The impact of killing in war on mental health symptoms and related functioning

Authors

  • Shira Maguen,

    Corresponding author
    1. San Francisco VA Medical Center, and Department of Psychiatry, University of California, San Francisco, San Francisco, CA
    • San Francisco VA Medical Center, PTSD Program (116-P), 4150 Clement Street, San Francisco, CA
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  • Thomas J. Metzler,

    1. San Francisco VA Medical Center, San Francisco, CA
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  • Brett T. Litz,

    1. National Center for PTSD, Department of Veterans Affairs Boston Healthcare System, Massachusetts Veterans Epidemiological Research and Information Center, and Department of Psychiatry, Boston University School of Medicine, Boston, MA
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  • Karen H. Seal,

    1. San Francisco VA Medical Center, and Department of Medicine, University of California, San Francisco, San Francisco, CA
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  • Sara J. Knight,

    1. San Francisco VA Medical Center, and Department of Psychiatry, University of California, San Francisco, San Francisco, CA
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  • Charles R. Marmar

    1. San Francisco VA Medical Center, and Department of Psychiatry, University of California, San Francisco, San Francisco, CA
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  • This study was funded by a VA Health Services Research and Development (HSR&D) Career Development Award. We would like to thank Dr. William Schlenger and Dr. Bruce Dohrenwend for their helpful assistance and feedback at various stages of this manuscript. We also would like to thank Jeane Bosch for her assistance.

    Preliminary results were presented at The International Society of Traumatic Stress Studies (ISTSS), Chicago, November 13–15, 2008.

Abstract

This study examined the mental health and functional consequences associated with killing combatants and noncombatants. Using the National Vietnam Veterans Readjustment Study (NVVRS) survey data, the authors reported the percentage of male Vietnam theater veterans (N = 1200) who killed an enemy combatant, civilian, and/or prisoner of war. They next examined the relationship between killing in war and a number of mental health and functional outcomes using the clinical interview subsample of the NVVRS (n = 259). Controlling for demographic variables and exposure to general combat experiences, the authors found that killing was associated with posttraumatic stress disorder symptoms, dissociation, functional impairment, and violent behaviors. Experiences of killing in war are important to address in the evaluation and treatment of veterans.

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