger, A., & Haas, A. (1984). Combat adaptations of Vietnam veterans without posttraumatic stress disorders. American Journal of Psychiatry, 141, 956–959.PubMedGoogle Scholar
  38. Horowitz, M. J. (1986). Stress response syndromes (2nd ed.) New York: Jason Aronson.Google Scholar
  39. Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychomatic Medicine, 41, 209–218.Google Scholar
  40. Hyer, L., O’Leary, W. C., Elkins, R., & Arena, J. (1985). PTSD: Additional criteria for evaluation. VA Practitioner, 2(9), 67–68, 73-75.Google Scholar
  41. Jelinek, J. M., & Williams, T. (1984). Post-traumatic stress disorder and substance absue in Vietnam combat veterans: Treatment problems, strategies and recommendations. Journal of Substance Abuse Treatment, 1, 87–97.PubMedCrossRefGoogle Scholar
  42. Kadushin, C. (1985). Social networks, helping networks, and Vietnam veterans. In S. M. Sonnenberg, A. S. Blank, Jr., & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans (pp. 57–68). Washington DC: American Psychiatric Press.Google Scholar
  43. Keane, T. M., Malloy, P. F., & Fairbank, J. A. (1984). Empirical development of an MMPI subscale for the assessment of combat-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 52, 888–891.PubMedCrossRefGoogle Scholar
  44. Keane, T. M., Fairbank, J. A., Caddell, J. M., Zimering, R. T., & Bender, M. E. (1985). A behavioral approach to assessing and treating post-traumatic stress disorder in Vietnam veterans. In C. R. Figley (Ed.), Trauma and its wake: The study and treatment of post-traumatic stress disorder (pp. 257–294). New York: Brunner/Mazel.Google Scholar
  45. Keane, T. M., Scott, W. O., Chavoya, G. A., Lamparski, D. M., & Fairbank, J. A. (1985). Social support in Vietnam veterans with posttraumatic stress disorder: A comparative analysis. Journal of Consulting and Clinical Psychology, 53, 95–102.PubMedCrossRefGoogle Scholar
  46. Keane, T. M., Zimering, R. T., & Caddell, J. M. (1985). A behavioral formulation of posttraumatic stress disorder in Vietnam veterans. The Behavior Therapist, 8, 9–12.Google Scholar
  47. Lacoursiere, R. B., Godfrey, K. E., & Ruby, L.M. (1980). Traumatic neurosis in the etiology of alcoholism: Vietnam combat and other trauma. American Journal of Psychiatry, 137, 966–968.PubMedGoogle Scholar
  48. Laufer, R. S., Brett, E., & Gallops, M. S. (1985). Symptom patterns associated with post-traumatic stress disorder among Vietnam veterans exposed to war trauma. American Journal of Psychiatry, 142, 1304–1311.PubMedGoogle Scholar
  49. Lindy, J. D., Grace, M. C., & Green, B. L. (1984). Building a conceptual bridge between civilian trauma and war trauma: Preliminary psychological findings from a clinical sample of Vietnam veterans. In van der Kolk, B. A. (Ed.), Post-traumatic stress disorder: Psychological and biological sequelae (pp. 43–58). Washington, DC: American Psychiatric Press.Google Scholar
  50. Lund, M., Foy, D., Sipprelle, C., & Strachan, A. (1984). The combat exposure scale: A systematic assessment of trauma in the Vietnam war. Journal of Clinical Psychology, 40, 1323–1328.PubMedCrossRefGoogle Scholar
  51. Lynn, E. J., & Belza, M. (1984). Factitious posttraumatic stress disorder: The veteran who never got to Vietnam. Hospital and Community Psychiatry, 35, 697–701.PubMedGoogle Scholar
  52. Malloy, P. F., Fairbank, J. A., & Keane, T. M. (1983). Validation of a multimethod assessment of posttraumatic stress disorders in Vietnam veterans. Journal of Consulting and Clinical Psychology, 51, 488–494.PubMedCrossRefGoogle Scholar
  53. Newberry, T. B. (1985). Levels of countertransference toward Vietnam veterans with postraumatic stress disorder. Bulletin of the Menninger Clinic, 49, 151–160.PubMedGoogle Scholar
  54. Penk, W. E., Rabinowitz, R., Roberts, W. R., Patterson, E. T., Dolan, M. P., & Atkins, H. G. (1981). Adjustment differences among male substance abusers varying in degree of combat experiences in Vietnam. Journal of Consulting and Clinical Psychology, 49, 426–437.PubMedCrossRefGoogle Scholar
  55. Reaves, M. E., & Maxwell, M. J. (1987). The evaluation of a therapy group for Vietnam veterans on a general psychiatric unit. Journal of Contemporary Psychotherapy, 17, 22–33.CrossRefGoogle Scholar
  56. Reaves, M. E., Atkinson, R. M., Ponzoha, C. A., & Kofoed, L. L. (1988). Trends in VA mental health services for Vietnam veterans. VA Practitioner.Google Scholar
  57. Rogers, B., & Nickolaus, J. (1987). Vietnam nurses. Journal of Psychosocial Nursing and Mental Health Services, 25(4), 10–15.Google Scholar
  58. Rosenheck, R. (1985). Malignant post-Vietnam stress syndrome. American Journal of Orthopsychiatry, 55, 166–176.PubMedCrossRefGoogle Scholar
  59. Roth, L. M. (1986). Substance use and mental health among Vietnam veterans. In Boulanger, G., & Kadushin, C. (Eds.), The Vietnam veteran redefined: Facts and fiction (pp. 61–71). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  60. Schnitt, J. M., & Nocks, J. J. (1984). Alcoholism treatment of Vietnam veterans with posttraumatic stress disorder. Journal of Substance Abuse Treatment, 1, 179–189.PubMedCrossRefGoogle Scholar
  61. Scurfield, R. M., & Blank, A. S., Jr. (1985). A guide to obtaining a military history from Vietnam veterans. In S. M. Sonnenberg, A. S. Blank, Jr., & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans. (pp. 263–291). Washington, DC: American Psychiatric Press.Google Scholar
  62. Sierles, F. S., Chen, J. J., McFarland, R. E., & Taylor, M. A. (1983). Posttraumatic stress disorder and concurrent psychiatric illness: A preliminary report. American Journal of Psychiatry, 140, 1177–1179.PubMedGoogle Scholar
  63. Silver, S. M., & Iacono, C. U. (1984). Factor-analytic support for DSM-III’s post-traumatic stress disorder for Vietnam veterans. Journal of Clinical Psychology, 40, 5–14.PubMedCrossRefGoogle Scholar
  64. Sineps, J. G. (1983). Vietnam veterans program, day hospital, Minneapolis VA Medical Center, psychiatry and psychology services. Unpublished manuscript.Google Scholar
  65. Smith, J. R. (1985a). Individual psychotherapy with Vietnam veterans. In S. M. Sonnenberg, A. S. Blank, Jr., & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans (pp. 125–163). Washington, DC: American Psychiatric Press.Google Scholar
  66. Smith, J. R. (1985b). Rap groups and group therapy for Vietnam veterans. In S. M. Sonnenberg, A. S. Blank, Jr., & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans (pp. 165–191). Washington, DC: American Psychiatric Press.Google Scholar
  67. Sparr, L. F., & Atkinson, R. M. (1986). Post-traumatic stress disorder as an insanity defense: Medico-legal quicksand. American Journal of Psychiatry, 143, 608–613.PubMedGoogle Scholar
  68. Sparr, L., & Pankratz, L. D. (1983). Factitious posttraumatic stress disorder. American Journal of Psychiatry, 140, 1016–1019.PubMedGoogle Scholar
  69. Sparr, L. F., Reaves, M. E., & Atkinson, R. M. (1987). Military combat, posttraumatic stress disorder, and criminal behavior in Vietnam veterans. Bulletin of the American Academy of Psychiatry and the Law, 15, 141–162.PubMedGoogle Scholar
  70. Spitzer, R. L., & Williams, J. B. W. (1985). Structured clinical interview for DSM-III. New York: New York State Psychiatric Institute, Biometric Research Department.Google Scholar
  71. Starkey, T. W., & Ashlock, L. (1984). Inpatient treatment of PTSD: An interim report of the Miami model. VA Practitioner, 1(12), 37–40.Google Scholar
  72. Sudak, H. S., Corradi, R. B., Martin, R. S., & Gold, F. S. (1984). Antecedent personality factors and the post-Vietnam syndrome: Case reports. Military Medicine, 149, 550–554.PubMedGoogle Scholar
  73. van der Kolk, B. A. (1983). Psychopharmacological issues in posttraumatic stress disorder. Hospital and Community Psychiatry, 34, 683–684, 691.PubMedGoogle Scholar
  74. van Putten, T., & Emory, W. H. (1973). Traumatic neuroses in Vietnam returnees: A forgotten diagnosis? Archives of General Psychiatry, 29, 695–698.PubMedCrossRefGoogle Scholar
  75. Walker, J. I., & Nash, J. D. (1981). Group therapy in the treatment of Vietnam combat veterans. International Journal of Group Psychotherapy, 31, 379–389.PubMedGoogle Scholar
  76. Williams, C. M., & Williams, T. (1985). Family therapy for Vietnam veterans. In S. M. Sonnenberg, A. S. Blank, Jr., & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans (pp. 193–209). Washington, DC: American Psychiatric Press.Google Scholar
  77. Williams, T. (1980). A preferred model for development of interventions for psychological readjustment of Vietnam veterans: Group treatment. In T. Williams (Ed.), Post-traumatic stress disorders of the Vietnam veteran (pp. 37–47). Cincinnati: Disabled American Veterans.Google Scholar
  78. Wilson, J. P. (1978). Identity, ideology and crisis: The Vietnam veteran in transition. The Forgotten Warrior Project. Cleveland: Cleveland State University.Google Scholar
  79. Wilson, J. P. (1980). Conflict, stress and growth: Effects of war on psychosocial development among Vietnam veterans. In C. R. Figley & S. Leventman (Eds.), Strangers at home: Vietnam veterans since the war (pp. 123–165). New York: Praeger.Google Scholar
  80. Wilson, J. P. (1985, February 27). Differential diagnosis of PTSD and personality disorder. Seminar. VA Region 5 and 6 Readjustment Counseling Centers Staff Training. Las Vegas NV.Google Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Roland M. Atkinson
    • 1
  • Michael E. Reaves
    • 1
  • Michael J. Maxwell
    • 2
  1. 1.Psychiatry ServiceVeterans Administration Medical CenterPortlandUSA
  2. 2.Vietnam Veterans Readjustment Counseling CenterPortlandUSA

Personalised recommendations