Army officials at Fort Bragg are trying to understand what led four soldiers returning from combat in Afghanistan to kill their wives in a six-week span.
Though there's been no immediate evidence that the men were showing symptoms of Post-Traumatic Stress Disorder, or PTSD, the string of killings has raised concern about the effect of their service on the men.
The wives were slain between June 11 and July 23, two shot to death, one stabbed and one strangled. In two of the incidents, the soldiers killed themselves after killing their wives.
PTSD is a social and mental disorder found among people exposed to an overwhelming event. It's common among veterans who were engaged in combat, but also abused children and people who witness natural disasters. Its symptoms derive from the stresses of readjusting to life as ordinary after witnessing the extraordinary. About half of all Vietnam combat veterans have suffered some form of PTSD since returning home, according to National Center for Post-Traumatic Stress Disorder. More than 150,000 veterans were treated for PTSD in 2001.
Feelings of Nervousness
Experts say those suffering from PTSD often display "hypervigilance," or restlessness, which keeps them from sleeping. Nightmares and repetitive thoughts are also a symptom, though not in every case. Those suffering are often described as nervous or jumpy, unable to concentrate and easily startled.
Recent studies have hinted that physiological changes could accompany PTSD. Cynthia Pfeffer, a psychiatrist from Cornell University, said evidence suggests extreme stress can alter hormone levels, leading to anxiety and depression. Pfeffer said scientists could check a person's saliva for the hormone cortisol to see what effect stress is having.
Pfeffer, who recently received a grant to monitor the development of children who lost of a loved one during the attacks of Sept. 11, said not everyone suffers from PTSD and the reasons could be genetic.
Most often, signs of PTSD begin within three months of the event, but sensory reminders — sights, smells, sounds — can trigger the stresses for years after. Treatment is provided by counseling. Experts say the sooner the disorder is addressed, the better.
Al Batres, chief officer of the U.S. Department of Veteran Affairs' Readjustment Counseling Service, said his agency has helped to treat World War II veterans for PTSD as many as 50 years after a traumatic event. Batres, a Vietnam veteran, said PTSD sufferers suppress memories of a traumatic event because they fear both how it will affect other people and how it will reflect on them.
For treatment of PTSD, veterans can visit any of the country's veteran centers, which are operated by the Readjustment Counseling Service. Since opening in 1980, the country's 206 veteran centers have helped more than 1.6 million veterans, and about 600,000 of their family members. The centers were designed to serve Vietnam veterans, but since 1996 have offered help to veterans of all of the United States' military conflicts, including more than 100,000 Gulf War veterans.
First assigned only to Vietnam veterans, PTSD was attributed to the ambiguous reception many received upon returning home, Batres said. By contrast, soldiers returning from World War II were honored across the country, and there was little discussion of the stresses of readjustment.
But Batres said veteran centers have treated more than 35,000 World War II vets since they became eligible for the centers' aid.
On the Battlefield
In his book Shook Over Hell, author Eric Dean argued that Civil War veterans, many of whom were celebrated with the same pomp and circumstance as World War II veterans upon their return, ended up suffering the same mental disorders as Vietnam veterans. Dean studied asylum records, which predate the creation of PTSD as a diagnosis by a century, and concluded that the experience in battle was the determining factor in an individual's mental state, not the perception back home.
"If you've been through the horrifying experience of combat, no parade is just going to wipe that away," Dean said. 'That's just a myth."
Batres said a welcome home does offer some help, but said the centers have treated veterans of all the United States' military actions — regardless of their popularity.
"A welcome homecoming will make a difference because it creates less conflict for the veteran coming home," Batres said. "Additional stresses can only exacerbate the situation."
Batres said he expects just as many veterans from the war in Afghanistan to seek the agency's assistance.
Everybody Is Affected
Three of the four Fort Bragg, N.C., soldiers involved in the killings were members of special forces units selected for their performance and stability under pressure. But Batres said the veterans centers have treated special forces veterans as regularly as any other soldier whose seen battle.
Dean said debate also surrounds which type of war is more stressful on an individual. In Vietnam, soldiers often fought a continuous series of shorter skirmishes, which kept them constantly on edge but allowed them to adjust to combat intensity. In the Civil War, soldiers were idle for weeks at a time, only to face terrifying two- or three-day battles.
"Every war is going to involve trauma," Dean said.