Persistence and Patterns of Combat-Related Posttraumatic Stress Disorder (PTSD), Medical, and Social Dysfunction in Male Military Veterans 50 Years After Deployment to Vietnam.

Abstract

We examined long-term patterns of posttraumatic stress disorder (PTSD) and behavioral outcomes in Vietnam veterans. A random sample of 12,400 veterans was surveyed in 1984, 1998, and a deployed subset (n = 729) in 2020. Outcomes included PTSD, psychological well-being, health functioning, and disability. Four PTSD patterns emerged over 35 years: current PTSD (9.1%, rising to 15.5% in heavy combat), prior PTSD (9.7%), subthreshold PTSD (25.2%), and never PTSD (56.0%). A strong combat-PTSD dose-response relationship persisted across time points. Veterans with current PTSD showed the worst outcomes; those with subthreshold or prior PTSD had intermediate outcomes, while never-PTSD veterans fared best. Community support mitigated adverse effects. Findings highlight the enduring impact of combat, with PTSD and related dysfunction affecting veterans even below clinical thresholds, leaving many ineligible for Department of Veterans Affairs (DVA) programs.