A Postwar Picture of Resilience

By ANTHONY D. MANCINI

WHEN the United States announced last week that its combat troops in Afghanistan would be withdrawn by mid-2013, there was obvious relief. But it was followed by familiar concerns.

One of the biggest of those concerns is the prevalence of post-traumatic stress disorder among the tens of thousands of returning veterans, which according to some media reports runs as high as 35 percent. These reports have incited fears that we will soon face a PTSD epidemic. But are such fears justified?

According to mounting scientific evidence, they are not. In fact, the prevalence of PTSD among veterans of recent wars is about 10 percent — substantially lower than is commonly believed. Indeed, the picture emerging is one of remarkable psychological resilience among the military.

This story of resilience has been ignored, partly because many assume that humans are inherently vulnerable to trauma. That belief makes us receptive to messages, most delivered by the media, that reinforce this perspective.

A growing body of scientific research, though, is telling another story: in short, that a traumatic event does not necessarily sentence a person to PTSD. Although an exact figure cannot be determined, a series of population-based studies has provided estimates that it occurs in just 5 percent to 20 percent of service members deployed to Iraq and Afghanistan, with most studies hovering around 10 percent. In a representative study soon to be published in the British Journal of Psychiatry, my colleagues and I examined stress responses among more than 7,000 members of all United States service branches, before and after their deployments. The respondents were not seeking treatment and were representative of the military as a whole. Perhaps most important, their reports were confidential and had no bearing on their military careers.

About 83 percent of respondents showed a pattern of resilience: they exhibited a normal-range ability to cope with stress both before and after deployment. By contrast, fewer than 7 percent showed signs of PTSD following deployment. Surprisingly, these numbers improved among those with multiple deployments, with 84.9 percent showing resilience and only 4 to 5 percent with PTSD. Predictably, those with more severe combat experiences, like witnessing death and injury to others, were at greater risk.

Statistics like these are unlikely to generate headlines for understandable reasons. We do not want to stigmatize those with the disorder. Nor do we want to suggest that war is easily managed or that the problem is not of the utmost importance. Even an estimate of 1 in 10 represents a public health issue of the first magnitude, requiring our full attention and resources.

War exacts immense demands on the human capacity to cope, but a forthright recognition of our capacity for resilience does no disservice to the afflicted.

With these challenges ahead of us, we should remember that PTSD is a treatable condition and that a realistic and informed understanding of our inherent coping abilities can only assist treatment and, perhaps one day, even prevention of this debilitating disorder.

Anthony D. Mancini is an assistant professor of psychology at Pace University.

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"The master class has always declared the wars; the subject class has always fought the battles. The master class has had all to gain and nothing to lose, while the subject class has had nothing to gain and everything to lose--especially their lives." Eugene Victor Debs

Baltimore Nonviolence Center

Monday, February 6, 2012