PTSD in the Popular Press: Evaluating Media Accuracy

Introduction

This paper critically examines post-traumatic stress disorder (PTSD) as it is presented in the popular press. Popular topics such as PTSD are often covered by writers who lack a thorough understanding of the underlying research or data. Although the popular press provides lay readers with an accessible means of obtaining critical health information, those readers are rarely equipped to evaluate the quality of the research on which a given article is based.

Using this limitation as a basis for investigation, this paper examines a recent article published in New Scientist on the topic of PTSD (MacKenzie, 2005). Through a careful review of the article alongside a review of the scholarly literature on this disorder, it is possible to effectively evaluate the overall quality of the information provided in the popular press piece.

Review of the MacKenzie Article

To begin this investigation, it is first necessary to summarize MacKenzie's (2005) original article. In her piece, MacKenzie highlights the results of a study on Vietnam War veterans conducted by the Centers for Disease Control (CDC) in 2004. According to the author, the CDC examined data from 18,000 veterans who had been included in a detailed health survey completed in 1985. The CDC sought to determine how many of the men had died and by what means. A review of the data revealed that although combat veterans were more likely to die of accidents and overdoses in the first five years after their return home, after this period "they seemed no more at risk than comrades who had spent the war in non-combat roles" (MacKenzie, 2005).

MacKenzie goes on to report, however, that Joseph Boscarino of the New York Academy of Medicine also reviewed the same CDC dataset in an effort to examine outcomes specifically for veterans suffering from PTSD. Boscarino found stark differences in death rates that persisted for 30 years after the veterans returned home. In addition to accidents, drug overdoses, and suicide, veterans with PTSD were also more likely to die of natural causes such as heart disease and cancer. MacKenzie notes that while a link between PTSD and heart disease has been reported in the literature, a link between PTSD and cancer had not been established elsewhere at the time of publication. Based on Boscarino's data, PTSD may contribute to a range of physical health complications that elevate mortality from natural causes.

To corroborate Boscarino's findings, MacKenzie cites another study in which researchers found that Israeli veterans of the 1982 Lebanon conflict who developed PTSD were more likely to suffer from a range of physical health problems, including high blood pressure, ulcers, diabetes, heart disease, and headaches. MacKenzie concludes her article by speculating on the implications for soldiers then serving in Iraq. According to statistics released by Walter Reed Army Medical Center, approximately 18% of Iraqi war veterans — an estimated 60,000 soldiers — could develop PTSD. Given these figures, MacKenzie issues a call to action urging efforts to mitigate the negative physical health outcomes that may confront these veterans.

Current Empirical Research on PTSD and Physical Health

Based on the data presented in MacKenzie's article, Iraqi war veterans suffering from PTSD appear to face a precarious future. If her account is accurate, soldiers struggling with PTSD may face physical health complications with long-term ramifications for their function, well-being, and quality of life. Although MacKenzie presents compelling evidence, it is important to evaluate current empirical research on PTSD to determine whether her arguments are valid.

A critical review of the most current literature on PTSD and physical health clearly demonstrates an emerging link between PTSD and heart disease. According to Romanoff (2006), new data collected on war veterans show that individuals with PTSD have a higher incidence of heart disease than the general population. Romanoff notes that the precise mechanism by which PTSD triggers cardiovascular disease has not been fully identified, but that ample evidence confirms the elevated prevalence of this condition in PTSD populations. Further, Ginzburg (2004) completed a longitudinal study matching individuals diagnosed with both PTSD and heart disease against controls to determine the impact of PTSD on disease progression. The results indicate a direct link between the presence of PTSD and the development and severity of cardiovascular disease.

Beyond heart disease, the literature links PTSD to a range of additional physical health problems. Martz and Livneh (2007) found that individuals with a history of PTSD were more likely to develop diabetes than individuals who had several conventional risk factors for the disease — including being overweight, smoking, poor diet, a sedentary lifestyle, family history, and age. According to these authors, PTSD elevates the levels of specific hormones and suppresses immune system response. When this physiological response is sustained over a long period, it creates conditions in which individuals with PTSD are significantly more likely to develop chronic health problems.

Weisler, Barbee, and Townsend (2006) studied patients who developed PTSD following Hurricane Katrina, matching them with a control sample drawn from the general population to examine the prevalence of hypertension, diabetes, and heart disease. Even after demographic variables were controlled, individuals suffering from PTSD had substantially higher rates of these conditions. Taken together, the current scholarly literature strongly suggests that physical health problems are more prevalent among patients with PTSD than in the general population.

Conclusion

In the final analysis of MacKenzie's work, it is clear that she provides a fair and honest account of PTSD and its physical health implications. Although MacKenzie appears to slightly overstep by implying that all 60,000 soldiers will be negatively impacted, the evidence does support her call to action. Mental health providers, communities, and families must consider the long-term implications of combat service and the current prevalence of PTSD among returning veterans. This concern lies at the heart of MacKenzie's argument. If efforts are not made to address this issue before it negatively affects veterans' health, a substantial portion of the population could suffer needlessly.

MacKenzie has selected research studies that strengthen her argument and serve as an impetus for change. Although she appears to have a genuine commitment to motivating action in this area, the data she reports does not represent a fringe or minority opinion. Throughout the medical community, there is a growing recognition that PTSD carries serious negative implications for physical health outcomes. While MacKenzie does not include dissenting opinions, there is in fact a scarcity of data that refutes her core claims. In this context, MacKenzie has done a fair and adequate job of representing the current state of the evidence.

References

Ginzburg, K. (2004). PTSD and world assumptions following myocardial infarction: A longitudinal study. American Journal of Orthopsychiatry, 74(3), 286–292.

MacKenzie, D. (2005). Trauma of war hits troops years later. New Scientist. Retrieved October 23, 2007, from http://www.newscientist.com/channel/health/mg18725143.800-trauma-of-war-hits-troops-years-later.html

Martz, E., & Livneh, H. (2007). Do posttraumatic reactions predict future time perspective among people with insulin-dependent diabetes mellitus? Rehabilitation Counseling Bulletin, 50(2), 87–98.

Romanoff, M. R. (2006). Assessing military veterans for posttraumatic stress disorder. American Academy of Nurse Practitioners, 18(9), 409–413.

Weisler, R. H., Barbee, J. G., & Townsend, M. H. (2006). Mental health and recovery in the Gulf Coast after Hurricanes Katrina and Rita. Journal of the American Medical Association, 296(5), 585–588.