"By measuring PTSD symptoms in soldiers deployed to Afghanistan at five different time points,we find previously unseen patterns of PTSD development across time, and show the importance of childhood traumas - not combat - as predictors for lack of resilience," says lead author Dorthe Berntsen of Aarhus University in Denmark.
Receiving harsh physical punishment and witnessing domestic violence were highly correlated with PTSD, confirming previous studies suggesting that severe stress is most toxic and traumatic when people feel they have no control over a situation, a common scenario for children raised in a chaotic and violent home. "Such events may be especially traumatic because they are events in which caregivers play a central role," says Berntsen, "In such cases, the child often has no one to turn to. Loneliness, isolation, negative self-appraisal, and a feeling of helplessness may be the result," says Berntsen.
But some behaviors arising from those circumstances can be adaptive during war. Being more attuned to potential signals of threat, for example, or having more sensitive startle response and the ability to dissociate yourself from particularly traumatic or violent situations involving combat and death can enhance survival during war. Terrorism expert Jessica Stern, herself a survivor of rape, described it this way, "If you think about what it takes to stay alive for a soldier - they call it PTSD when the soldier retires - but if he didn't have hypervigilance and dissociation while on the battlefield, he's a danger to himself and everybody else."
That could explain in part why some soldiers with a history of trauma report feeling better during deployment: their "symptoms" are potentially useful during combat. Rather than debilitating them, they help them become better soldiers. But Berntsen found no relationship between the amount of combat exposure and the improvement seen in those with traumatic childhoods, so she suspects other aspects of the war experience, such as the camaraderiethat develops during combat, may be involved. "More likely, being deployed in Afghanistan may have provided these people with a sense of commitment, a sense of being part of a team, a sense of recognition and comradeship," she says.
But past traumatic experiences are likely only one of a myriad factors, along with genetic
predisposition , that may make certain people more vulnerable to PTSD than others. In a separate study published in the Archives of General Psychiatry investigating such risk factors, researchers turned their attention to a more biological culprit in the brain. Their results support the idea that people with smaller amygdalas were more likely to have PTSD. But amygdala size wasn't related to how much trauma the person had experienced, so the scientists suspect that smaller amygdalas are a risk factor, rather than a result of trauma.
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