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Behavioral Healthcare


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Killing in War Associated with PTSD and Behavioral and Adjustment Problems

In a study of 1,200 veterans of the Vietnam war, those who reported taking a life in combat had a higher incidence of post-traumatic stress disorder (PTSD), violent behaviors, trouble with daily functioning and other psychological problems than those who did not, even decades after their war experience.

The study authors emphasize the relevance of their results for the current generation of troops serving in Iraq and Afghanistan, citing previous research indicating that up to 65 percent of service members returning from the war in Iraq report killing an enemy combatant, and up to 28 percent report being responsible for the death of a noncombatant.

The results of the study, which was led by researchers at the San Francisco VA Medical Center (SFVAMC) and the University of California, San Francisco (UCSF), indicated that the negative psychological effects of killing strongly outweighed those of simply being in combat, according to lead author Shira Maguen, Ph.D., a staff psychologist at SFVAMC.

The authors used data collected during the mid- to late 1980’s for the National Vietnam Veterans Readjustment Study (1990), a comprehensive U.S. government study of psychological problems among Vietnam veterans who served between August 1964 and May 1975. They classified respondents into two groups — those who reported killing, or believing that they killed, another person during combat, and those who did not. They then compared the two groups according to various psychological and behavioral measures: PTSD, violent behaviors, functional difficulties in areas such as employment, relationships, legal problems and substance abuse; and dissociation, a mental state in which a person experiences a sense of separation from his or her own thoughts or feelings. The 47 percent of veterans who reported killing scored significantly higher in all those categories than those who did not.

Dr. Maguen stresses that the study was not designed to investigate why veterans who killed had more psychological difficulties than those who did not, and that the results need to be replicated in future studies. However, she says that in her own clinical practice, she has observed that the act of taking a life can have a profound effect on a veteran of war. “In the military, you’re trained to shoot at a target, but sometimes the humanity of that target intrudes, and people come to question what they’ve done.”


Source: University of California, San Francisco, November 6, 2009

Anxiety, Phobias and Panic Disorders Clinical Guidelines

This 83-page report is for the evaluation and management of common anxiety disorders and panic disorder. Plus, separate guidelines for post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD). Extensive references and resources follow each of the three guidelines.

Anxiety, Phobias and Panic Disorders Clinical Guidelines is available from the Healthcare Intelligence Network for $62.50 by visiting our Online Bookstore or by calling toll-free (888) 446-3530.

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