Psychological Effects of Traumatic Experiences among Veterans

War is one of the most difficult and challenging situations that an individual can meet in his or her lifetime. It is particularly traumatic for the soldiers involved for it often involve intimate violence which includes witnessing death from direct combat, watching friends and comrades die and viewing the enemy before or even after killing him. Individual exposed to heavy fighting in addition to those who witness their comrades getting injured or dying, including prisoners of war significantly experience trauma beyond their stay in the military, a factor that significantly impacts their psychological functioning, social relation and physical health. A young adult who gets exposed to military combat is at higher risk of being traumatized compared to their older counterparts. A traumatic experience among veterans is an issue that impacts not only the individual but their children, spouses, friends, extended family and the society as a whole. A traumatic experience among veterans is an issue that has caught the attention of the public and aroused debates in the society. Therefore, by looking at some of its significant consequences, current statistics, theories and risk factors, the paper will provide social policies that have been provided to address the issue. 

Traumatic experiences among veterans with families are associated with various mental health issues that can impact the ability of an individual to parent effectively. Post-veterans parents who suffer from depression may find that they have little or no motivation to look after or even participate in their youngster’s lives (Coric, Klaric, Petrov, & Mihic, 2016) . As a result of depression, they are faced with struggles of interacting with their children and sometimes may become irritable, impatient with their children or lack the confidence to set limits when it comes to parenting (Australian Government: Department of Veteran Affairs, 2018) . Research indicates that children with veteran parents affected by various mental health issues are more likely to experience some behavioral problems, have poor coping skills and academic difficulties, often find it difficult forming and maintain relationship, and have high likelihood of developing mental health issues compared to their counterparts (Coric, Klaric, Petrov, & Mihic, 2016) . The stressful intrafamilial atmosphere that these children get exposed to is a factor that increases their vulnerability for developing mental health problems as a result of their loss of faith in parental relations and the security that is provided by the family environment (Coric, Klaric, Petrov, & Mihic, 2016) . Consequently, violence and family conflicts that occur in this atmosphere have been linked to indifference and lack of parental warmth, unstable attachment and neglect, which are the basis for these children developing behavioral problems and emotional symptoms. 

It is often said that the healthy development of a child requires constant regulation of their closeness to their parents to enable them to form a separate identity. However, this is a factor that is challenging and difficult to achieve in an unstable family environment with parents suffering from post-traumatic stress disorders (PTSD) due to war. The physical presence of veteran parents with PTSD, their psychological absence that results from their preoccupation with trauma in addition to difficulties in justifying their behaviors is a factor that can confuse youngsters leading to disappointments and lack of respect towards the parent (Coric, Klaric, Petrov, & Mihic, 2016) . Additionally, long-term missing roles of fathers in families with a veteran parent confuse positions within the family and boundaries, and emotional distresses in the family and the redistribution of family function from the father to the mother or the children (Australian Government: Department of Veteran Affairs, 2018) . In a situation such as these, children will always feel responsible the emotional state of their fathers and thus suffer from low self-esteem to loss of interest in daily activities thereby increasing their risks of continuing these behavioral patterns even into their adulthood. 

Moreover, mental illness associated with traumatic experiences during the war can further significantly impact veteran partners. As such, individuals with veteran partners may deal with issues of emotional withdrawal, suicide attempts or threats and substance abuse (Australian Government: Department of Veteran Affairs, 2018) . Additionally, partners of veterans may also find themselves taking additional responsibilities in their family homes or have difficulties in adjusting to unwanted lifestyle changes brought about by increased isolation from the community friends. This often leads to strain in relationships, lack of intimacy and the separation of not only the veteran but also his own family from potentially receiving valuable social support (Taft, Fredman, & Monson, 2009) . According to studies conducted on families with mentally affected veteran’s partners, it was found that mental illnesses such as anxiety disorders and severe depression were a common phenomenon among them compared to the general population. 

One of the most common issues associated with traumatic experiences among veterans is post-traumatic stress disorders (PTSD). PTSD is primarily linked to systems of intrusive memories, avoidance and hyperarousal that often result in difficulties in family relationships (Prause, Silver, & Pizarro, 2006) . Hyperarousal regularly contributes to aggression and domestic violence while avoidance inhibits intimacy among veterans and their partners thus reducing any little amount of satisfaction that they may derive from their relationships. Consequently, individuals with veteran partners have been found to experience high cases of vicarious traumas from being exposed to their partners PTSD (Prause, Silver, & Pizarro, 2006) . Individuals with veterans as partners further can experience depression, anxiety, feelings of hopelessness and social isolation due to their partner’s trauma and subsequent symptoms. For instance, studies conducted on couples with veteran partners determined that individuals with veterans as partners often talk about “walking on eggshells” around their partners as they are afraid of their veteran symptoms (Australian Government: Department of Veteran Affairs, 2018) . 

Statistics 

From the world wars to the United States Civil war, soldiers who are lucky to return to their communities and families alive often do not return whole. As a result of the traumatic events they experience during the war, they are left broken with significant psychological problems. This has prompted researchers to conduct various studies relating to the psychological effects of traumatic war experiences. In the United States, approximately 69% of the total adult population, that is 51.2% women and 60.7% male have experienced traumatic events at least once in their lifetime (Deitz, 2014) . However, only 10% of females and 5% of men are recognized to develop PTSD. 

Conversely, the majority of soldiers who experience combat-related traumas can re-adapt back to their civilian lives without having many difficulties. As such, only 15% of veterans, both men and women who witness combats develop PTSD (Deitz, 2014) . According to current research conducted on the relationship between veterans and PTSD, it was found that 15% to 17% who returned from Iraq experienced symptoms of trauma or acute stress. Data on veteran affairs further indicate that among the female veterans who served in Iraq and Afghanistan, 20% were diagnosed with PTSD upon their return to the United States (Prause, Silver, & Pizarro, 2006) . F urther research on PTSD and veterans indicate that only 10% who served in the gulf war developed PTSD, while 30% of those who served in the Vietnam War developed PTSD. 

According to a report released by the Veterans Health Administration on January 2014, as cited in Prause et al. (2006), it was indicated that suicide rates among both female and male veterans exceeded the national percentage of the general American population. Veterans comprised of 20 percent of the total domestic suicides with approximately 22 veterans dying every day through suicide. In this number, three out of five were explicitly diagnosed with severe mental health conditions (Taft, Fredman, & Monson, 2009) . Another finding from the studies conducted revealed that approximately 10 per cent of homeless individuals in the United States are veterans. More importantly among this homeless group, three out of four people have an issue with mental and, or substance use disorders, while one fifth is those who are treated continuously for substance use (Prause, Silver, & Pizarro, 2006) . 

Consequently, studies have further noted that 30% of veteran soldiers develop various mental health problems within a span of three to four months of being home while 20% of returning Iraq and Afghanistan veterans often turn to heavy drinking and use of drugs after returning to the United States 

Moreover, a study conducted in Afghanistan on the psychological effects of war using a national multistage, cluster population-based survey that included 799 households with members aged 15 and above, sixty-two per cent of the respondents agreed to have experienced at least four trauma events during their previous ten years. Among the participants, 67.7% were found to have symptoms of depression, 72.2% had symptoms of anxiety while 42% were found to be experiencing PTSD (Deitz, 2014) . 

Consequently, women who were disabled were noted to have poor mental health status which was significantly linked to their mental health statuses and traumatic events. Another study conducted using multicluster sample population in the Nangarhar province of Afghanistan specifically to estimate the prevalence of psychiatric symptoms and risk factors found that nearly half of the people at one point experienced traumatic events. The study observed symptoms of depression in 38.5% of the respondents, anxiety in 51.8% and PTSD in 20.4%. It was noted that higher rates of symptoms were closely associated with high numbers of traumatic events that these population experienced (Kang, Liu, Tang, Yang, Xue, & Zhang, 2015) . However, it was found that women had high rates of symptoms compared to their male counterparts. 

Theories and risk factors 

The Conservation of Resource Theory 

This theory is among those that have been employed in the field of psychology. The Conservation of Resource theory has been found to be efficiently reliable in providing the basis for understanding various processes that are involved with experiencing, coping and overcoming traumatic and chronic stresses (Leake & Joyner, 2018) . The theory states that human beings are particularly motivated to procure, protect and preserve resources. In short, humankind has an affinity for valuing various resources ranging from objects, conditions, personal characteristics and energies. The COR theory thus postulates that stress often results when the resources of an individual are threatened, depleted or when they do not accrue as required (Leake & Joyner, 2018) . The theory, therefore, proposes that traumatic stress primarily results from an accelerated loss of resources that are most valued by an individual. 

Veteran individuals often experience military trauma which may include their exposure to combat, military sexual trauma and terrorism. Even though studies indicate that majority of veterans adapt well after serving in war across their lifespan, they often experience posttraumatic stress disorder and depression as a result of the traumatic events that they get exposed to (Deitz, 2014) . Therefore, veterans suffering PTSD or even depression may be because these traumatic events often impact their resources while they fight to challenge their coping capabilities. The uniqueness of traumatic events lies in the fact that they primarily attack the core values of an individual, they are unanticipated, the typical coping strategies are ineffective in managing them, they require significant energy and imprints strong mental images on individual’s minds (Leake & Joyner, 2018) . Therefore in the course of their service, it becomes increasingly difficult and challenging for them to utilize, protect and maintain resources such as social support following traumatic experiences. 

According to the first principle of the COR theory, the loss of resources significantly has stronger impacts on the individual than on gaining of resources. For instance, when a veteran loses his or her comrade in battle, receiving a medal to recognize the exemplary efforts they place in their service does not in any way mitigate the loss of a friend. This is because the loss of an individual's resources is closely associated with psychological distress while the gain of a resource has restricted impact on psychological distress. According to a study conducted on the links between pre-trauma, war-zones, PTSD and post-trauma experiences, pre-trauma life experiences tend to deplete an individual’s ability to later cope with stressors in life (Leake & Joyner, 2018) . Thus, it supports the COR theory argues that the loss of resources outweighs the gain of resources. 

Accordingly, the second principle of the COR theory postulates that every individual must invest in resources so to prevent and restore the loss of resources and to acquire new resources as well. The principle predominantly indicates that investing in resources is a coping mechanism that is used to prevent future losses. When it comes to serving in the military, soldiers must learn to adjust to traumatic circumstances by investing in a resource as a way of overcoming the effects of a traumatic event (Leake & Joyner, 2018) . Thus, according to the COR theory, members of the armed forces who utilize social support are less likely to develop PTSD. As such, investing in resources has a high likelihood of assisting a service member to protect his or her services, to acquire new resources and to prevent future loss of resources. According to the third principle involving losses and gains, specifies that the loss of resources is a factor that contributes to trauma reactions that in turn leads to the loss of additional resources. Thus in the wake of a traumatic event, veterans will lose resources that may include their sense of wellbeing, trust or optimism (Leake & Joyner, 2018) . Therefore having fewer resources to help cope with the challenges of war increases the impact of future stressors such as PTSD. 

The Influential Cognitive Theory 

Stress and anxiety are one of the most crucial aspects that are involved in preparing various individuals to meet the everyday demands of life and to consequently increase their chances of survival (Shin, Hayes, & VanElzakker, 2012) . Therefore, often it is not a surprise that arousing stimuli that is emotionally salient has the effect of readily capturing attention and influencing the processing, encoding, storing and retrieval of information. However, when levels of stress surpass the usual standards required, it can immensely impact the normal functioning of an individual. This aspect is indicated in the development of various psychiatric disorders such as PTSD which is developed after an individual gets exposed to life-threatening and terrifying events. PTSD involves relieving traumatic events through the disruption of memories in addition to nightmares, being hyper vigilant towards potential threats in the environment, and the avoidance of the remainders of the event (Shin, Hayes, & VanElzakker, 2012) . Most of the common symptoms of PTSD involve the alterations of various human cognitive processes that include memory, attention, and problem solving and planning thus underscoring the impact of emotion on cognitive functioning. 

Thus the influential cognitive theory of PTSD mainly provides emphasis on the interaction that occurs between emotion and cognition, and their contribution to PTSD symptoms. The theory postulates that psychopathology arises mostly when extreme emotional stress leads to an alteration in the cognitive networks processing information relating to meaning, perception and action responses of executing objectives and goals (Shin, Hayes, & VanElzakker, 2012) . According to the theory, the networks that represent information on fear become extremely elaborated and accessible in individuals with PTSD thus impacting their encoding and retrieval of information (Shin, Hayes, & VanElzakker, 2012) . For example , situations in which elaborated fear structures occur has the effect of lowering people's capacity to process information that does not indicate any signs of threat thereby resulting in attention bias towards potential risks that might be in the environment. Consequently, nodes of fear networks that represent the arousal of threats may make an individual to interpret even the irrelevant stimuli to be threatening (Shin, Hayes, & VanElzakker, 2012) . Thus intrusive memories are due to the activation of threat arousal nodes that are related threat nodes while inhibiting the nodes that represent opposing alternatives. 

Risk Factors 

Various psychological disorders that are related to traumatic experiences during combat including PTSD arise due to the involvement of individual risk factors. However, studies on the risk factors for psychological effects of traumatic events indicate that not all individuals who experience a traumatic event will develop PTSD, thus coming to a conclusion that the individual vulnerability factors result in the development of PTSD beyond traumatic events (Kang, Liu, Tang, Yang, Xue, & Zhang, 2015) . The risk of developing psychological disorders such as PTSD due to traumatic events thus includes pre-trauma factors, peri-trauma factors and post-trauma factors. Pre-trauma factors include socio-demographic factors such as; race, age, gender, marital status and level of education, military characteristics that may consist of; rank, length of deployment, occupation, a branch of service and the number of deployments. It further may include an individual’s drinking status, smoking status, prior trauma, prior psychological problems and previous life events (Kang, Liu, Tang, Yang, Xue, & Zhang, 2015) . Consequently, peri-trauma factors involve aspects such as combat exposure, unit support, discharging of weapons, the severity of trauma and witnessing someone being injured or worse killed. Post-traumatic factors include co-morbid psychological problems, post-deployment support and subsequent life events. 

Social policy 

To help veterans experiencing the psychological effects of traumatic events as a result of the war, the Department of Veteran Affairs introduced the Disability Compensation and Rehabilitation Policy (Tsai& Rosenheck, 2016). The policy caters for soldiers that have experienced psychological effects from the wars they have fought. Soldiers that have been traumatized by the events are the ones being targeted by this policy. The policy involves the establishment of VA clinics to help in the treatment of PTSD and other psychological diseases. Lately, the policy has increased its scope by ensuring that behavioral health services are available through telecommunications technology. The strategy is focusing on rural areas where 37% of veterans with psychological disorders live. For a veteran that takes advantage of the Veterans Affairs Department policy, his professional, as well as personal growth, is going to increase significantly. The policy is almost 60 years old. The military disability was established in1776, and since then, disability related to post-traumatic stress has been added from the years after World War II and the Vietnam War. The policy is meant to neutralize the effects that the veterans have concerning psychological effects from war activities. 

The treatment of the PTSD under this policy should be timely and accurate. The primary purpose of the policy is to help the victim fit socially in the environment he is operating in whether at work or home (Tsai& Rosenheck, 2016). The treatment is established after the individual has filed for compensation from the department. VA compensation is given to a person depending on the degree of the effects caused as a result of duty on his line of work. The scale of the compensation is usually from 10- 100%. The victim can claim a percentage if he is not hugely affected, but can also claim full compensation if he is unable to work and raise any income. In the past, PTSD was not included as a disability. However lately, improvements have been made to help veterans improve their professional as well as personal work life. Before the compensation can be paid out, the state requires that one provides evidence of the disability. 

To be eligible for this compensation under the policy, one should have been discharged from the military under honorable conditions (Drew et al., 2001). The person should at least be more than 10% disabled. The claimer should also indicate strictly how the injury has affected his life and that of the family. The PTSD should have been caused by the traumatic events such as one seeing civilians and military personnel dying in horrible ways. Medical evidence of the mental instability is also required. The policy also has outlined presumed disability. These are veterans that were prisoners of war. Being prisoners can have some traumatic effects causing the individual to lose work or be involved with alcohol and drug intake. The department of veteran affairs is the one concerned with the financing of the treatments and compensation of the PTSD 

The number of the veterans that are benefiting from the policy on rehabilitation and compensation is almost 79% as of 2004. The figures have seemed to rise by 12% by the year 2016. This indicates that there is a rapid expansion of compensation stating that veterans are being taken care. Payments for those with disability have been estimated to be $4.3 billion annually. This compensation is meant to help the distressed soldier's live comfortable lives in spite of their disability. Only a half of those that are seeking treatments for their mental disorders mainly PTSD applies for the compensation. It is hence safe to say that veterans are moderately using the policy to improve their professional as well as personal life. 

Many reports have analyzed the outcome of the compensation and disability policy to see if it is working. About 13% of those seeking treatments and compensation is said to be fraudulent. It hence becomes difficult implementing the policy to help genuine people in need of it. The remedies under the Departments of Veteran Affairs have also been examined to not being evidence-based methods (Freuh et al. 2007). It hence becomes difficult for veterans to be efficiently treated for them to live fulfilling professional as well as personal lives. However, a significant number of the veterans have benefited substantially from the policy. Some have gone to have promising careers after the treatment. Critiques state that the policy does not help the veterans effectively. Compensation alone for those with PTSD does not address the condition that the individual has. Some use this platform to gain financially from the policy. With the improvement in the policy, all loopholes will be filled. 

In conclusion, despite the quality of life among veterans being characterized by poor mental health, they can benefit from the Disability Compensation and Rehabilitation Policy. Research has linked the war trauma to depressions, post-traumatic stress disorder, change of personality and sensitive disease elements among others. These psychological effects eventually hinder the professionals as well as the mental growth of the veteran. However, with adequate support from the federal state and the society, this social problem will be managed adequately. Stopping stigmatization is also a way to support the policy in helping the veterans with psychological disorders such as Post Traumatic Stress Disorder 

References  

Australian Government: Department of Veteran Affairs. (2018). Impact of veteran's experiences on their families. In Mental Health Advice Book. 

Coric, M. K., Klaric, M., Petrov, B., & Mihic, N. (2016). Psychological and behavioral problems in children of war veterans with Post Traumatic Stress Disorder. The European Journal of Psychiatry , 30 (3). 

Deitz, M. F. (2014). Explaining combat-related posttraumatic stress disorder: An integrated mental illness and military process model. Electronic Thesis and Dissertations , pp. 1-103. 

Drew, D., Drebing, C. E., Van Ormer, A., Losardo, M., Krebs, C., Penk, W., & Rosenheck, R. A. (2001). Effects of disability compensation on participation in and outcomes of vocational rehabilitation. Psychiatric Services, 52(11), 1479-1484 

Frueh, B. C., Grubaugh, A. L., Elhai, J. D., & Buckley, T. C. (2007). US Department of Veterans Affairs disability policies for posttraumatic stress disorder: Administrative trends and implications for treatment, rehabilitation, and research. American Journal of Public Health, 97(12), 2143-2145. https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2007.115436 

Halimi, R., & Halimi, H. (2015). Risk among Combat Veterans with Post-traumatic Stress Disorder: The Impact of Psychosocial Factors on the Escalation of Suicidal Risk. Noro Psikiyatr Ars, 62 (3), 263-266. 

Kang, P., Liu, Y., Tang, B., Yang, G., Xue, C., & Zhang, L. (2015). A Meta-Analysis of Risk Factors for Combat-Related PTSD among Military Personnel and Veterans. PloS One, 10 (3). 

Leake, V., & Joyner, J. (2018, January 24). A Brief Review of the Conservation of Resources Theory as it Applies to Military Trauma. Retrieved from Trauma Psychology News: http://traumapsychnews.com/2018/01/a-brief-review-of-the-conservation-of-resources-theory-as-it-applies-to-military-trauma/ 

Prause, J., Silver, R. C., & Pizarro, J. (2006). Physical and Mental Health Costs of Traumatic War Experiences Among Civil War Veterans. Arch Gen Psychiatry, 63 (2), 193-200. 

Shin, L. M., Hayes, J. P., & VanElzakker, M. B. (2012). Emotion and cognition interactions in PTSD: a review of neurocognitive and neuroimaging studies. Front Integr Neurosci, 89 (6). 

Taft, C. T., Fredman, S. J., & Monson, C. M. (2009). Military-related PTSD and Intimate Relationships: From Description to Theory-Driven Research and Intervention Development. Clin Psychol Rev , 29 (8), 707-714. 

Tsai, J., & Rosenheck, R. A. (2016). US veterans’ use of VA mental health services and disability compensation increased from 2001 to 2010. Health Affairs, 35(6), 966-973.