The long term psychological consequences of war experiences
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The present study was carried out to examine long-term psychological difficulties associated with war experience. 731 World War Two and Korean War veterans completed a questionnaire supplying biographical details, war-related experience, and present day psychological health. A significant proportion had war-related psychological difficulties, these problems correlating more strongly with war-related intrusive thoughts and avoidance than with actual combat experiences. A subgroup of 25 veterans were selected for depth interview. The results of these interviews supported the finding that many veterans have war-related problems, and that they related more to intrusion and avoidance than to actual experiences. For some veterans these problems have been present since the war, but for many they only started after retirement, when they have had more time to think about their past experiences. The problems include nightmares, intrusive thoughts, depression and anxiety. Coping is expressed by these veterans in terms of a) developing a narrative about their experiences which allows them to consciously control their traumatic recollections, or b) avoidance, where veterans avoid potential stimulus material, eg war films. Other forms of coping such as social support are secondary. Even after 50 years, veterans still experience traumatic recollections, memories which, to them at least, are accurate and detailed pictures of the events that occurred. The findings are explained in terms of a theoretical model which examines the role of traumatic recollections as conditioned responses that are out of conscious control, and likely to emerge into consciousness when the veteran is reminded of the war through some stimulus, eg the anniversary of a battle. Implications for post-traumatic stress disorder, ageing, and treatment models are considered.
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