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Am J Psychiatry 1997; 154:178-184
Copyright © 1997 by American Psychiatric Association
Posttraumatic stress disorder associated with peacekeeping duty in Somalia for U.S. military personnel [published erratum appears in Am J Psychiatry 1997 May;154(5):722]
BT Litz, SM Orsillo, M Friedman, P Ehlich and A Batres
National Center for Post-Traumatic Stress Disorder, VA Medical Center, Boston, MA 02130, USA. Litz.Brett@Boston.Va.Gov
OBJECTIVE: The end of the Cold War has marked a period when the U.S.
military is asked to secure peace under conditions in which peace is
tenuous, yet the need for resolution of the conflict is great. Combat-
trained soldiers are highly visible and are exposed to threats to their
lives, yet are asked to exhibit restraint and neutrality. The psychiatric
consequences of peace-keeping duty under these conflicting and volatile
conditions have been underresearched. The authors examined the prevalence
of posttraumatic stress disorder (PTSD) associated with exposure to
peacekeeping duty in Somalia. METHOD: A large cohort of active duty
personnel deployed to Somalia (N = 3,461) were surveyed approximately 5
months after their return to the United States. A variety of military
service characteristics and exposure variables and PTSD symptoms were
examined. RESULTS: Eight percent of peacekeepers were found to meet
diagnostic criteria for PTSD. PTSD symptom severity was best predicted by
the rewards of military service, war zone stress, and frustrations with
peacekeeping (e.g., restrictive rules of engagement). CONCLUSIONS: It is
likely that the mission in Somalia represents a new paradigm of dangerous
military operations for the United States. These data suggest that
peacekeeping may be difficult to reconcile for some combat-trained soldiers
and can create a risk for PTSD.
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