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BBI's Peter Blanck and Larry Logue Pen "PTSD and Suicide" OpEd for Stars and Stripes

Posted on Friday 7/20/2018
Burton Blatt Institute

Vets, PTSD and Suicide: An Age-Old Problem?

By Larry M. Logue and Peter Blanck

(Stars and Stripes | July 20, 2018) July observances are more about patriotism and independence than soldiering, but the two are never far apart. This past Independence Day, you may have seen the two concepts dovetail on yard signs notifying revelers that “A COMBAT VETERAN LIVES HERE — PLEASE BE COURTEOUS WITH FIREWORKS.” These signs have engendered a lively debate about veterans’ mental health and the public’s proper response, but what is less debatable (and what is assumed by the signs) is that veterans are a class apart. They are men and women whose exploits are at once admirable and unfathomable, especially when it comes to the psychological wounds of war.

Scholars have done their best to demystify soldiers’ and veterans’ experience, but they have found psychological traumas especially intractable. Post-traumatic stress disorder (PTSD) is among the “signature casualties” of conflicts from the Vietnam War onward. However, the condition’s relationship to earlier conflicts and warfare in general is less clear. Is PTSD a genuine product of today’s extraordinarily lethal technology, or is it a new name for an age-old response to the horrors of combat?

Both sides in this dispute have marshaled evidence. Advocates of PTSD’s timelessness point to the occurrence of its symptoms — flashbacks, irritable behavior, depression, and the like — as far back as the Civil War. Their critics point to the specificity with which those who coined PTSD invoked the Vietnam War, and to warnings against “retroactive diagnosis.”

Our recent book investigates assertions about the Civil War’s psychological damage. Our principal source is military and pension records for approximately 72,000 Union army soldiers, digitized by the Center for Population Economics at the University of Chicago. When they examined applicants for federal pensions, physicians reported signs of mental illness (mania, dementia, hysteria and the like) in approximately 5 percent of white veterans. This incidence is close to the proportion of 21st-century veterans who develop PTSD, but the similarity masks the perils of comparison across centuries. While the Union army diagnoses were recorded by physicians, the 21st-century occurrence of PTSD comes primarily from self-reports. The earlier information also reflects the prejudices of physicians who ignored most instances of mental illness in black veterans...

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