Study: High Combat Activity Producing Epidemic of Acute Stress in Afghanistan

WASHINGTON — Acute stress is rampant among troops in Afghanistan who are experiencing “a dramatic increase” in the levels of combat activity, according to a recent study. The study found that stress and combat activity were significantly higher than levels reported at any other period when the survey was taken, i.e. 2005, 2007 or 2009.

U.S. Army Sgt. David Smitt maintains overwatch during an air assault patrol with U.S. soldiers and British gunners in Afghanistan’s Kandahar province,
Feb. 10, 2011. U.S. Army photo by Sadie Bleistein.

“We know from history that behavioral health and morale can be linked to combat intensity,” said Army Surgeon General Lt. Gen. Eric Schoomaker, MD. “Measures of combat exposure are at historically high levels for these MHAT studies.”

The findings were reported in the 2010 Joint Mental Health Advisory Team (MHAT) survey, which has been conducted to assess the behavioral health of troops since 2003. The most recent study included 911 soldiers and 335 marines surveyed during July and August of 2010. In addition, 85 surveys were collected from behavioral health personnel deployed in Afghanistan.

Among the soldiers, more than 60% said in the survey that they had experienced an IED exploding near them, compared with 48% in 2009; nearly three-fourths had experienced a member of their unit dying, compared with 63% in 2009. Nearly 80% had experienced shooting at the enemy, and nearly half had said they were responsible for the death of a combatant.

Marines also reported heavy fighting. Nearly 80% said they had experienced a fellow marine in their unit become a death casualty, compared with 27% in 2007; about 67% said they had experienced an IED exploding near them, compared with 30% in 2007; 75% said they shot at the enemy, and 66% said they were responsible for killing a combatant.

Addressing Mental Health

Schoomaker acknowledged “there are few stresses on the human psyche as extreme as exposure to combat.” He said the military is taking a holistic and comprehensive approach in helping troops in theater deal with stress.

Moving the “behavioral health indices when you have extremely high combat exposure,” is difficult, according to Col. Paul Bliese, who led the study. Still, he said the research team was struck by the fact that the surveyed troops did not appear to be having “as much of an increase in the mental health symptoms as we would have expected,” given the increase in intense combat. He acknowledged, however, that individuals often report symptoms when they return from combat, so this does not mean that these individuals will not later experience problems.

The report also had some positive findings, officials reported. For example, soldiers and marines reported high levels of cohesion and perceived unit readiness relative than in past years, which can counter the negative effects of the high combat exposure. In addition, soldiers and marines reported having received more adequate training for suicide prevention and handling combat stress than in previous years.

“I look at those items in the report from that lens, and I would say that one can make the case that there have been some positive changes done in the military, doing what we can do with a very difficult situation in terms of preparing soldiers for the harsh reality of combat,” said Bliese.

Capt. Frederick Kass, deputy to the Medical Officer of the Marine Corps, pointed out that not all solutions for helping troops manage stress in theater are medical, but that others include providing realistic training, unit cohesion and a clear sense of mission. Page 2

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