Hispanic Soldiers PTSD the American

Hispanic Soldiers PTSD

The American Soldier: From a Hispanic Perspective

Introduction el Movimiento," is the Spanish word that describes the movement of the 1970s. It is a movement about which little is known by people outside of the Hispanic community, but one that came about Chicano Americans asserted themselves into the fabric of American life in ways that caused them to seek equal rights for themselves (Rosales, F. Arturo, 1996, p. vx). Not the least among the actions taken by Chicano and Latino-Americans that made them look to be treated as equals in America was the fact that many thousands of them performed military service for America, and many, too, lost their lives, in the Vietnam conflict. Since Vietnam, thousands of Hispanic men and women have joined the forces of the United States military as a way to achieve a better life for themselves and their families, and to assert their commitment to America as their homeland.

Since Vietnam, many Hispanic-Americans, and even some who were not citizens by birth or even naturalized citizens, but Hispanics who wanted to serve the American armed forces in a demonstration of loyalty and their desire to become Americans; have fought on behalf of America in Operation Desert Storm, Bosnia, the Afghan and Iraq wars since September 11, 2001. These military men and women have experienced the same conditions and have been subjected to the same threats and injuries as non-Hispanic-American soldiers. However, no real effort has been made to address the physical and psychological needs of Hispanic-American soldiers from the Hispanic cultural perspective. And in some cases, even though the individual's military service resulted in their loss of life, tributes and memorials to that sacrifice have been hard fought for and won on individual case basis, and not as a response to what is morally and socially right on behalf of the dead solider. However, it begs the question: Are the social or cultural needs of Hispanic-American combat veterans different than those of non-Hispanic soldiers; and should they be afforded care and treatment based on their specific social and cultural needs?

Taking two brief scenarios, this study will attempt to identify the uniqueness of the Hispanic-American soldiers in order to answer the question posed here. Relying upon the existing body of expert and professional research, studies and ideas of professionals and experts will be introduced as the discussion of the topic here warrants it.

About PTSD

Post traumatic stress disorder, or PTSD, is the often times latent side effect of the war experience. In a journal article, Patricia B. Sutker, John Mark Davis, Madeline Uddo, and Shelly R. Ditta discuss cultural ethnicity and PTSD. These experts say:

Sutker, Uddo, Brailey, and Allain (1993) also documented clinically significant levels of depression in 24% and symptoms of PTSD in 16% of soldiers returning from war-zone duty in the Persian Gulf. This body of work has revealed that, for some veterans, the extreme psychological, behavioral, and physical disruption associated with military combat leads to mental discomfort and such disorders as PTSD (Fontana & Rosenheck, 1994).

In spite of these results, it has been recognized that only a subset of people exposed to war stress develop negative psychological sequelae (Chemtob etal., 1990; Sledge, Boydstun, & Rahe, 1980; Sutker, Bugg, & Allain, 1991; Ursano et al., 1981). Most importantly, there appears to be a potent relationship between the severity and nature of stressor exposure and the extent to which psychopathological outcomes occur (Hobfoll et al., 1991; Sutker, Uddo-Crane, & Allain, 1991). However, research findings also show that personal-resource or individual-difference factors may set individuals at risk for development of psychological symptoms subsequent to trauma. In addition to military rank, education, and socioeconomic status (Sutker, Bugg, & Allain, 1990; Tennant, Goulston, & Dent, 1986; Ursano et al., 1981), factors of minority ethnicity and female gender may be associated with increased risk for negative psychological sequelae. With greater diversity of troops deployed to military duty, including higher representation of ethnic minorities and women, researchers and clinicians have begun to recognize the possibly unique experiences or vulnerability of these military subgroups (Brende & Parson, 1985; Wolfe, 1993) (Sutker, et al., 1995, p. 416)."

The group cites one of the largest to date (1995) studies conducted on ethnicity and the war experience conducted by Kulka and colleagues (1990) (p. 416). The subjects of the Kulka study were Vietnam era veterans, a war experience that represents a truly diverse cultural group of military personnel and even women, although those roles were mostly of an administrative and medical capacity. The Kulka study reported this:

Kulka and colleagues (1990) found significantly higher prevalence rates of PTSD among African-American and Hispanic veterans than among their White counterparts. Similar results, or greater symptoms of PTSD, were also described among AfricanAmerican Vietnam veterans exposed to heavy combat who sought substance abuse treatment (Penk et al., 1989). Research addressing responses of women veterans to war-zone experiences has revealed high rates of PTSD symptoms (Norman, 1988) and physical complaints (Baker, Menard, & Johns, 1989) in women nurses who served in Vietnam and in women Vietnam veterans who were re-exposed to cues of war experiences during the intense media coverage of the Persian Gulf War (Wolfe, Brown, & Bucsela, 1992) (Sutker, et al., 1995, p. 416).

The current research group points out that these findings are preliminary in nature, and emphasize that further study and research are needed to arrive at more conclusive findings in support of, or otherwise, concerning the study (p. 416). Sutker, et al., go on to say:

In most cases, particularly involving comparisons of men and women, studies lack sufficient numbers of participants and suitable comparison samples to allow meaningful conclusions. Nevertheless, research has suggested that psychological disturbances, and PTSD specifically, may be greater among ethnic minority and women veterans of military service. It has been hypothesized that these veteran subsets may be more vulnerable to the negative impact of war-zone stress on personal well-being, in part, because of their less advantaged social status and unique readjustment needs (Allen, 1986; Brende & Parson, 1985) (Sutker, et al., 1995, p. 416)."

The current research group of Sutker, et al., conducted a study with soldiers from Operation Desert Storm (ODS) in an effort to test the Kulka, Allen, and Brende and Parson study groups findings that minority male soldiers and female soldiers present a higher risk of succumbing to PTSD because of their minority and economic statuses (p. 416).

A including negative mood states, complaints of physical discomfort, and PTSD symptoms, following war-zone duty. Compared to previous military operations, ODS mobilized a more diverse mix of ethnicity and gender among troops, and our work benefitted from opportunity to compare subsets of ethnic minority and women troops who were assigned similar war-zone duties with subsets of military personnel who were mobilized for action but not deployed to the Persian Gulf war zone (p. 417)."

The results of the current group's research is presented in the following table:

Deployment Status, Ethnicity, and Sex Subgroup Means on Psychological Distress Measures

Deployment Status Ethnicity Sex War Zonea Statesideb Whitec Minorityd Matee Femalef Measure M. SD M. SD M. SD Deployment F. Ethnicity F. Sex F. BDI 5. 39 6. 15 3. 69 6. 45 4. 46 5. 88 5. 65 6. 94 4. 76 6. 29 5. 89 6. 17-16. 30* 7. 53* 2. 19 a-State 36. 51-11. 13-36. 64-10. 86-35. 76-11. 30-37. 85-10. 51-36. 32-11. 11-38. 02-10. 58 0. 01 6. 27 1. 06 STAS 20. 54 8. 91-19. 48 7. 98-19. 66 8. 50-21. 20 8. 86-20. 07 8. 49-21. 30 9. 65 3. 72 6. 24 1. 03 BSI

Depression 54. 39-11. 18-52. 31-10. 27-53. 51-10. 96-54. 27-10. 96-53. 76-11. 07-54. 06-10. 24 7. 21* 1. 39 0. 03 Anxiety 52. 43-11. 90-50. 06-11. 55-51. 48-11. 61-52. 21-12. 23-51. 91-12. 00-50. 77-10. 80 7. 67* 1. 79 1. 20 Anger 54. 59-12. 39-53. 43-11. 99-54. 23-12. 22-54. 32-12. 39-54. 14-12. 50-55. 07-10. 79 1. 77 0. 00 0. 68 HSC 8. 61 8. 57 6. 59 7. 81 7. 59 8. 15 8. 77 8. 79 7. 48 8. 14-11. 56 9. 27-13. 86* 1. 70-24. 29*

Note. BDI = Beck Depression Inventory, a-State = State Anxiety scale, STAS = State Anger Scale, BSI = Brief Symptom Inventory, HSC = Health Symptom Checklist.

A an = 653. bn = 259. cn = 569. dn = 343. en = 789. fn = 123.

007. (Sutka, Davis, Uddo and Ditta, 1995, p. 421)

Much of what the current study found supports their hypothesis that there minorities and women experience a higher level of battle stress than do white males. In a discussion of the results, the group says:

Results suggest that, within a large sample of ODS-mobilized troops, the experience of war-zone duty was associated with higher levels of post-military-duty psychological distress, specifically symptoms of depression, anxiety, and physical discomfort, than was found for troops who remained stateside, regardless of gender and ethnicity characteristics. These findings are noteworthy, because the study compared sizeable samples of demographically similar military troops who differed in war-zone exposure. Although the absolute magnitude of group differences on measures such as the BDI may appear moderate, the finding that 22% of troops deployed to the Persian Gulf reported at least mild levels of depression on the BDI compared to 9% of those who served stateside within the first year of such military duty is of clinical significance (p. 422)."

Amy B. Adler (1996), writing for Military Psychology, points out that soldiers experiencing the highest levels of combat stress were those exposed to dead troops and civilians, but exposure to their own fallen comrades, people with whom they had bonded, resulted in the highest levels of stress (p. 2).

The goals of the study were to identify the extent of PTS symptomatology following redeployment and to identify the relation between such symptoms and rank and type of traumatic exposure. It was hypothesized that soldiers who had been exposed to the most stressful types of combat trauma -- those involving death and wounding -- and soldiers of lower rank would be most at risk for stress reaction symptoms. Previous research found that rank is positively related to psychological well-being (Griffith, 1988) (Adler, 1996, p. 2)."

Adler's contention that stress is found at greater levels amongst those soldiers of lower rank is not contradictory to the findings of the first group, Sutker, et al., since minorities and women often comprise the elements of the lower ranks by virtue of education and economic factors. So, for this reason, the conclusions of both groups of researchers support the findings of the other.

The Scenarios

The subject of the first case study we'll examine here is the case of Jesse, a 1967 Vietnam era veteran, who was involved in the fighting that took place during what has become known as the Tet Offensive. In addition to the Tet Offensive, as a soldier of war, Jesse has experienced the horrors of war: the bloodshed, bonding with his fellow soldiers and experiencing their deaths while in a military capacity that made it difficult to mourn those losses of friendship and camaraderie. By the time Jesse returns home to the U.S., to his family in San Francisco, he is a changed man.

Sometimes, the California terrain triggers memories of places in Vietnam where Jesse experienced traumatic events of war. Jesse struggles to between the flashbacks from Vietnam and his reality at home in San Francisco. The constant need to focus and to work to remain in the moment of the present while at the same time being haunted by the nightmarish scenes of tragedy in Vietnam have taken a toll on Jesse's physicality; he experiences poor sleep habits, disinterest in diet and exercise, and he is wary of the people at work and whom he meets socially. Jesse has no relationship, even though he has attended school to become a lawyer and he would very much like to begin a family. Jesse does not believe he can begin a family until he addresses his problems associated with the war.

Jesse's war time experience is consistent with the study cited by Sutka, et al., wherein Kalka found the high level of PTSD amongst individuals of Hispanic origins who were veterans of the Vietnam conflict. As a participant in the Tet Offensive, an event that caught the United States troops very much off guard, Jesse would have experienced a traumatic event resulting in the loss of life amongst his fellow soldiers.

Even though Jesse rose above his Vietnam level of education, it was only once he was back in the United States and in a familiar setting that he was able to do that. However, a post experience education did not serve to help Jesse past the experiences that caused him to manifest symptoms of PTSD, and his experience caused him to suffer socially in that respect.

Another soldier, Amos, who, like Jesse, was in Vietnam experienced a very different side effect of his experience; when he was at home making love to his wife, he was thinking of the war, and when he was at war, he thought about his wife. This is an avoidance mechanism that turns into a vicious circle for a soldier experiencing PTSD. Felix focused on his wife while at war to avoid the experiences and trauma of war; and vice a versa, because the experience of war, like Jesse, had left Felix affected.

Another solider, a veteran of Operation Iraqi Freedom, experienced the horrifying and traumatic experience of mistaking innocent civilians for insurgents, and killing them, including a child. Upon of return to the States, Felix finds he relieves the experience time and again and is unable to eradicate the memory of the event from his thoughts. He, like Felix and Jesse, is experiencing PTSD.

Each of the three men's cultural ethnic heritage made him both susceptible to the conditions from which they suffer as a result of their war time experiences; and, upon return to their cultural settings, they remain vulnerable because it is not consistent with the Hispanic machismo to, first, suffer the condition, and, second, to acknowledge that condition by seeking treatment.

Especially for a Chicano or Latino soldier coming out of a Vietnam war experience, the study of Hispanic social science was virtually non-existent at that time (Blea, Irene I., 1988, p. 1). Only since ODS, Operation Desert Storm, have studies been conducted, like the several cited here, that lend themselves towards understanding the Hispanic soldier as having unique needs in the aftermath of his or her war experience.

Steven B. Knouse, Alvin Smith, Patricia Smith, and Schuyler C. Webb (2000) discuss the culturally unique needs to troops in a journal article for Review of Business (p. 48). These professionals describe the present day military this way: