(114) Part II – The Dog’s on the Trail: Findings of an Important PTSD Study

Miss Molly profile

Golly, Miss Molly

A Blog about a Service Dog and her Veteran with PTSD

(Supporting the Veteran and the Family Caregiver)

In Tuesday’s Molly Blog, we discussed the newly-released findings of the NVVLS (National Vietnam Veterans Longitudinal Study), which revealed that PTSD symptoms worsened in a majority of combat Veterans over the 25-year period of the study. The study findings stated that 40 percent of Vietnam Veterans with PTSD experience major depressive disorder more than 40 years after the war.

As promised, this blog focuses on a few additional study findings. Following a trail of crumbs left in the study, the blog also looks at what the study did not say with alarming statistics that bite you on the nose.

An Easy Trail to Follow 

For Veterans, living with the nightmares of war, the study results may be self-evident. For those of us just learning about PTSD with little exposure to war, the trail to these conclusions are hidden beneath the jungle canopy, having never been considered. The easiest way to clear the trail requires a machete and flashlight. Cutting through the statistics and research language, here lays the summary:

    1. The prevalence of PTSD symptoms over time for war-zone Veterans is higher than for non-war-zone military and civilians. The astonishing part of this finding is that a study combined this data into one statistic, which leaves the impression that war-zone trauma PTSD is lower than it is by diluting the data with other study participants not exposed to combat. Although the study properly separated the data by each category of participant when reporting the data, such a finding can be manipulated easily to report lower incidence of PTSD than exists in combat Veterans.
    2. Multiple studies, including a ten-year study of Vietnam Veterans reported a gradual decline in PTSD rates and “diminished effects of exposure levels on PTSD symptoms during a ten-year follow up.” These findings clearly contrasted with a 20-year study of World War II Veterans, which reported intensification of PTSD symptoms over time. The NVVLS sets the record straight by showing that PTSD does not go away but worsens over time for combat Veterans.
    3. This study (NVVLS) is the only statistically valid, longitudinal study on the effects of PTSD in Vietnam Veterans and, therefore, boasts of authenticity and reliability. Its findings become highly relevant and beneficial to Veterans, who suffer from PTSD because it underscores the need for on-going treatment and support of our Veterans both current and future.
    4. Since 1980 with DSM-III R when PTSD became an official disorder until the DSM-V was published in 2013, the threshold of symptoms required for diagnosis was raised, making the diagnosis of PTSD more difficult to reach. If the same criteria had been used, it likely would reveal a greater decline of Veterans’ mental health over the 25-year period. This is not the fault of the study; however, it does raise concern that less Veterans receive help for PTSD symptoms today because fewer are included in the diagnosis due to the higher threshold of proof.
    5. Alcohol and substance abuse declined over time in Vietnam Veterans with PTSD. In fact, the alcohol abuse percentage for war-zone Veterans is lower than alcohol abuse in those without PTSD. (Way to go Vietnam Veterans!) 

Where the Trail Runs Cold 

The study offers astonishing insights for the layperson but where it stops cold, left me stuck in the jungle without a guide—morbidity. Of the 2,348 Veterans, who participated in the original NVVRS, 428 died by 2012—the year the longitudinal study began. Eighty-one additional Veterans died between the time of the first mailing and the launching of Phase 1 of the longitudinal study. Following Phase II of the study, 40 more Veterans died before the third phase. This represents a death rate of 23.38 percent of Vietnam Veterans, who died during the 24-year period from completion of the NVVRS in 1988 to the beginning of the NVVLS in 2012.

The study scope did not cover causes of death; consequently, we remain clueless about the deaths. We do know, however, that more Vietnam Veterans died by suicide after the war than died in the war.

And the Winner Is . . . 

Not wanting to leave our readers stranded in the jungle, Molly brings us back to the present with her newest candidate for the Golden Paw Award. She gives a High Paw to Dr. Marmar, his research team, and the New York University Cohen Veterans Center for this exemplary study, which demonstrates the need for greater access to mental health services and support for our Veterans. Miss Molly proudly issues Dr. Marmar the Molly Dog Tag Certificate. Well done, Dr. Marmar and team.

Post your Comments: 

Did any of the study findings surprise you? Please reply below. 

Source cited:

  • Marmar, Charles R., et al. “Course of Posttraumatic Stress Disorder 40 Years After the Vietnam War: Findings From the National Vietnam Veterans Longitudinal Study.” JAMA Psychiatry, 2015; 10.1001/jamapsychiatry.2015.0803

About the blogger

Dr. Penelope “Penny” Culbreth-Graft is a retired city manager and graduate professor. She lives with her disabled Vietnam Veteran husband, William, and his service dog, Molly, on Cheyenne Mountain in Colorado. She writes, paints, cares for her husband, and spends time with her granddaughter.