Grayson D, Dobson M, Marshall R
Centre for Education and Research on Ageing, Repatriation General Hospital at Concord, NSW, Australia.
Soc Psychiatry Psychiatr Epidemiol. 1998 Apr;33(4):186-92. doi: 10.1007/s001270050042.
The research literature on the psychiatric consequences of the Vietnam War focuses primarily on the construct of Posttraumatic Stress Disorder (PTSD), after an initial focus in the 1970s on depression and alcohol and substance abuse. The present paper examines the hypothesis that among men without current PTSD, those with higher combat in Vietnam will be more likely to have current DSM-III-R illnesses. The Australian Vietnam Veterans' Health Study (AVVHS) collected a broad range of interview data on 641 Vietnam veterans throughout 1990-1993. Measures of combat exposure, age at embarkation to Vietnam, enlistment IQ and pre-Army personality problems were drawn from Army records of the era. Retrospective measures of combat were obtained at interview. The interview also involved the administration by trained lay interviewers of the DSM-III-R based Diagnostic Interview Schedule (DIS). This epidemiological instrument provides current psychiatric diagnoses as well as temporal (retrospective) symptom and diagnosis onset data. The results of this study show that current disorders (without PTSD comorbidity) with onsets within 5 years of embarkation to Vietnam are more likely among men who saw higher combat, as indexed by combat-exposure measures drawn from Army records of the era as well as retrospective self-report. This combat relatedness remains when age at embarkation. IQ at enlistment and pre-Army personality measures are used as covariates. No more than 11.4% of sampled Vietnam veterans currently meet DSM-III-R diagnostic criteria for PTSD, while a further 7.8% do not have current PTSD but do have some other current DIS diagnosis with onset in the 5-year period following (first) emabarkation to Vietnam. Our data support the hypothesis that the current illnesses of many of these men without PTSD are combat-related DSM-III-R illnesses.
越战精神后果的研究文献最初在20世纪70年代聚焦于抑郁症、酗酒和药物滥用，之后主要关注创伤后应激障碍（PTSD）这一概念。本文检验了这样一个假设：在目前没有患创伤后应激障碍的男性中，那些在越南战争中经历战斗更多的人更有可能患有目前的《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）所定义的疾病。澳大利亚越战老兵健康研究（AVVHS）在1990年至1993年期间收集了641名越战老兵的广泛访谈数据。战斗暴露程度、前往越南时的年龄、入伍智商以及入伍前的人格问题等测量数据均取自那个时代的军队记录。访谈时获取了战斗经历的回顾性测量数据。访谈还包括由经过培训的非专业访谈人员使用基于DSM-III-R的诊断访谈表（DIS）进行评估。这种流行病学工具可提供当前的精神疾病诊断以及症状和诊断发作时间（回顾性）的数据。本研究结果表明，根据那个时代军队记录中的战斗暴露程度测量数据以及回顾性自我报告，那些经历战斗更多的男性在前往越南后5年内更有可能出现目前的疾病（无创伤后应激障碍共病）。当把前往越南时的年龄、入伍智商和入伍前的人格测量数据作为协变量时，这种与战斗的相关性依然存在。抽样的越战老兵中目前不超过11.4%符合PTSD的DSM-III-R诊断标准，另有7.8%目前没有患PTSD，但在（首次）前往越南后的5年期间确实患有其他一些目前的DIS诊断疾病。我们的数据支持了这样一个假设：许多这些没有患PTSD的男性目前的疾病是与战斗相关的DSM-III-R疾病。
