Laman utama Journal of Traumatic Stress Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans...
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Book Reviews 321 The importance of preserving evidence, determining the need for emergency care, acceSS to records, guidelines for interviewing children as opposed to adults, monitoring and the need for ongoing training are some of the areas often given short shrift in general discussions of child abuse. The author, who has a legal background, writes essentially from a jurisprudence perspective and leaves few, if any, stones unturned in carefully delineating the issues noted above. The book, in paperback, is modestly priced and ought to be widely read and accepted by professionals and nonprofessionals alike. Calvin J. Frederick LQS Angek, California Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. Edited by Richard A. Kulka Ph.D., William E. Schlenger, Ph.D., John A. Fairbank, Ph.D., Richard L Hough, Ph.D., B. Kathleen Jordan, Ph.D., Charles R. Marmar, M.D., Daniel S. Weiss, Ph.D., David A. Grady, Psy.D., New York BrunnerMazel, Publishers, 1990, 322 pages, $19.95. Trauma and the Vietnam War Generation is a comprehensive review of the National Vietnam Veterans Readjustment Study ( N V V R S ) . This study was mandated by Congress in 1983 to better determine the prevalence of psychiatric disorders and psychosocial adjustment difficulties in Vietnam veterans. It is considered a landmark study in the F’TSD field and, in my understanding, is also considered a critical study in psychiatric epidemiology in general. As noted in the preface, the N W R S is considered “broader and more inclusive” than past studies and has a number of important findings. For example, the “majority of Vietnam theater veterans have made a successful reentry into civilian life.” However, the N V V R S indicates that 15.2% (479,000) of male and 8.5% (610) of women Vietnam theater veterans have current F E D . Furthermore, 11.1% of males and 7.8% of female theater veterans have current “partial PTSD,” i.e., dysfunctional EYrSD symptoms without meeting full criteria for the ; syndrome. These and other important findings have emphasized the significant public health problem of PTSD in Vietnam veterans and stimulated increased interest in providing adequate treatment and research resources in VA facilities for the disorder. The book is well-organized and well-written. It is over 300 pages in length and organized into 13 chapters. The first chapter provides an overview Ilook Reviews 322 of the rationale for and goals of the study and the study design. The second chapter provides definitions/descriptions of the sample population. The third and fourth chapters address findings about the prevalence of PTSD and component symptoms of F E D . The fifth chapter discusses predisposition (premilitary) factors in the development of PTSD. As noted in the overview for this chapter, “the results are consistent with a model of PTSD that posit a role for individual vulnerability . . .and a role for exposure to environmental factors .’.. . However, it is also clear that exposure to war-zone stress makes a substantial contribution to the development of FTSD in war veterans that is independent of a broad range of potential predisposing factors.” The next three chapters discuss NVVRS findings regarding the prevalence of other psychiatric disorders besides PTSD, the prevalence of other readjustment problems, and the prevalence of physical health problems. Chapter nine addresses health and mental health care service utilization by this population. Chapter ten discusses the critical issue of perspectives and adjustment in families of veterans with and without PTSD. The findings presented here signify the dramatic impact on adjustment that PTSD may have on family systems and also further validate these veterans’ reports, i.e., the finding of “a strong correlation between PTSD symptoms reported by the Veterans themselves and reports of the veteran’s symptoms from their spouses.” The remaining three chapters present a general overview, suggestions for further NVVRS data analysis, and a vital “Epilogue: A SelfGuide for Vietnam Veterans.” This book will serve as an important reference (likely “the reference”) for years to come on psychiatric epidemiology in Vietnam veterans. Understanding this work will also be helpful in appreciating future analyses and interpretations of N W R S data, e.g., further investigations regarding specific psychiatric morbidity in Vietnam veterans (Jordon ef al., 1991). It is recommended reading for every clinician and clinical researcher working with veterans. Mark B. Hamner SC Charkston, REFERENCE Jordon, B. K., Schlcngcr. W. E.. Hough. R., KuIk:i, R . A,. W c k . D..Fiiirhiiilk. J . A.. ; i d Marmar, C. R. (199 I ) . Lilctimc and current prevalence ol’ spccilic psychiatric disordcrs among Virlnam ve1cr:ins and control.\. A d r . Geu. P.i>r/ricr/iy4X: N 7 - 2 IS.