Exposure to recurrent combat stress: Can successful coping in a second war heal combat-related PTSD from the past?

The psychological aftermath of participation in war was examined for two groups of Israeli combat veterans, both of whom had participated in two wars. Soldiers who experienced a psychological breakdown (combat stress reaction [CSR]) in the first war but not in the second (n = 30) were compared to soldiers who did not sustain a CSR in either war (n = 37). The former group had higher PTSD rates, more posttraumatic symptoms, a higher overall level of psychiatric distress, and higher levels of instrusion and avoidance. The two groups also differed in self-expectations regarding future wars. No differences in social functioning, somatic complaints, or perceived self-efficacy in combat were observed. These findings indicate that even for veterans who had apparently recovered from a breackdown in the first war and went on to cope successfully in a subsequent war, the psychological scars created by a CSR do not really heal.