AUSTRALIAN VIETNAM VETERANS - FACTORS CONTRIBUTING TO PSYCHOSOCIAL PROBLEMS

Objective: The objective of the present paper is to present comprehens ive models of the current psychosocial morbidity of Australian Vietnam veterans. Seldom has research in this area attempted to 'untangle' di rect and indirect influences on current functioning via possible pre-a rmy, Vietnam and homecoming pathways. Method: The Australian Vietnam V eterans' Health Study gathered data on a sample of 641 veterans throug hout Australia drawn randomly from army Vietnam tour lists of the era. The data arose from interview and army records of the era, and fall i nto four temporal categories: pre-army, Vietnam service, homecoming af ter Vietnam, and current state. Path analysis models of the veterans' current psychological morbidities and social wellbeing are used to ide ntify direct aetiological influences of earlier era constructs on curr ent state, free of confounding by indirect (often selection) effects. Results: Our results indicate that psychological morbidity (particular ly posttraumatic stress disorder) is largely influenced by combat and poor homecoming experiences, although pre-military characteristics do play some direct roles in symptomatology. Social dysfunction measures show smaller effects of the Vietnam War, which may be accounted for by an indirect association with Vietnam-related psychological morbidity. Some social measures show evidence of compensatory influences of comb at, high combat leading to social dysfunction because of morbidity, bu t simultaneously being associated with healthier social disposition (p ossibly because of increased ex-service activity). Conclusions: For Au stralian Vietnam veterans, combat-related and homecoming effects persi st on a range of psychosocial endpoints 20-30 years after exposure. Th ese effects are not explicable in terms of veterans' pre-Vietnam chara cteristics.