Conduct disorder, war zone stress, and war‐related posttraumatic stress disorder symptoms in American Indian Vietnam veterans

Abstract

This study examined whether conduct disorder (CD) was associated with war zone stress and warrelated post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. CD was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and whether the association exists in other AI populations.Posttraumatic stress disorder (PTSD) is a common and serious problem among U.S. military combat veterans (Koenen et al., 2002). Studies consistently find that the severity of war-related PTSD symptoms is positively associated with the degree of exposure to war zone stress. Combat is the form of stress most commonly studied (Green, Grace, Lindy, Gleser, & Leonard, 1990;King, King, Foy, Keane, & Fairbank, 1999). However, war zone stress can be defined as a combination of both objective and subjective factors. Objective factors include direct combat experience and exposure to atrocities, while subjective factors include perceived threat and deprivation in the war zone. Each of these types of stress differentially affect PTSD symptoms (King, King, Gudanowski, & Vreven, 1995). Factors occurring before and after the war also affect war zone stress and PTSD symptoms. These factors can include demographic variables such as age and education, service factors such as rank, and the presence of other mental illness, including substance dependence (Brewin, Andrews, & Valentine, 2000;Davidson, Hughes, Blazer, & George, 1991;Frueh, Brady, & de Arellano, 1998;Green et al., 1990;King, King, Foy, & Gudanowski, 1996;Wolfe, Erickson, Sharkansky, King, & King, 1999). For instance, males who are younger when they enter the military experience higher levels of combat than those who are older at entry (King et al., 1996).Childhood antisocial behavior is another important factor associated with exposure to war zone combat and PTSD symptoms in national samples of Vietnam veterans Koenen et al., 2002). People with antisocial characteristics may perceive less threat in a war (King et al., 1996), and risk-taking behavior associated with childhood conduct disorder (CD) may increase chances of trauma exposure (Koenen et al, 2002). Individuals with CD may have insufficient resources to cope with the sequelae of stressful or traumatic events once exposed (Koenen et al., 2002). Since onset of CD precedes the minimum age for military enrollment, the veteran population is well suited to study the potential association between CD and PTSD symptoms. Methods SampleWe conducted a retrospective analysis using cross-sectional data from...

Lifetime history of traumatic events in an American Indian community sample: Heritability and relation to substance dependence, affective disorder, conduct disorder and PTSD

“…Fewer other studies have investigated the co-morbidity of PTSD with other psychiatric disorders in American Indian communities. In one study of American Indian Veterans, conduct disorder was found to be associated with elevated war-related PTSD symptoms among males (Dillard et al, 2007). In the present study ASPD but not CD, was associated with having experienced injury or assault, having witnessed a trauma, and crime.…”