Study: PTSD rates higher for troops who kill

CHICAGO — New research presented at the International Society for Traumatic Stress Studies shows post-traumatic stress disorder rates are higher in service members who have had to kill someone.

Shira Maguen, health sciences assistant clinical professor at the University of California, began her research when she realized that the Vietnam vets she treated at the San Francisco VA Medical Center were “really struggling with taking another life,” she said, adding that they often told her: “Killing really changed me.”

She started hearing the same complaint from veterans of the wars in Iraq and Afghanistan, but found “there’s not much discussion” about the issue in VA and Pentagon research. She and her colleagues decided to look into past research to see if there was a correlation between those who had killed and those who had mental health issues. They found that killing is “strongly predictive of PTSD.”

She talked to 259 veterans involved in the National Vietnam Veterans Readjustment Study, and found that if a person had killed someone, they were 3½ times more likely to have symptoms of PTSD than someone who hadn’t killed.

Maguen concluded that more research is needed on the context of killing: Did the veteran kill because his life was at risk? Was he ordered to kill or make the decision himself? Was it another combatant or did the service member kill a civilian?

“I think it’s very important for DoD and VA to be more explicit about killing,” Maguen said, while adding that therapists also need to target the issue in their treatments.

Sabra Inslicht, principal investigator for the San Francisco VA Center, looked at the impact of killing on Afghanistan and Iraq veterans, also because of work she had done with Vietnam veterans. She looked at work by Charles Hoge, chief of psychiatry and behavioral sciences at the Walter Reed Institute of Research, as well as the Soldier Wellness Assessment Program at Fort Lewis, Wash., reviewing a total of 3,000 service members.

She found 40 percent had reported killing someone, and that killing someone was a “strong predictor” for PTSD, depression and alcohol use.

In Hoge’s research, service members also were asked if they had seen anyone killed or wounded, if they had fired their weapons during direct combat, and if they ever felt they were in great danger of being killed.

In the survey of troops who had deployed and may or may not have killed someone, they found that 19 percent of those in Iraq screened for a potential mental health disorder, while those in Afghanistan screened at 11 percent and those in other areas at 8.5 percent.