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The war in Vietnam is a watershed moment in United States history -- the first war lost by the U.S. despite its seemingly overwhelming military might. Surviving Vietnam focuses on the psychological consequences, especially posttraumatic stress disorder (PTSD), of service in such a war for U.S. veterans. The diagnosis of PTSD, termed following and significantly influenced by this war, stirred controversy. Much of the initial controversy centered on a major report in 1990 of what numerous critics regarded as unrealistically high rates of this disorder in U.S. veterans. Controversy continues about whether exposure to one or more potentially traumatic events is more significant to the development and persistence of PTSD than pre-exposure personal vulnerability factors, such as age, education and prior psychiatric disorder. This book describes attempts to resolve these controversies.Surviving Vietnam develops a unique blend of historical material, military records, clinical diagnoses of PTSD, and interviews with representative samples of veterans surveyed approximately a decade (the National Vietnam Veterans Readjustment Study) and nearly four decades (the National Vietnam Veterans Longitudinal Study) after the war's conclusion. The book begins with a history of the Vietnam war that provides context for the discussions of mental health thereafter, the outcomes of the severity of veterans' exposure to combat, their personal involvement in harm to civilians and prisoners, their race-ethnicity, and their military assignments. It discusses nurses' experiences in Vietnam and the psychological impact of veterans' chronic war-related PTSD on their families. Surviving Vietnam then examines factors affecting veterans' post-war readjustment, including the effects of changing public and veteran attitudes toward the war and the veterans' own appraisals of the impact of the war on their lives after the war. The authors conclude with a discussion of the policy implications of the research findings.
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"Adversity" involves exposure to unpropitious or calamitous circumstances. It occurs in extreme situations such as prolonged combat or natural disasters, both of which affect whole groups or communities of people simultaneously. It is found as well in more individually targeted events such as child abuse, bereavement, rape, physical illness, marital separation or divorce, unemployment, and homelessness. Exposure to adversity is not randomly distributed in society. It varies, for example, with gender, ethnic or racial background, and socioeconomic status. And some types of adversity can be precipitated by an individual's own actions.In this volume, the leading investigators review research on the nature of adversity and its relationship to major types of psychopathology including schizophrenia, depression, alcoholism and other substance-use disorders, antisocial personality disorder, post-traumatic stress disorder, and nonspecific distress. These relationships are examined in terms of theoretical concepts of life stress that describe the characteristics of the ongoing situation in which adverse events occur and the factors of personality and coping ability that also affect psychiatric outcomes. The authors sift through firm and infirm findings and critically evaluate existing theory and research strategies and provide and integrative theoretical framework. No other book offers as comprehensive and authoritative a discussion of the role of psychosocial stress in causing mental disorders.