Karestan C.

Koenen, PhD
Effect of Post Traumatic Stress Disorder on Vietnam Veterans

Karestan C. Koenen, PhD is an Assistant Professor at Harvard School of Public Health.

Dr. Koenen is a licensed clinical psychologist with expertise and experience in
developmental psychology and psychiatric epidemiology. Koenen received her Ph.D, in
1999 in Clinical Psychology at Boston University. Her work has focused on
understanding the role of genetic and environmental risk factors in the development of
PTSD and its comorbidity with psychiatric and substance use disorders.
Koenen along with her associates researched was one conveyed over the course of
fourteen years in a random sample of 1,377 American Legionnaires who served in the
Vietnam War. The purpose of the study was to determine what factors at a given primary
period of time would lead to increased or decreased levels of risk for PTSD.
There were two questionnaires mailed to each of the members twice, once in 1984
and again 14 years later, in 1998. The questionnaires were mailed to 8,008 eligible
veterans, but only 1,377 of the veterans responses were accounted for due to the lack of
proper responses. The purpose of the questionnaire was to obtain demographic
information and detailed military service history. The categories measured were Vietnam
combat exposure, perceived social support, perceived negative community attitudes,
discomfort disclosing Vietnam experiences, community involvement, alcohol use, and
emotional distress. The questions were asked using a 5-point Likert-type style. After the
data was collected, the prevalence of PTSD in both time periods was calculated. The
consistency across the two time periods was also calculated. Using these assessments,

they came up with results that separated the veterans into four categories: PTSD at both
times, PTSD in 1984 only, PTSD in 1998 only, and no PTSD at either time period.
The first three categories had a similar number, ranging from 71 to 88. The fourth
category had a significantly larger number of 1,144. Of course, these numbers simply are
used to correlate the risk factors and how much they contribute in the individuals PTSD.
One of several discoveries made was that poor social support was associated with the
greater risk of developing PTSD and causing it to be chronic. Also was the conclusion
that the strongest predictor of PTSD in 1998 was PTSD being present in 1984. A minority
issue was delved into, but the results were inconclusive due to the lack of participation
from minorities in the study. The presence of higher levels of depression and anger also
correlated with higher chances of PTSD. An important finding showed that the avoidance
of the incident also led to increased PTSD symptoms, whereas individuals who did not
avoid their experiences were less likely to develop chronic PTSD. The presence of social
support was imperative for improvement. The findings led to high combat exposure being
the strongest predictor of PTSD persistence. Community support, especially perceived
social and community support, was significantly related to
PTSD. The results of this study also brought forth a viable future target to studydepression and anger.
The study done to discover the risk factors related to PTSD was only a small part
of a larger study, but resulted in meaningful and important results. The findings from this
experiment brought forth methods to prevent chronic PTSD due to the longitudinal

format of the study. Rather than short-term answers, the result found treatments of
positive community attitudes to be more helpful than others. Simply because there
werent other taken place over 14 years, the unique studys depth and the span of time
produced information essential for chronic treatment.
Dr. Karestan Koenen is currently conducting a family- based association study
aimed at identifying polymorphisms associated with onset and course of post-traumatic
psychopathology using a genotype by environment interaction framework. Dr. Koenen is
also an experienced clinician, specializing in empirically-validated short-term treatments
for PTSD. (HSOPH)

References Page

Harvard School of Public Health (2005 Nov 2, 2005).

http://www.hsph.harvard.edu/faculty/KarestanKoenen.html
Koenen, K.C., Stellman, J.M., Stellman, S.D., & Sommer, J.F. (2003). Risk factors for
course of posttraumatic stress disorder among Vietnam veterans: A 14-year follow-up of
American Legionnaires. Journal of Consulting and Clinical Psychology, 71, 980-986.