Enduring social and behavioral effects of exposure to military combat in vietnam

PURPOSE: To assess current social and behavioral outcomes among Vietnam veterans up to 35 years after exposure to military combat. METHODS: A cohort of 1,315 American Legion members whose combat experiences were assessed with a standard quantitative measure in 1984 were followed-up through 1998 for current health and psychosocial status. Another 2,260 Legionnaires who served outside Vietnam during the same period were used as a comparison group. Outcomes included smoking and drinking habits as health risk indicators, income, measures of marital and general happiness and life satisfaction, and the Columbia Univerity PERI (Psychiatric Epidemiology Research Instrument) scales for psychological well-being: anxiety, depression, helplessness/hopelessness, anger and irritation, and physical symptoms of depression. Combat intensity was classified as high, medium, and low. RESULTS: Income was significantly lower in the high-combat group by $4,000 per year compared to the low- and medium-combat groups and the non-Southeast Asia veterans, whose incomes were similar to each other. Marital happiness, life happiness, general life satisfaction, decreased with increasing combat, while smoking prevalence increased with combat score. The PERI scale components were strongly dose-related to combat intensity. Furthermore, the anger/irritation score for the low-combat group was significantly higher than for the non-SEA group. CONCLUSIONS: Although practically all veterans in this study last saw combat prior to 1971, the detrimental effects of having experienced combat which were strongly apparent when this group was surveyed in the 1980s continue to exert an adverse effect on many aspects of their lives almost three decades after the war.