PTSD and Special Operations Forces

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    PTSD in SOF Personnel

    by

    Jud Kauffman

    ExBellum.com

    As a special operations soldier, I always held the belief that my fellow operators andI were relatively immune to post-traumatic stress disorder (PTSD) when compared

    with other soldiers. Of course no one is really immune to such a disorder, but it was

    so rarely a problem with anyone I worked with, and we talked about it often. After a

    violent engagement or a traumatic event, wed briefly discuss the events openly and

    critically and then move on. We were sensitive to the dangers of mental and

    emotional problems associated with combat because we had had hours of classes

    and training on the subject, but it never became a major problem within our units.

    Speaking from personal experience, when I was on my very first real combat

    operation, we became surrounded by enemy forces and took effective and sustained

    fire. I distinctly remember having a discussion during the engagement with a fellowrookie about how calm we were. I had always expected to have tunnel vision and be

    so amped that my decisions would be less than clear. That was not at all the case. I

    was calm and collected and after we returned to base I fell right asleep.

    From then on I knew that our training actually worked and worked well. As a

    result of these experiences I came up with a hypothesis regarding PTSD in Special

    Operations Forces. Consider the following: a typical conventional soldier joins when

    he is eighteen years old and fresh out of high school. He is given fifteen weeks or so

    of basic training before being shipped to combat upon which time he is immediately

    exposed to shocking experiences. Clearly, he will likely not react well to such

    traumatic experiences. Conversely, SOF recruits are generally older and moremature, and are trained for 18 to 24 months in highly specialized courses of

    instruction before ever setting foot on a battlefield. These men will have a

    significantly lower likelihood of experiencing trauma when they see combat because

    they are exceptionally prepared for it, theyre mature, and have had ample time to

    psychologically prepare for what is to come. Therefore it is natural to expect to see

    a lower incidence of PTSD in SOF personnel than in conventional infantry soldiers.

    I developed this hypothesis based purely on anecdotal evidence. However, in light

    of recent media knee-jerk reaction to one or two crazy veterans who became violent

    and subsequent PTSD finger-pointing, I decided to research the subject. I found a

    number of studies which support my hypothesis and counter the medias broadbrush strokes.

    A study conducted by the US National Center for PTSD in 2003[i] found that SOF

    combat personnel were much less likely to suffer symptoms of PTSD than

    conventional infantry. The study, which was conducted at Fort Bragg, tested

    whether SOF soldiers have neurological differences that make them more resilient

    to post-traumatic stress disorder than the average soldier. SOF soldiers were tested

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    for levels of a molecule called neuropeptide Y (associated with preventing stress)

    in their blood. The researchers found that nearly all SOF personnel had elevated

    levels of neuropeptide Y in their blood. According to the researchers, studies have

    shown a correlation between high levels of norepinephrine and chronic feelings of

    stress; neuropeptide Y molecule blocks norepinephrine, and this could be the

    functional basis for its effectiveness in lower stress levels.

    Matt Friedman, the director of the National Center for PTSD, explained at the 2003

    conference of the American Association for the Advancement of Science that the SOF

    soldiers in the Fort Bragg study demonstrated a higher capacity to mobilize the

    neuropeptide Y molecule and sustain it for longer periods of time. Furthermore, the

    level of neuropeptide Y their bloodstream returned to normal levels within twenty-

    four hours, whereas conventional soldiers still showed decreased levels.

    According to Friedman, the capacity to mobilize neuropeptide Y is correlated to a

    lower likelihood of developing PTSD. He believes that neuropeptide Y may offer the

    key to primary prevention of PTSD, if a means of artificially elevating it could bediscovered. Although the work has been going on for several years, researchers are

    still uncertain whether the SOF members enhanced capacity to endure trauma was

    genetic or had been acquired through Special Forces training.

    A broader and more focused study conducted in 2012 by researchers in the

    Department of Psychological Medicine in Sri Lanka[ii] compared the mental health

    problems of SOF personnel with conventional forces who had been engaged in

    combat for at least one year. Exposure to traumatic events and problems with

    family life were identified as risk factors. The outcome measures were common

    mental disorder, fatigue, multiple physical symptoms and hazardous alcohol use.

    The researchers found that while overall exposure to potentially traumatic eventswas high in both groups, the SOF personnel experienced significantly more

    traumatic events during their tours than conventional forces. In spite of this, Special

    Forces personnel exhibited significantly fewer common mental disorders, fatigue or

    poor general health than regular forces. Prevalence of PTSD was only 1.9% in the

    Special Forces and 2.9% among the conventional forces. So, even with more

    exposure to trauma, the SOF members still had lower rates of PTSD. The

    researchers suggested that better training, comradeship, and unit cohesion

    protected Special Forces personnel from negative mental health outcomes of

    combat.

    I also looked at studies of PTSD in civilian populations. PTSD rates in studies ofcivilian populations vary, and depend on the background and experiences of the

    cohorts these studies. However, civilian populations tend to have only slightly lower

    rates of PTSD than do military personnel who have served one or more combat

    tours. Incidents such as car accidents, losing a loved one, assaults, or simply

    prolonged periods of elevated stress are all common causes of PTSD amongst the

    non-military populations.

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    A study conducted in 1991[iii] examined PTSD rates among non-military urban

    youth in Detroit, a sample with an above-average exposure to traumatic

    events. Within the sample, 39% had been exposed to traumatic events, and among

    those exposed, 23.6% reported symptoms of PTSD. A 1993 study of PTSD[iv] rates

    among civilian American women found that lifetime prevalence of PTSD was 9.4%

    among women who were not victims of crime, and 25.8% among women who hadbeen victims of crime. These studies are congruent with reporting from the National

    Center for PTSD, which says that about 8% of the overall population will experience

    PTSD at some point in their lives.[v]

    Generally speaking, available literature on the subject tends to support the

    hypothesis that Special Operations Forces have a higher resilience to combat

    stress. It is interesting that biochemical markers associated with stress control and

    reduction have been found to be higher and sustained for longer periods of time in

    SOF personnel than in conventional soldiers; this discovery demands more

    attention. It is possible that this could be a result of the extended and more rigorous

    training SOF personnel are given. A number of studies[vi] have shown thatprolonged exercise cause the body to exhibit elevated levels of pain-killing

    neurochemicals, so it is safe to assume that a similar mechanism may be at work in

    SOF training. Perhaps extended exposure to rigorous, but controlled, environments,

    allows trainees to develop elevated levels of stress-reducing neurochemicals.

    My own experience, along with the available research on the subject, indeed leads

    me to believe and assert that SOF personnel do have higher resilience to combat

    stress and are less likely to exhibit PTSD symptoms than conventional

    soldiers. Furthermore, my research suggests that PTSD levels in the military overall

    are very near the averages of civilian rates of PTSD. At any rate, it is clear that more

    research needs to be done and less assumptions need to be made anytime a personwho served in the military does something violent. If the reasons for this

    phenomenon are discovered, we may be able to use that knowledge to reduce PTSD

    in combat personnel throughout the Armed Forces as a whole.

    Jud Kauffman, ExBellum.com

    ExBellum.com is an exclusive online network of special operations personnel, both active and separated,

    designed to connect the community with employers and with each other.

    ________________________________

    [i] Battacharya, Shaoni. 2003. Molecular secret of Special Forces toughness. New

    Scientist.

    [ii] Hanwella R, de Silva V.2012. Mental health of Special Forces deployed in battle.

    Social Psychiatry and Psychiatric Epidemiology 47(8): 1343-51.

    [iii] Breslau N et al. 1991. Traumatic events and posttraumatic stress disorder in an

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    urban population of young adults. JAMA Psychiatry (Archives of General Psychiatry)

    48(3):216-222.

    [iv] Resnick H et al. 1993. Prevalence of civilian trauma and posttraumatic stress

    disorder in a representative national sample of women. Journal of Consulting and

    Clinical Psychology 61(6):984-991.

    [v] Vorenberg, Sue. 2012. Civilians also suffer from PTSD. The Columbian

    (Vancouver, WA).

    [vi] Kotlyn K.F. 2000. Analgesia following exercise: a review. Sports Medicine 29(2):

    85-89.