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The VA recently published data that reveals an alarming increase in the number of disabilities affecting veterans and an increasing prevalence of post-traumatic stress disorder (“PTSD”). At the same time, trends in the personal lives of the “millennial generation” of veterans may contain clues that explain the higher rates of PTSD.
Gone are the days when the average veteran had only a few fairly simple disabilities. The global war on terror has produced medically complicated cases involving multiple disabilities that often overlap and are intertwined. As a veterans disability lawyer, I can attest to this trend from personal experience.
The VA has observed that the nature of the disabilities is now more complex, involving issues like PTSD, traumatic brain injury (TBI), diabetes and related issues, and environmental diseases.
The VA now concludes that the average veteran is now claiming 16 different medical conditions on his claim. This is compared with an average of 3.9 issues for WWII veterans, and 6.4 issues for Vietnam era veterans.
PTSD Is on the Rise
What’s striking about the current data is the prevalence of PTSD. Among Iraq and Afghanistan veterans, the VA reported 261,998 cases of diagnosed PTSD as of the first quarter of 2013. This rate is far higher than among any previous generation of combat veterans.
Prior to the global war on terror, commentators observed a much higher rate of PTSD in Vietnam era veterans compared with their predecessors from Korea or WWII. And various explanations were offered for the disparity. But now, the data is suggesting an even higher prevalence of PTSD amongst the current generation of veterans.
Many Explanations for Higher Rates of PTSD
Some observers have cited the chronic, low-grade violence associated with the war on terror, which involves situations where the combatants are commingled with the civilians. It is suggested that this type of warfare magnifies the psychological stress on service personnel. There’s no doubt that the unconventional nature of the warfare plays a role.
But the disparate hypotheses for the increasing prevalence of PTSD, which appears to have increased with successive generations following the Korean Conflict, suggest there may be more to the picture than meets the eye. In other words, there would be more consistency in the explanations if researchers really understood the complete picture.
PTSD in the Military vs. the General Population
Consider this: There is a wide range of responses, both behaviorally and cognitively, among trauma survivors. Research has determined that a relationship exists between psychological trauma and the development of PTSD. This is well known. But statistically, the vast majority of people exposed to psychologically traumatic events do not develop PTSD. Some studies suggest that the percentage of the general population experiencing a lifetime prevalence of events capable of producing PTSD is somewhere between 50 to 90 percent. Yet, the prevalence of PTSD in the general population is only about 8 percent. One study found that the risk of developing PTSD in the general population after a traumatic event was about 9 percent.
It appears that neuroscientists have looked to personality factors to explain this disparity. With PTSD victims, neuroimaging studies also show reduced volume and activation of the hippocampus and left hemisphere of the brain. Also showing reduced activation is the medial pre-frontal cortex, anterior cingulate, and the pre-frontal dorso-lateral cortex.
So there are actually physical impairments to the brain of PTSD sufferers. So why do some individuals demonstrate a resilience to regain a normal life after trauma exposure and others do not? One researcher drew upon the experiences of WWII concentration camp survivors. The researcher, Antonovsk, coined the phrase, “sense of coherence” to explain why some prisoners of war were able to live normally despite their past trauma.
A Sense of Coherence Can Help
Apparently, people with a strong “sense of coherence” have a greater degree of resilience. In short, individuals who find positive means of coping with trauma do better. Whereas individuals that resort to self-victimization or self-pity appear to experience an intensification of negative feelings.
One researcher suggested that spirituality or religiosity may also be important in setting the stage for a positive sense of coherence. An interesting study of WWII veterans in the Journal of Religion and Health observed that, “The more a combat veteran disliked the war, the more religious they were 50 years later.” It was suggested that the level of combat intensity may be related to subsequent religious activity.
Religion & PTSD
On the other hand, the more a veteran associated the combat experience with valor and victory, the less interested he was in religion. The study further found that among the WWII generation, religious behavior was high. It found that 69.1 percent of WWII veterans were church members, attending church 3.1 times per month. Even among those experiencing the heaviest combat, they still attended church 2.3 times per month.
The researchers concluded that church attendance was a much stronger cultural norm for the WWII generation than it was for their children and grandchildren. Indeed, the Pew Research Center found that the WWII generation, as a whole (not just veterans) had the highest percentage of regular church attendance. And the numbers continued to decline with each successive generation.
The so-called “greatest generation” saw 75 percent of its demographic attending church regularly whereas the so-called “millennial generation” (born 1981 or later) had only 40 percent of its demographic attending church regularly.
This raises an interesting question. The children of the WWII generation were the Vietnam era veterans. There were higher rates of PTSD among the Vietnam veterans. Is there a correlation between religiosity and resilience to psychological trauma?
What we do know is that suicide among veteran is currently at epidemic proportions. So consider the results of one VA study from a sample of 5,378 veterans: those veterans with suicidal ideation more often rate their spiritual health as worse than veterans without suicidal ideation. Further, among the military population, the “no religious preference” group is the largest single group.
As a veterans disability lawyer I have represented an enormous cross-section of the veteran population from all over the world and from every geographic region of the country. From an anecdotal perspective, I will say that religiosity does appear to be higher for veterans living in the so-called “Bible Belt.” And recent surveys do reveal that with the exception of Utah, the top 10 most religious states are in the South.
Thus, the data may support a correlation between rising rates of PTSD and declining religiosity. With some researchers suggesting that a sense of coherence can explain the resiliency of those that do not develop PTSD, perhaps military chaplains may play a larger role in helping to prevent future cases of PTSD. These uncanny correlations demand further research. Veterans suffering from PTSD know all too well the horrors they continue to re-experience with PTSD. As such, the evidence militates in favor of society, the clergy, and individuals taking a candid look at the wide-ranging psychiatric consequences of our post-religious, post-modern culture.
As the owner of a veterans benefits law firm dedicated to representing disabled veterans in VA appeals, we are deeply concerned about the plight of veterans suffering from PTSD, TBI, and other psychiatric problems. In our day-to-day practice handling VA appeals, we know firsthand how much more needs to be done to ensure the full recovery of those suffering from military-related PTSD or psychiatric illness. To those treating veterans with PTSD, every possibility to improve resiliency should be considered. As a veterans disability attorney, I believe we owe it to those veterans who have sacrificed so much.