PTSD in SOF Personnel by Jud Kauffman ExBellum.

com As a special operations soldier, I always held the belief that my fellow operators and I were relatively immune to post-traumatic stress disorder (PTSD) when compared with other soldiers. Of course no one is really immune to such a disorder, but it was so rarely a problem with anyone I worked with, and we talked about it often. After a violent engagement or a traumatic event, wed briefly discuss the events openly and critically and then move on. We were sensitive to the dangers of mental and emotional problems associated with combat because we had had hours of classes and training on the subject, but it never became a major problem within our units. Speaking from personal experience, when I was on my very first real combat operation, we became surrounded by enemy forces and took effective and sustained fire. I distinctly remember having a discussion during the engagement with a fellow rookie about how calm we were. I had always expected to have tunnel vision and be so amped that my decisions would be less than clear. That was not at all the case. I was calm and collected and after we returned to base I fell right asleep. From then on I knew that our training actually worked and worked well. As a result of these experiences I came up with a hypothesis regarding PTSD in Special Operations Forces. Consider the following: a typical conventional soldier joins when he is eighteen years old and fresh out of high school. He is given fifteen weeks or so of basic training before being shipped to combat upon which time he is immediately exposed to shocking experiences. Clearly, he will likely not react well to such traumatic experiences. Conversely, SOF recruits are generally older and more mature, and are trained for 18 to 24 months in highly specialized courses of instruction before ever setting foot on a battlefield. These men will have a significantly lower likelihood of experiencing trauma when they see combat because they are exceptionally prepared for it, theyre mature, and have had ample time to psychologically prepare for what is to come. Therefore it is natural to expect to see a lower incidence of PTSD in SOF personnel than in conventional infantry soldiers. I developed this hypothesis based purely on anecdotal evidence. However, in light of recent media knee-jerk reaction to one or two crazy veterans who became violent and subsequent PTSD finger-pointing, I decided to research the subject. I found a number of studies which support my hypothesis and counter the medias broad brush strokes. A study conducted by the US National Center for PTSD in 2003[i] found that SOF combat personnel were much less likely to suffer symptoms of PTSD than conventional infantry. The study, which was conducted at Fort Bragg, tested whether SOF soldiers have neurological differences that make them more resilient to post-traumatic stress disorder than the average soldier. SOF soldiers were tested

for levels of a molecule called neuropeptide Y (associated with preventing stress) in their blood. The researchers found that nearly all SOF personnel had elevated levels of neuropeptide Y in their blood. According to the researchers, studies have shown a correlation between high levels of norepinephrine and chronic feelings of stress; neuropeptide Y molecule blocks norepinephrine, and this could be the functional basis for its effectiveness in lower stress levels. Matt Friedman, the director of the National Center for PTSD, explained at the 2003 conference of the American Association for the Advancement of Science that the SOF soldiers in the Fort Bragg study demonstrated a higher capacity to mobilize the neuropeptide Y molecule and sustain it for longer periods of time. Furthermore, the level of neuropeptide Y their bloodstream returned to normal levels within twentyfour hours, whereas conventional soldiers still showed decreased levels. According to Friedman, the capacity to mobilize neuropeptide Y is correlated to a lower likelihood of developing PTSD. He believes that neuropeptide Y may offer the key to primary prevention of PTSD, if a means of artificially elevating it could be discovered. Although the work has been going on for several years, researchers are still uncertain whether the SOF members enhanced capacity to endure trauma was genetic or had been acquired through Special Forces training. A broader and more focused study conducted in 2012 by researchers in the Department of Psychological Medicine in Sri Lanka[ii] compared the mental health problems of SOF personnel with conventional forces who had been engaged in combat for at least one year. Exposure to traumatic events and problems with family life were identified as risk factors. The outcome measures were common mental disorder, fatigue, multiple physical symptoms and hazardous alcohol use. The researchers found that while overall exposure to potentially traumatic events was high in both groups, the SOF personnel experienced significantly more traumatic events during their tours than conventional forces. In spite of this, Special Forces personnel exhibited significantly fewer common mental disorders, fatigue or poor general health than regular forces. Prevalence of PTSD was only 1.9% in the Special Forces and 2.9% among the conventional forces. So, even with more exposure to trauma, the SOF members still had lower rates of PTSD. The researchers suggested that better training, comradeship, and unit cohesion protected Special Forces personnel from negative mental health outcomes of combat. I also looked at studies of PTSD in civilian populations. PTSD rates in studies of civilian populations vary, and depend on the background and experiences of the cohorts these studies. However, civilian populations tend to have only slightly lower rates of PTSD than do military personnel who have served one or more combat tours. Incidents such as car accidents, losing a loved one, assaults, or simply prolonged periods of elevated stress are all common causes of PTSD amongst the non-military populations.

A study conducted in 1991[iii] examined PTSD rates among non-military urban youth in Detroit, a sample with an above-average exposure to traumatic events. Within the sample, 39% had been exposed to traumatic events, and among those exposed, 23.6% reported symptoms of PTSD. A 1993 study of PTSD[iv] rates among civilian American women found that lifetime prevalence of PTSD was 9.4% among women who were not victims of crime, and 25.8% among women who had been victims of crime. These studies are congruent with reporting from the National Center for PTSD, which says that about 8% of the overall population will experience PTSD at some point in their lives.[v] Generally speaking, available literature on the subject tends to support the hypothesis that Special Operations Forces have a higher resilience to combat stress. It is interesting that biochemical markers associated with stress control and reduction have been found to be higher and sustained for longer periods of time in SOF personnel than in conventional soldiers; this discovery demands more attention. It is possible that this could be a result of the extended and more rigorous training SOF personnel are given. A number of studies[vi] have shown that prolonged exercise cause the body to exhibit elevated levels of pain-killing neurochemicals, so it is safe to assume that a similar mechanism may be at work in SOF training. Perhaps extended exposure to rigorous, but controlled, environments, allows trainees to develop elevated levels of stress-reducing neurochemicals. My own experience, along with the available research on the subject, indeed leads me to believe and assert that SOF personnel do have higher resilience to combat stress and are less likely to exhibit PTSD symptoms than conventional soldiers. Furthermore, my research suggests that PTSD levels in the military overall are very near the averages of civilian rates of PTSD. At any rate, it is clear that more research needs to be done and less assumptions need to be made anytime a person who served in the military does something violent. If the reasons for this phenomenon are discovered, we may be able to use that knowledge to reduce PTSD in combat personnel throughout the Armed Forces as a whole. Jud Kauffman, ExBellum.com
ExBellum.com is an exclusive online network of special operations personnel, both active and separated, designed to connect the community with employers and with each other.

________________________________ [i] Battacharya, Shaoni. 2003. Molecular secret of Special Forces toughness. New Scientist. [ii] Hanwella R, de Silva V.2012. Mental health of Special Forces deployed in battle. Social Psychiatry and Psychiatric Epidemiology 47(8): 1343-51. [iii] Breslau N et al. 1991. Traumatic events and posttraumatic stress disorder in an

urban population of young adults. JAMA Psychiatry (Archives of General Psychiatry) 48(3):216-222. [iv] Resnick H et al. 1993. Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology 61(6):984-991. [v] Vorenberg, Sue. 2012. Civilians also suffer from PTSD. The Columbian (Vancouver, WA). [vi] Kotlyn K.F. 2000. Analgesia following exercise: a review. Sports Medicine 29(2): 85-89.