Emotional effects of heavy combat can be lifelong for veterans

The findings are ominous with the exposure of today's men and women to heavy combat in the ongoing Iraq and Afghanistan wars on terror at a rate that probably exceeds the length of time for U.S. veterans during World War II, said UF sociologist Monika Ardelt.

"The study shows that we really need to take care of our veterans when they arrive home, because if we don't, they may have problems for the rest of their lives," she said. "Yet veterans report they are facing long waiting lines at mental health clinics and struggling to get the services they need."

The 60-year study, co-authored with UF graduate student Scott Landes and George Vaillant, a psychiatry professor at Harvard Medical School, compared 50 World War II veterans with high combat exposure with 110 veterans without any combat experiences. Results showed that heavy combat exposure at a young age had a detrimental effect on physical health and psychological well-being for about half of the men well into their 80s, she said. The findings were published in the latest issue of the journal Research in Human Development.

Getting treatment not only prevents serious health problems but it can boost the mental well-being of veterans with heavy combat exposure to higher levels than their comrades who saw little battle action, Ardelt said.

The study found that about half of the veterans who experienced a high level of combat showed signs of stress-related growth at mid-life, leading to greater wisdom and well-being in old age than among veterans who witnessed no combat, she said.

Firing at the enemy, killing people and watching others die is enormously stressful, but it can result in personal growth as with survivors of cancer and sexual assault, Ardelt said.

"You can either conclude that God has abandoned you, the world is an unfair place and there is nothing else to do but close yourself off from it all or you can manage to open yourself up and develop compassion for the suffering of others realizing that you have now become a part of it," she said.

Participants were veterans who had been members of Harvard's undergraduate class between 1940 and 1944. In 1946, a year after the war ended, the men filled out an extensive questionnaire and participated in an in-depth interview. They took part in additional in-depth interviews at about 30, 50 and 65, answered follow-up questionnaires every two years, took personality tests and received physical examinations every five years starting at age 45.

The study found that some veterans experienced stress-related growth, the ability to press on with life in a purposeful manner after hardship or adversity. This was measured by whether or not they reached "generativity" in middle age, a life stage identified by psychologist Erik Erikson that is characterized by a desire to mentor the next generation and give back to the community.

Veterans in the high combat group who experienced stress-related growth or reached "generativity" reported significantly less anxiety and depression than other veterans who did not attain this stage of development, either in the high or low combat group, the study found.

In addition, veterans with high combat exposure who experienced this type of growth were less likely than those who did not attain it to abuse alcohol in their early 50s, while the difference in alcohol consumption in the no combat group between veterans who reached "generativity" and those who did not was statistically insignificant, Ardelt said. Among veterans who failed to reach "generativity," those exposed to heavy combat tended to drink significantly larger amounts of alcohol in midlife than veterans with no combat experience, she said.

"In some ways, it was probably easier for World War II veterans because that was a war supported by all the American people and the men were celebrated as liberators when they came home," she said. "Although not as bad as Vietnam, Afghanistan and Iran are wars that we just want to forget."

Even though effects from heavy combat could be long lasting, the Ivy League-educated World War II veterans studied were probably much better off than today's veterans, Ardelt said. Their educational background may have let them serve in better positions than the average soldier, she said.

"Because this was a very privileged sample, I would be even more concerned about the people who are coming home now, who are not necessarily privileged and joined the army for economic reasons," she said.