Vietnam Veterans 50 Years Later: This Is All That We Know! This Is How I Have Been Living!

Background and Purpose

Joining Forces (2011) recognized at the federal level the importance of identifying the strengths and addressing the needs of the more than 22 million veterans and military families across the United States.  Social work is uniquely situated to make a significant contribution to this initiative, particularly in the area of wellness.  Vietnam Veterans, the largest living cohort of male veterans, may present with unique needs given the influence of their advancing age.  As part of a larger cross-sectional study of Vietnam theater veterans, the current research explored the association between post-traumatic stress symptoms and utilization of mental health treatment, as well as predictors of life satisfaction.  This study sought to understand their experiences and to identify potential areas for social work intervention.

Methods

A cross-sectional study using purposive and snowball sampling was conducted from June to December, 2016 among Vietnam theater veterans living in the Western New York region.  Participants were recruited from the local community and branches of veteran organizations (e.g. Veterans of Foreign Wars).  Of the 117 males (M_age = 69.53; SD= 3.39) who participated, 94% were non-Hispanic white and 66% had served in the Army.  At a location of their choosing, participants completed face-to-face interviews with the primary researcher and completed computer-administered self-report measures, including Life Events Checklist, the World Health Organization Quality of Life, and Life Satisfaction Survey.  Data management and analyses, including descriptive statistics, chi-square, and hierarchical regression were conducted in SPSS.

Results

Of the respondents, 23% met criteria for PTSD; 51% endorsed 10 or more life events that met DSM 5 criteria; and, 52% scored high/very high on life satisfaction.  A significant association was identified between severity of PTSD symptoms with psychotherapy  and with pharmacotherapy   Of those who met criteria for PTSD, 52% utilized pharmacotherapy and 67% utilized psychotherapy.  However, of those with symptoms just below the clinical threshold, only 33% utilized psychotherapy and 29% utilized pharmacotherapy.  Regression models were statistically significant (p<.01) and accounted for 25% of the variance in life satisfaction.  Income (, self-reported PTSD symptoms (, and social support ( were significant predictors, however, other demographics, physical health, and therapy utilization were not significant.

Conclusions and Implications

Despite having experienced considerable adversity and continuing to contend with post-traumatic stress symptoms, many Vietnam Veterans report high levels of satisfaction with life.  It is important to interpret their life satisfaction within the context of their lived experiences, from the time of deployment and return through present day.  Likewise, it is important to consider sub-threshold PTSD symptoms within this population.  Future research should seek to understand reasons behind utilization of mental health services among Vietnam Veterans and mental health services.  Similarly, it may be appropriate to understand the other systems of care with which they interact as venues within which to advocate for trauma-informed care (TIC).  Use of TIC can promote wellness and reduce the likelihood of re-traumatization, while also fostering safety and trustworthiness which are critical elements to engaging this population.