Combat exposure, wartime performance, and long-term adjustment among combatants

This study examined the contribution of exposure to specific battlefield Stressors (life-threatening situations, injuries and death, active fighting, and the fallibilities of one's own army) to combatants' battlefield functioning and long-term psychological adjustment. Participants consisted of 399 Israeli veterans of the 1973 Yom Kippur War, categorized by their wartime functioning into 3 groups: combat stress reaction (CSR) casualties, decorated war heroes, and controls (i.e., those who functioned adequately but without special distinction). Findings show that, even though the decorated war heroes reported the highest exposure to battlefield Stressors, they functioned better than the other 2 groups during the war. Moreover, some 2 decades later, they showed lower rates of posttraumatic stress disorder and better general psychological health than the CSR casualties. Findings also show that battlefield functioning made a greater contribution to postwar pathology than battle Stressors. These findings thus raise questions about how decisive the role of battle stress actually is in precipitating war-related pathology.