What makes some veterans more susceptible than others?
Post-traumatic stress disorder (PTSD) disproportionately affects veterans, and it’s not hard to imagine why. After all, people who have served in the military are likely to witness or experience traumatic events during combat. That said, not every veteran develops PTSD—so what makes some veterans more susceptible than others?
Here are the biggest risk factors for PTSD among veterans, according to Amanda M. Spray, PhD, psychologist at NYU Langone Health, and Collin Reiff, MD, psychiatrist at NYU Langone Health.
Exposure to a Traumatic Event
Each person’s experience may differ, and not everyone may have an experience they perceive as traumatic. However, veterans obviously have a higher risk of experiencing life-threatening situations than the general civilian population.
“They're at imminent risk of danger,” says Dr. Reiff. “They don't know what to expect, and in an instant, they can find themselves surrounded by the enemy or in an unforeseeable situation, which can be worse than they ever imagined beforehand.”
The more severe the event, the more likely it is to lead to PTSD. Similarly, repeated exposure to multiple traumatic events is also more likely to lead to PTSD.
Trauma Prior to Service
“Having exposure to trauma before military service and military trauma puts one at a higher risk for developing PTSD later on,” says Dr. Spray.
“We often see, unfortunately, quite a number of veterans that had childhood sexual abuse or physical abuse, and then had another traumatic experience in combat, and we see that putting someone at an increased risk for development of PTSD,” she says.
“The younger they are when they experience a traumatic event, the more likely they are to develop post-traumatic stress disorder,” says Dr. Reiff.
One explanation for this is that the human brain is still developing until about age 25. For this reason, someone who is younger may interpret and process a traumatic event differently. Notably, about two-thirds of active-duty military personnel were age 30 or under in 2015, according to the Pew Research Center.
Besides serving in the military, one of the other main causes of PTSD is domestic and sexual violence. Women in the military, then, may face an increased risk over their male peers due to the combination of combat trauma and rape or sexual assualt within the military.
“Rank within the military may affect how susceptible the individual is to witnessing, observing, or learning about an event that may be perceived as traumatic,” says Dr. Reiff. “Soldiers on the front lines, oftentimes, are exposed to more violence on a daily basis than perhaps a general who is not directly on the front lines but who is rather coordinating attacks.”
Ability to Make Meaning
Making meaning is an important part of trauma recovery. After a traumatic event, many people struggle to “make sense” of what happened to them and why. Making meaning involves finding the narrative of the event that allows for positive growth.
Thus, being unable to make meaning of military trauma increases the risk of PTSD in veterans. “For instance, if they perceive or they are able to frame the experience as positive and meaningful and perhaps making a contribution to the world or serving the war in some way, then that may decrease the risk of PTSD,” says Dr. Reiff.
Amanda M. Spray, PhD, is a psychologist at NYU Langone Health in New York City and a clinical associate professor at the NYU Grossman School of Medicine.Collin Reiff
Collin Reiff, MD, is an addiction psychiatrist at NYU Langone Health and a clinical assistant professor at NYU Grossman School of Medicine.
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So, the number one risk factor for PTSD
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is obviously exposure to a traumatic situation.
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Anyone in a job that would incur more trauma
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than others would put you at an increased risk
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for development of PTSD.
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(somber piano music)
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Being in the military,
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right away, that puts you at an increased risk
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for developing PTSD because you're exposed
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to much more trauma than maybe a civilian.
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Inherently, a veteran goes off into unknown territory
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where they're at imminent risk of danger,
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and they don't know what to expect,
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and in an instant, they can find themselves
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surrounded by the enemy
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or in an unforeseeable situation,
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which can be worse than
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they ever imagined beforehand.
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One thing we see quite a bit in the research
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and clinically as well, is having exposure to trauma
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before military service and military trauma
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puts one at a higher risk for developing PTSD
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So we often see, unfortunately, quite a number
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of veterans that had childhood sexual abuse
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or physical abuse, and then had another
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traumatic experience in combat,
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and we see that putting someone at
an increased risk
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for development of PTSD.
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The younger they are when they experience
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a traumatic event, the more likely they are
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to develop post-traumatic stress disorder.
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Keep in mind that the human brain
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finishes developing at 25 years old,
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so it may be the case that
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individuals that are under 25,
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the brain may react differently to events
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that are witnessed or experienced.
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Veterans have a higher risk of PTSD
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because they're exposed to life-endangering
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more frequently than the civilian population.
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So as a result, there's more exposure over time
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to situations that can be perceived as traumatic.
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It's also worth noting that women are at higher risk
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of PTSD than men because they're exposed
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to rape, sexual assualt,
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and more interpersonal violence,
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so it's more or less, it's a numbers game.
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Rank within the military may affect
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how susceptible the individual is
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to witnessing, observing, or learning about
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an event that may be perceived as traumatic.
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Soldiers on the front lines, oftentimes,
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are exposed to more violence on a daily basis
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than perhaps a general who is not directly
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on the front lines but who is rather
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An individual may be more susceptible
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to developing post-traumatic stress disorder
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depending on whether or not they can
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of the experience that happened.
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For instance, if they perceive or they are
able to frame
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the experience as positive and meaningful
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and perhaps making a contribution to the world
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or serving the war in some way,
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then that may decrease the risk of PTSD,
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whereas if they're unable to make meaning
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of what's happened,
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and they're unable to understand what their role
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in this war was and what their role in this battle was,
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and how did this happen,
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then they may have negative cognitions
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about the events that happened.
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- 6 facts about the U.S. military and its changing demographics. Pew Research Center, 2017. (Accessed on July 17, 2020)
- Post-traumatic stress disorder. Bethesda, MD: National Institute of Mental Health. (Accessed on July 17, 2020)
- Risk and resilience factors after disaster and mass violence. Washington, DC: U.S. Department of Veterans Affairs. (Accessed on July 17, 2020)