Vietnam Myths?

[HOLLiS]

I read this on another forum, and searched here, I did not see it. It is a good read on the myths of that war.

http://www.25thaviation.org/johnkerry/id27.htm

If it is a repeat, Moderator please delete it.

[CPTAUSRET]

I read this on another forum, and searched here, I did not see it. It is a good read on the myths of that war.

http://www.25thaviation.org/johnkerry/id27.htm

If it is a repeat, Moderator please delete it.

HOLLIS:

I just scanned it, I've seen it before...It seems that a great many VN Vet's are now getting on the PTSD rolls, so I imagine those stat's will change upward.

I didn't look for the date of publication.

Terry

[Jack Moroney (RIP)]

HOLLIS:

IIt seems that a great many VN Vet's are now getting on the PTSD rolls!
Terry

Oh good grief!!

[NousDefionsDoc]

Oh good grief!!
LOL - What are you trying to say Sir?

[Jack Moroney (RIP)]

LOL - What are you trying to say Sir?

Don't get me started. My wife just came running back here into my den when she heard me explode over this. No, she did not find me under my desk, huddled under a poncho liner, mini-mag in my teeth, while I tried to type on the key board while being blinded by strange lights and confused by the sound of B-40 rockets ringing in my ears while my senses recalled the sound and smell of charred flesh-well maybe that part was correct because she left the hamburgers broiling on the stove when she came back to see what was putting me in orbit. What was your question again?????????????

[Texian]

I'm happy that these facts have come to light. They show clearly that we had a purpose to fight and that we did not lose. What saddens me is that my father, who was very proud to have served in Vietnam, went to his grave unaware that he had fought in what should be remembered as the decisive battle that broke the enemy's back ( the Tet Offensive) all the while believing we had lost the war.

Maybe now he knows his true place in history.

[Croooz]

Don't get me started. My wife just came running back here into my den when she heard me explode over this. No, she did not find me under my desk, huddled under a poncho liner, mini-mag in my teeth, while I tried to type on the key board while being blinded by strange lights and confused by the sound of B-40 rockets ringing in my ears while my senses recalled the sound and smell of charred flesh-well maybe that part was correct because she left the hamburgers broiling on the stove when she came back to see what was putting me in orbit. What was your question again?????????????
Sir,
If it's any consolation:

One of the most significant findings was with a peptide called "Neuropeptide Y." It is a substance that, in addition to many other actions, works on the prefrontal cortex of the brain and helps you stay focused on a task even under stress. We found that the Special Forces trainees-the Green Berets-produced significantly more NPY than the Rangers and Marines who were going through the same training. Twenty-four hours after completing the training, the Green Beret trainees were back to baseline levels of NPY while the others were significantly depleted. In fact, there was a direct positive relationship between the amount of NPY and performance in the training. There also was a clear, negative relationship between performance scores and the number of dissociative symptoms reported by the trainees and [a negative relationship] between NPY and dissociation. In other words, the less NPY soldiers had, the more they dissociated, and the more they dissociated, the worse they did in their training...

Interestingly, the people who go through Special Forces training all say, at the end, that it was the best training experience of their lives. The people who don't do so well are the individuals who leave without completing the training. They carry away a sense of failure. They think, "Not only was I scared, but I failed too." You know, one of the best predictors of PTSD is the subjective view the person has of the traumatic experience, the story he carries around in his head, and his sense of self-efficacy.

When I'm on the military post or Navy base, I meet soldiers and sailors who have seen and done incredibly stressful things and who are, psychologically, amazingly healthy in spite of it. They go home from work just like the rest of us, they have great families, and they love their jobs. They say, "I jump out of airplanes, and it's the greatest job in the world." Those of us who work with patients in a clinical setting sometimes forget that most people who are exposed to trauma or stress won't have a problem. They may have thoughts and reactions, but they won't develop a mental disorder.
So I guess this would explain why you weren't under the desk....you gentlemen just aren't built that way....at least not at the molecular level. :cool:

[CPTAUSRET]

Crooz:

There was an article in my wifes journal (AJP) attesting to what you are stating.

Terry

[Croooz]

Crooz:

There was an article in my wifes journal (AJP) attesting to what you are stating.

Terry
It's all the rage with the military scientists I work with. There is "talk" that the military would be able to reduce attrition rates by subjecting potential trainees to a mini version of SERE.....
I thought that was SFAS I told them? ;)

[HOLLiS]

My take on the article was who it was applicable today. With our War in Iran. The only similarity I see is the fight at home. RVN was lost at home, never in RVN.

ON PTSD, it gets patterned. Dealing EARLY with the stressors / trauma negates it's effect. IMHO for many who served in RVN it was a individual war. One goes over alone, comes home alone. Plus a few mistakes were made to reduce combat stress. I think those who work in teams, we able to help each other, those who did not, were just by themselves.

[CPTAUSRET]

It's all the rage with the military scientists I work with. There is "talk" that the military would be able to reduce attrition rates by subjecting potential trainees to a mini version of SERE.....
I thought that was SFAS I told them? ;)

Here is my "scientist".

http://www.mc.vanderbilt.edu/reporter/index.html?ID=4711

Terry

[Croooz]

Here is my "scientist".

http://www.mc.vanderbilt.edu/reporter/index.html?ID=4711

Terry
Your wife?

[CPTAUSRET]

Your wife?


Correct.

Always marry up!

Terry

[HOLLiS]

Correct.

Always marry up!

Terry

Congratulations Captain.......... WOWIE..

[Croooz]

Correct.

Always marry up!

Terry
WOW!
Read the article. That is truly awesome. Congratulations! I married up but my wife is all "artsy fartsy"...:D Interior designer....

So is she buying you any toys with the money? :D

[Jack Moroney (RIP)]

ON PTSD, it gets patterned. Dealing EARLY with the stressors / trauma negates it's effect. IMHO for many who served in RVN it was a individual war. One goes over alone, comes home alone. Plus a few mistakes were made to reduce combat stress. I think those who work in teams, we able to help each other, those who did not, were just by themselves.

My point is that I have no doubt. even though no one I have ever served with or know has, some folks come away with problems, but many of the problems are a result of the psychological baggage they carried with them into the service. The fact that there is a sudden rise in the VN vets coming down with PTSD has more to do with their lack of attention and loss of status as "combat stressed and damaged veterans" because there are new vets on the block who are taking the lime light away from them and the crutch they have used to manipulate the "social scientists" in our country who have always had an anti-military bias. Maybe I am just a cold, insensitive, nasty SOB but each time some unbathed, unshaven, honey-wagon aroma tainted jerk in an old shredded fatique jacket covered with an array of patches, military ribbons, unit pins, and grease stains comes up to me and says "Welcome home, brother" in that plaintive psuedo-sincere cracking voice I want to puke. The ones that really get me are the slobs that show up in recently purchased stuff from whatever store sells them and solomnly stand around the memorials and sites in DC. I mean damn, if you really want to honor your buddies take a damn bath, stand tall and thank whatever diety you considered your creator that for his grace and your buddies sacrifice someone else isn't standing there disgracing your death.

[FILO]

I mean damn, if you really want to honor your buddies take a damn bath, stand tall and thank whatever diety you considered your creator that for his grace and your buddies sacrifice someone else isn't standing there disgracing your death.

Amen Sir!

[DPB]

COL Moroney,

Here's lifting a glass to the cold, insenstitive, nasty SOBs.

Damn few left.

I think your idea of pre-service baggage accounts for about 99% of the in service and post service issues people have.

[HOLLiS]

My point is that I have no doubt. even though no one I have ever served with or know has, some folks come away with problems, but many of the problems are a result of the psychological baggage they carried with them into the service. The fact that there is a sudden rise in the VN vets coming down with PTSD has more to do with their lack of attention and loss of status as "combat stressed and damaged veterans" because there are new vets on the block who are taking the lime light away from them and the crutch they have used to manipulate the "social scientists" in our country who have always had an anti-military bias. Maybe I am just a cold, insensitive, nasty SOB but each time some unbathed, unshaven, honey-wagon aroma tainted jerk in an old shredded fatique jacket covered with an array of patches, military ribbons, unit pins, and grease stains comes up to me and says "Welcome home, brother" in that plaintive psuedo-sincere cracking voice I want to puke. The ones that really get me are the slobs that show up in recently purchased stuff from whatever store sells them and solomnly stand around the memorials and sites in DC. I mean damn, if you really want to honor your buddies take a damn bath, stand tall and thank whatever diety you considered your creator that for his grace and your buddies sacrifice someone else isn't standing there disgracing your death.

I understand, sort of the click of the Cammi wearers. I met a guy who was VVA, he was promoting the organization It was interesting that he was wearing the cammi outfit. I asked him what unit he was in, He stated he was a Fleet Salior. I wonder how many of those people actually served in RVN. A number of years ago there was a big SEA thing, "I was in SEA". Then there are the posers, one estimate I read was 10 Million RVN posers.

Maybe it is a big mix of things, like the article stated. The attitude for the Average American refelcted a strong bias agains the Viet-Nam war and all who were associtate with it.

Wallowing in self pitty does not help anyone. I think Stats are that most RVN vets have done very well, contrary to the holly wierd version of the derange vet.

What I saw in the article was how it pretains today. RVN was "lost" at home, not RVN. The enemy knows our countries weakness and the big fight is here in the states.

[DPB]

I read something not too long ago that stated that Vietnam vets had done better for themselves, on average, than the veterans of any previous conflict. Regrettably, I can't remember the source of that information, but here's another web site that gives similar info.

http://www.nam-vet.net/stats1.html

Of course, I've never seen any of these statistics or research in the main stream media. Successful vets don't make good news.

[Monsoon65]

My father, who was there twice, always felt that the guys that came back screwed up would have been regardless if there was a war there or not.

He told me he doesn't have time for the guys hanging around in the beat-up fatigues and whatnot.

[12B4S]

I just spent some 15 minutes typing. I got logged off. Anyway Col. Basically, what I was trying to say, was I agree and would have liked to put it as succinctly as you did. I have, when I was talking, but typing...... no. Had more to say, but all typed out now. I'll try again tomorrow.

[CPTAUSRET]

I read something not too long ago that stated that Vietnam vets had done better for themselves, on average, than the veterans of any previous conflict. Regrettably, I can't remember the source of that information, but here's another web site that gives similar info.

http://www.nam-vet.net/stats1.html

Of course, I've never seen any of these statistics or research in the main stream media. Successful vets don't make good news.


I spent 3 1/2 years in VN, I observed one individual who "went nuts" over there, the day I reported in to the 235th Aerial Weapons Co (Can Tho) there was a bunch of people milling around, and cleaning up the orderly room...Just prior to my arrival a young PFC had stepped into the doorway screaming that he couldn't take it anymore, he then crammed his M-16 into his mouth amd pulled the trigger (full auto), I think he put three rounds through his brain.

But I also saw two individuals "go nuts" in Korea (62-63), a lot of it has to be the baggage you bring to the table with you. I never used drugs, yet they were plentiful in VN, I always believed the kids who "used" during VN, would also have used back home.

Terry

[incommin]

Service in Vietnam was a big excuse for many...... it became a reason for some to drink and or use drugs. It also became a reason to give up trying to make a living for yourself. The "Army" turned me into a baby killer. Or the "Army" turned me into a pothead. The shrinks didn't help. I think they find a new disorder every day. And they reinforce the weak willed and weak minded who use Vietnam as an excuse. The world is full of mant-to-bes and excuse users.

[CPTAUSRET]

Incommin:


Great post!

My wife is the M.D. who wrote the definition of PTSD for DSM lll.

Here is an editorial she wrote recently.




Acute and Delayed Posttraumatic Stress Disorders: A History and Some Issues

Nancy C. Andreasen
This issue of the Journal features stress disorders as its theme. The study of the psychological and emotional consequences of stress has become a burgeoning and important field in psychiatric research and treatment. In fact, the diagnoses of posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) are now so frequently made that one wonders how we once got by without them.

The stress syndromes that we refer to as PTSD and ASD have a very long descriptive history. In general, their early history was closely linked to the experiences that soldiers suffered in combat. Before a diagnosis existed, many features of the syndrome were well-described in literary form in The Red Badge of Courage. The terrible carnage of trench warfare during World War I led many young men to return home deeply traumatized, and this led in turn to systematic descriptions of the syndrome under names such as "shell shock" or "combat fatigue." World War II was, however, the catalytic event that led to the creation of a formal diagnostic category to refer to this syndrome: Gross Stress Reaction. World War II for the first time brought together soldiers, psychiatrists, and other medical personnel from all over the country, giving them an opportunity to discover the many things that they had in common and also to recognize the ways that they differed. Socially, our great melting pot received yet another incentive to continue to melt—and to meld together all the diverse components of our society. (The World War II musical, Oklahoma, celebrated this fact—watch it again some time in the context of our current world situation.) On the medical and psychiatric scene people discovered that they did not always share a common vocabulary with which to discuss the syndromes and diagnoses observed in their patients.

After the war ended, the Veterans Administration (VA) developed a diagnostic manual, which provided the incentive for the APA to create its own first manual: DSM-I. The manual was very concise, but it included a diagnosis that covered victims of stress: Gross Stress Reaction. During that post-war era and after, psychiatrists also began systematic investigations of the consequences of exposure to death camps and the POW experience, as well as nonmilitary stressors, such as mass catastrophes—fires, earthquakes, or plane crashes (1). However, for reasons that remain obscure but that perhaps reflect the early links between military combat and the diagnosis of stress disorders, Gross Stress Reaction was somehow dropped from DSM-II. That manual was written when our country was not engaged in any major war. However, the scientific study of the consequences of stress continued. In fact, your editor began her early research career by studying the consequences of severe burn injuries in the pre-DSM-III era—identifying symptoms, risk factors for poor outcome, and the prevalence of severe psychiatric consequences (2–5).

DSM-III was crafted in the post-Vietnam era, a time when our country contained yet another wave of young men who had been exposed to the trauma of combat. VA and military psychiatrists had no official diagnosis to give them, as long as DSM-II was the official diagnostic manual. As a member of the DSM-III Task Force, I was assigned to this problem. An active group of advocates were lobbying for the inclusion of a diagnosis of "Post-Vietnam syndrome." The purpose and the concept were correct, but the name and the specificity were not. I pointed out the long history of the syndrome, as well as the fact that it frequently occurred in traumatized civilians as well. A stress syndrome characterized by reliving, indicators of autonomic overarousal, and other such features was simply a final common pathway with many different sites of entry. We worked together to agree on diagnostic criteria, which were rooted in the extensive literature on stress disorders already available at that time, and christened our 100-year-old offspring Post-traumatic Stress Disorder. I wrote the entire text description of the syndrome, which was based on my experience caring for burn patients and the substantial literature available at the time. My burn patients had almost universally experienced this syndrome immediately after their injuries. So we designated an acute form of PTSD. However, many soldiers do not develop stress symptoms until they return home, since a stress reaction in the midst of combat is not adaptive, and so the impact of their traumatic experiences is delayed. Therefore, we also identified a delayed form.

The concept of PTSD took off like a rocket, and in ways that had not initially been anticipated. The DSM-III text struggled with many issues: how severe should the trauma be? What types of trauma could be considered causative? Does it make a difference if the trauma is inflicted by another human being, by an accident, or by a natural disaster? What impact does duration of the stressor have? What impact does premorbid psychiatric status have? And so on. PTSD is a complex concept. The DSM-III formulation emphasized that the stressor should be significant—outside the range of normal human experience. It assumed, but did not explicitly state, that there would be a temporally close juxtaposition between the stressor and the development of symptoms.

Many psychiatrists liked the DSM-III formulation and began to use the diagnosis widely. Its application broadened steadily. For example, it was used for victims of childhood sexual abuse who developed traumatic stress symptoms much later. Dissociation, a component of the original definition but not its core, received increasing emphasis. And the requirement that the stressor be outside the range of normal human experience was sometimes reinterpreted to include less severe stressors. In fact, that stringent requirement was dropped in DSM-III-R and DSM-IV, providing a much broader concept than was originally intended. (In my view, this broadening should be reconsidered. Giving the same diagnosis to death camp survivors and someone who has been in a motor vehicle accident diminishes the magnitude of the stressor and the significance of PTSD.) Acute PTSD, dropped from DSM-III-R, was fortunately added back in DSM-IV with a new name: Acute Stress Disorder.

This issue includes several articles on various forms of PTSD. The literature on this diagnosis is now vast. It goes far beyond the descriptive psychopathology upon which the original DSM-III definition was based. We now have a multitude of papers covering topics such as neural mechanisms as revealed in imaging studies, risk factors, prevalence, comorbidity, symptom patterns, and outcome. The study of PTSD has enriched our conceptualization of memory in both its conscious and unconscious forms. The task of summarizing all this literature—and producing a DSM-V description and definition—will be challenging. Not all the studies converge on the same conclusions.

Why?

A clue is provided by the articles in this issue. Although the final common pathway (in the psychological and physical/autonomic sense) is the same, there are many different kinds of stressors. As detailed by Verger et al., experiencing a terrorist bombing in a metro—a man-made and unanticipated disaster that produced concomitant physical injuries, facial deformities, and the psychological terror that was intended—is indeed something outside "the normal human range." A PTSD prevalence rate of 31% was observed approximately 2.6 years after the event. If anything, this seems surprisingly low, but the assessments were done via phone interview and could be an underestimate. A companion paper by Fullerton et al. examines both ASD and PTSD in disaster workers at the site of a plane crash. Their stressors are quite different. A plane crash is an accident, and therefore has a different impact than man-made malevolence. Disaster workers have chosen their occupation with foreknowledge of its risks. To say this is not to diminish the enormous value of their work. But the psychological impact is different. And, not surprisingly, the prevalence of PTSD at a 13-month assessment was lower than in the terrorism victims: 16.7%. The studies examine different predictors of outcome and produce different results. These articles are but two examples of the many difficulties in conceptualizing the essence of PTSD and its consequences. A third article by O’Donnell et al. examines the thorny issue of comorbid depression. (The original concept of Gross Stress Reaction specified that it must occur in an otherwise normal individual—which was probably wrong, since stressors do not preferentially occur in normal individuals, and those with other disorders may have fewer adaptive resources remaining.)

As the psychiatrist who was also midwife at the birth of PTSD, I have followed its growth and maturation with great interest. Others have parented it, and generally well. It is of particular interest in the 21st century, when the entire world is filled with the spectre of terrorism—a stressor of great magnitude that can strike any time and anywhere. This is also a time when we again will have many young soldiers returning from yet another war: the treacherous combat experience in Iraq and Afghanistan. Unfortunately, the present world situation is likely to give us many more opportunities to study ASD and PTSD. For this I have regrets, but I am pleased that I helped create a diagnostic category and conceptual framework for this important syndrome, so that its causes and consequences can be examined both clinically and scientifically.