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See Inside Scientific American Mind Volume 23, Issue 5

Troubled Childhood May Predict PTSD

Many soldiers' cases of post-traumatic stress disorder may in fact stem from troubled civilian life

Problems at Home

Even more interesting were the remaining soldiers, about 13 percent of the subjects in the study, whose stress seemed to ease during deployment. That is, they had significant stress symptoms, such as major anxiety and frequent nightmares, after signing up for service but before deploying—symptoms that eased in the first months of war, only to spike again later, when they were safely at home. This pattern has never been observed before, and it seems puzzling: Why would shipping off to a dangerous and unfamiliar war zone ameliorate stress symptoms?

The scientists have a theory, and it has to do with the root causes of PTSD, previously undocumented. As compared with the resilient Danish soldiers, all those who developed PTSD were much more likely to have suffered emotional problems and traumatic events prior to deployment. In fact, the onset of PTSD was not predicted by traumatic war experiences but rather by childhood experiences of violence, especially punishment severe enough to cause bruises, cuts, burns and broken bones. PTSD sufferers were also more likely to have witnessed family violence and to have experienced physical attacks, stalking or death threats by a spouse. They also more often had past experiences that they could not, or would not, talk about.

These previously overlooked PTSD sufferers whose stress actually diminished in the war zone were also much less educated than the resilient soldiers. This disadvantage, combined with their pronounced mental health problems before going to war, suggests that they may in reality have been escaping a different war zone: the family. In other words, they showed improvement as soldiers only because they were in such poor psychological condition in civilian life. Army life—even combat—offered them more in the way of social support and life satisfaction than they had ever had at home. These soldiers were probably benefiting emotionally from being valued as individuals for the first time ever and from their first authentic camaraderie—mental health benefits that diminished after they once again returned to civilian life.

This article was originally published with the title "Embattled Childhood: The Real Trauma in PTSD."

(Further Reading)

Peace and War: Trajectories of Posttraumatic Stress Disorder Symptoms before, during and after Military Deployment in Afghanistan. Dorthe Berntsen, Kim B. Johannessen, Yvonne Thomsen, Mette Bertelsen, Rick Hoyle and David Rubin in Psychological Science (in press).

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