Combat, dissociation, and posttraumatic stress disorder in Australian Vietnam veterans

The specificity of various wartime stressors for different posttraumatic st ress disorder(PTSD) symptoms is inconsistently reported in the literature. Combat, wounding, and peritraumatic dissociation have not been assessed tog ether in their effects on each of the various PTSD symptom clusters. This c ohort study of a random sample of male Australian Army Vietnam veterans yie lded psychiatric assessments of 641 subjects. PTSD measures comprised sympt om criteria for reexperiencing, numbing and avoidance, hyperarousal, and PT SD diagnosis both lifetime and current within the past month. Logistic regr ession is used to examine the effects of combat, wounding, and peritraumati c dissociation together on PTSD. Combat experiences comprised four componen ts derived from a principal components analysis of combat experiences: dire ct combat exposure, exposure to death and injury, exposure to civilian deat h and injury, and exposure to mutilation. Each was differentially related t o reexperiencing, avoidance, hyperarousal, and PTSD diagnosis. Being wounde d was not related to lifetime or current PTSD and peritraumatic dissociatio n was related to all diagnostic components of PTSD in the presence of other variables.