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Science 18 August 2006:
Vol. 313. no. 5789, pp. 979 - 982
DOI: 10.1126/science.1128944
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Reports

The Psychological Risks of Vietnam for U.S. Veterans: A Revisit with New Data and Methods

Bruce P. Dohrenwend,1,2,3* J. Blake Turner,3 Nicholas A. Turse,3 Ben G. Adams,4,5 Karestan C. Koenen,6,7,8 Randall Marshall1,2

In 1988, the National Vietnam Veterans Readjustment Study (NVVRS) of a representative sample of 1200 veterans estimated that 30.9% had developed posttraumatic stress disorder (PTSD) during their lifetimes and that 15.2% were currently suffering from PTSD. The study also found a strong dose-response relationship: As retrospective reports of combat exposure increased, PTSD occurrence increased. Skeptics have argued that these results are inflated by recall bias and other flaws. We used military records to construct a new exposure measure and to cross-check exposure reports in diagnoses of 260 NVVRS veterans. We found little evidence of falsification, an even stronger dose-response relationship, and psychological costs that were lower than previously estimated but still substantial. According to our fully adjusted PTSD rates, 18.7% of the veterans had developed war-related PTSD during their lifetimes and 9.1% were currently suffering from PTSD 11 to 12 years after the war; current PTSD was typically associated with moderate impairment.

1 New York State Psychiatric Institute, New York, NY 10032, USA.
2 Department of Psychiatry, Columbia University, New York, NY 10032, USA.
3 Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
4 Teachers College, Columbia University, New York, NY 10027, USA.
5 Brookdale University Hospital and Medical Center, Brooklyn, NY 11212, USA.
6 Department of Society, Human Development, and Health, Harvard University, Boston, MA 02115, USA.
7 Department of Epidemiology, School of Public Health, Harvard University, Boston, MA 02115, USA.
8 Department of Psychiatry, Boston University, Boston, MA 02115, USA.

* To whom correspondence should be addressed. E-mail: dohrenw{at}pi.cpmc.columbia.edu

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