Reintegrating Subjective and Objective Aspects of War-Related PTSD

Studies of PTSD in military populations have repeatedly demonstrated a dose-response relationship between combat exposures and PTSD symptoms. While this relationship is compelling, the strong focus on objective events (combat exposures) has lead to a diminished emphasis on subjective reactions such as horror and helplessness. In this manuscript we (1) replicate the dose-response relationship in a sample of Navy personnel deployed to Operation Iraqi Freedom or Operation Enduring Freedom, and (2) demonstrate that subjective reactions to events account for more of the variance in PTSD than is explained by objectively reported combat exposures. We conclude that service members must be prepared not just for general aspects of combat stress, but also for feelings of intense fear, helplessness, or horror. Sponsored in part by the Navy Medicine Support Command, Jacksonville, FL. Prepared in collaboration with the Bureau of Medicine and Surgery, Washington, DC.