Iraqi War Vets Face Mental Challenges

Study Shows Mild Problems With Memory and Concentration

Medically Reviewed by Louise Chang, MD on August 01, 2006
From the WebMD Archives

Aug. 1, 2006 -- U.S. soldiers who serve in Iraq can expect to experience subtle mental and emotional challenges when they return home, even if these issues don't rise to the level of posttraumatic stress, a new study shows.

Veteran's Administration and U.S. Army researchers documented what they characterized as "mild" problems with memory, concentration, and stress in active duty Army soldiers who had just returned from a year-long tour in Iraq.

The study is the first to scientifically assess mental functioning in the same group of soldiers prior to and immediately after a tour of duty in a war zone.

As a result, it offers a unique perspective on the short-term impact of war service on a soldiers' mental health, researcher Jennifer J. Vasterling, PhD, tells WebMD. The soldiers received the same battery of tests before leaving for Iraq and within three months of returning to the U.S.

"The testing showed mild impairment in memory performance and ability to pay attention, and the deployed soldiers reported feeling more tension and stress," Vasterling says. "But for the most part, these issues did not have a big impact on their daily lives."

More Stress, Quicker Reactions

A total of 654 male and female active duty Army soldiers who served in Iraq and 307 soldiers with similar characteristics who did not serve overseas were recruited for the study, published in the Aug. 2 issue of the The Journal of the American Medical Association.

The deployed soldiers were first examined before deployment (April-December 2003) and within 2.5 months after returning from deployment (January-May 2005). Almost all reported having been in potentially life-threatening situations, such as combat missions or transportation convoys. More than half (55%) reported having witnessed a fellow soldier being seriously injured or killed.

At each exam, all the participating soldiers took the standardized performance tests, which were designed to measure various mental functioning tasks, including short-term memory, ability to concentrate, and tension and stress level.

The soldiers who served in Iraq exhibited "mild neurospsychological compromise" in these areas. But the deployed soldiers also tended to have faster reaction times, suggesting that they were still experiencing a "fight or flight" mental arousal commonly seen in war zone settings.

"Clearly improved reaction time is a good adaptive behavior for a soldier serving in a war zone," Vasterling says. "The Army even has a term for this. They call it battlemind."

Cause for Concern?

The researchers will continue to follow the soldiers to determine if the mental function differences persist.

In an editorial accompanying the study, medical psychiatrists Matthew Hotopf, PhD, and Simon Wessely, FMedSci, weighed in on the issue. Both have done extensive research on post-traumatic stress syndrome (PTSD) among soldiers.

They wrote that while the subtle mental changes outlined in the study bear some similarities to PTSD, they might also be considered perfectly normal coping behaviors. Longer follow-up of the soldiers in the study should help determine if the reactions are normal or cause for concern, they concluded.

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SOURCES: Vasterling, J.J. The Journal of the American Medical Association, Aug. 2, 2006; vol 296: pp 519-529. Jennifer J. Vasterling, PhD, researcher, Veteran's Administration South Central Mental Illness Research and Clinical Center; professor of medicine, Tulane University School of Medicine, New Orleans. Matthew Hotopf, PhD, department of psychological medicine, King's College London.

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