Prewar, War-Zone, and Postwar Predictors of Posttraumatic Stress in Female Vietnam Veteran Health Care Providers

Abstract

Using the National Vietnam Veterans Readjustment Study database, we explored predictors of current posttraumatic stress disorder (PTSD) symptom severity in 373 female Vietnam veteran health care providers. We derived war-zone stressor scales to encompass general contextual and specific occupational stressors. To assess the comparative impact of war-zone stressors, we included measures of prewar and postwar factors in a multivariate model. PTSD symptom severity was significantly related to war-zone deprivation, dilemmas for health care providers, purposelessness, and unit cohesion. In contrast, the war-zone stressors more clearly identifiable as crite-rion-A-level traumatic exposure were not directly related to outcome. Results support the clinical relevance of war-zone occupational stressors while emphasizing the predominance of postwar emotional support and life events in the expression of chronic PTSD symptoms among this population.