Vietnam Veterans: Overreporting Versus Acceptable Reporting of Symptoms

Overreporting of symptoms among Vietnam combat veterans is a problem area with little research. Five hundred thirty Vietnam-era veterans were given the MMPI. They were divided according to two criteria, combat status and reporting status. For combat status, subjects were either in Vietnam (in-country) or in the military but not in Vietnam (Vietnam-era) between 1964 and 1975. For reporting status, the MMPI overreporting criteria of the subtle-obvious (S-O) items given by Green (1986) were used. Overreporters had an S-O total of > 160, and acceptable subjects were at or below this figure. Also, all subjects who responded randomly were excluded (MMPI Test-Retest scales > 4). Results indicated that a high number of subjects randomly responded to the MMPI, and that in-country veterans met the overreporting criteria in greater numbers than the Vietnam-era group. Also, multivariate analyses of variance (MANOVAs) showed significant differences among groups in four distinct areas—MMPI basic scales, Harris-Lingoes, Wiggins, and special subscales—for both reporting status and combat status, but not for the interaction. Post hoc analyses of variance (ANOVAs) showed that reporting status was especially robust. Two Vietnam in-country PTSD types, overreporters and "acceptable" patients, are discussed. Overreporters are more pathological and a distinct challenge in treatment relative to the other in-country veterans.     

The Long-Term Effects of Military Service on Quality of Life: The Vietnam Experience1

In this study, we examined the effects of military service during the Vietnam War on the quality of life in middle adulthood for a cohort of men characterized by a privileged socioeconomic status. The final sample included 374 men who, upon graduating from an Ivy League college in 1966, performed military service in Vietnam, engaged in military service during this time in regions other than Vietnam, or did not serve in the military. As indices of quality of life in the middle years, we used a set of health-related behaviors, a series of life transitions experienced after the age of 40, and satisfaction with various components of life, as well as life as a whole. Multivariate analyses of variance and chi-square analyses revealed significant differences among the sample subgroups on several quality-of-life indices. The subgroup of Vietnam veterans reported more frequent alcohol use than the nonveterans. In terms of midlife transitions, the Vietnam veterans were most likely to have changed careers and to have moved residence, and the least likely to feel lonely in middle adulthood. Compared to the Vietnam veterans and the Vietnam-era veterans, the nonveteran group was least likely to have questioned their values, experienced depression, or to have moved to a new home. Finally, the Vietnam veterans were significantly less satisfied with their careers, finances, and with life in general, compared to their nonveteran counterparts; however, they reported more satisfaction with their male friendships than did Vietnam-era veterans. These findings suggest that the Vietnam War experience is associated with lower quality of life during middle adulthood in certain domains, even among a select group of individuals, of high socioeconomic status, whose privileged background could have presumably protected them from the adversities of the Vietnam War.     

The psychophysiology of combat-induced post-traumatic stress disorder in Vietnam veterans

The psychophysiological responses of heart rate (HR), systolic and diastolic blood pressure, skin conductance level and forehead electromyogram were compared during: rest, mental arithmetic and combat sounds of gradually increasing intensity for five groups of Ss: Vietnam veterans with post-traumatic stress disorder (PTSD); Vietnam veterans without PTSD but with comparable levels of combat experience; Vietnam veterans with other psychiatric disorders; Vietnam-era veterans; and nonveteran phobics. HR response to low-intensity combat sounds provided good discrimination between veterans with PTSD and the other groups and seems to resemble a conditioned emotional response.     

The role of attentional biases in PTSD: is it interference or facilitation?

Although attentional biases have been demonstrated in individuals with posttraumatic stress disorder (PTSD), the cognitive methodologies used have not allowed for disambiguation of two types of attentional biases. It remains unclear if PTSD involves difficulty disengaging attention from threatening stimuli (interference) or facilitated detection. To differentiate between attentional interference and facilitation, 57 male Vietnam-era veterans (30 High PTSD and 27 Low PTSD) completed a visual search task with a lexical decision component. High PTSD veterans who engaged in the interference task first showed increased interference to threat-relevant words relative to Low PTSD veterans. However, no evidence was found for facilitated detection of threatening stimuli in PTSD.     

Relationship distress in partners of combat veterans: the role of partners' perceptions of posttraumatic stress symptoms

Partners of combat veterans with posttraumatic stress disorder report elevated relationship and psychological distress, but little is known about the mechanisms by which such distress develops. In two separate samples, we examined partners' perceptions of veterans' PTSD symptoms, with a specific focus on the simultaneous associations of partners' distress with their perceptions of veterans' reexperiencing, withdrawal/numbing, and hyperarousal symptom clusters. The first sample consisted of 258 partners of Operation Enduring- and Iraqi Freedom-era veterans who completed questionnaires. The second sample consisted of 465 partners of Vietnam-era veterans who completed interviews as part of the National Vietnam Veterans Readjustment Study. In both samples, path analyses revealed that, when examined simultaneously, partners' perceptions of withdrawal/numbing symptoms were associated with greater distress, but perceptions of reexperiencing symptoms were unrelated to psychological distress and significantly associated with lower levels of relationship distress. Given the cross-sectional nature of the data in both samples, there are multiple plausible interpretations of the results. However, the pattern is consistent with an attributional model of partner distress, whereby partners are less distressed when symptoms are more overtly related to an uncontrollable mental illness. Potential clinical implications are discussed.     

Political Attitudes and the Vietnam War: A Study of College-Educated Men of the Vietnam Generation1

Groups of Vietnam veterans (n= 52), Vietnam era veterans (n= 77), and nonveterans (n= 249), all of whom had graduated from an Ivy League university in 1966, were compared in terms of their retrospectively reported general political orientation in 1966 and their current orientation and specific political attitudes in 1990–1991. The Vietnam veterans rated themselves as being more conservative than the nonveterans on political orientation and on specific political issues in 1990–1991. The Vietnam-era veterans tended to take an intermediate position politically between the other two groups. Controlling for retrospective political orientation in 1966, intensity of military experience predicted more ideological conservatism and more support for the war against Iraq, as well as a more conservative position on a number of specific political issues of current interest. Results are consistent with the idea that critical experiences in young adulthood, namely military service in Vietnam, may affect political attitudes over many years.     

Placement Counseling: Focus on the Community College

Because of the vocational emphasis in the two-year college, placement is even more important here than in other institutions. Statistics accentuate the employment needs of two-year college students during their attendance at college and after graduation. Despite the needs, placement services have not been adequately developed. Counseling needs in the two-year colleges are varied and complex. There is a need for career counseling, counseling for career flexibility, preparing for the job interview and how to keep a job, follow-up, counseling and developing opportunities for minorities as well as concern with handicapped, veterans, and marginal students. Community awareness and participation is essential. To accomplish this, an adequate, well-prepared staff is required.     

Evaluating the impact of career management skills module and internship programme within a university business school

This study evaluates the impact of an intervention on business school graduates' employability comprising of a curriculum-based career management skills (CMS) module and an industrial placement year. The study uses data from the destinations of leavers of higher education survey to examine the employability of different groups within the cohort (no intervention, CMS module only and CMS module plus structured work experience). It finds that structured work experience has clear, positive effects on the ability of graduates to secure employment in ‘graduate level’ jobs within six months of graduation. Furthermore, participation in the CMS module also has a clear, positive effect upon the ability of participants to secure employment.     

The impact of sport and physical activity on the well-being of combat veterans: A systematic review

ObjectivesThis review examined the potential impact of sport and physical activity upon the subjective and psychological well-being of combat veterans in the aftermath of physical or psychological combat trauma.DesignA systematic review was conducted. The question guiding this review was ‘what is the impact of sport and physical activity on the well-being of combat veterans?’MethodsKey databases were searched for articles relating to the use of sport and/or physical activity in supporting combat veterans. 11 studies were identified as relevant for inclusion. Data from these studies were extracted by means of a directed content analysis, the results of which were reported in a narrative synthesis.ResultsSport and physical activity enhances subjective well-being in veterans through active coping and doing things again, PTSD symptom reduction, positive affective experience, activity in nature/ecotherapy, and quality of life. Impact on psychological well-being includes determination and inner strength, focus on ability and broadening of horizons, identity and self-concept, activity in nature/ecotherapy, sense of achievement/accomplishment, and social well-being. Participating in sport and/or physical activity can also enhance motivation for living.ConclusionsThe review advances knowledge by producing a synthesis of evidence that highlights the value of sport and physical activity for supporting the well-being and rehabilitation of disabled combat veterans and combat veterans diagnosed with Post-Traumatic Stress Disorder. It also develops knowledge by identifying the type of sports and physical activities used to promote well-being, offering the first definition of combat veterans in the sport literature, taking a critical approach, and highlighting the under researched role of nature-based physical activity.     

Self-Defeating Behavior Workshops: Systems Approach for Hard-to-Serve Veterans

For the past two and one-half years, the self-defeating behavior (SDB) theory has been applied to a population of veterans who had a history of problems in job training, vocational placement, and academic settings. A group-therapy structure meeting eight times during a four-week period is the basic approach of the SDB seminar. In conjunction with the SDB seminar, a variety of support people and agencies have combined efforts to develop a systems approach to helping the veterans eliminate behaviors that are self-defeating. Results from the systems approach have been excellent.     

Attentional interference by threat and post-traumatic stress disorder: The role of thought control strategies

Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which increase PTSD risk. Conversely, attentional interference might be associated with reduced use of adaptive strategies, such as talking about threatening thoughts (social control), which decrease PTSD risk. This study tested if thought control strategies mediate the relationship between attentional interference and PTSD. Sixty-one male Vietnam-era veterans completed measures of PTSD symptoms and thought control strategies. Participants also completed a Visual Search Task measuring attentional interference, which required participants to identify a target letter string among a group of threat or neutral words. Attentional interference by threat was related to PTSD symptoms, and mediation analyses revealed significant indirect effects of attentional interference through thought suppression and worry. Attentional interference was related to re-experiencing and avoidance, but not hyperarousal, symptom clusters. Thought suppression was a unique mediator for re-experiencing, whereas thought suppression and worry both mediated the relationship with avoidance. These results offer evidence for maladaptive thought control strategies as a mechanism linking attentional biases for threat to PTSD.     

Creating hope: Assisting Veterans with Job Search Strategies using Cognitive Information Processing Theory

Providing effective employment services to today's veterans is essential. Given the high unemployment rate that currently exists for the veteran population, it is essential that career development professionals consider ways to effectively address their needs. This article highlights the complexities veterans experience in the job preparation and job search processes, as well as current efforts addressing the veteran unemployment concern. A clinical case study shows how cognitive information processing theory, a theory of career problem solving and decision making, can be used as a foundation for assisting veterans in the job search process.     

The Representation of Immigrants in Federal,State, and Local Government Work Forces

Public sector employment of immigrants can increase their economic assimilation and potentially improve their treatment by government. Yet, as we show using Census data from 1990, 2000, and 2009–2011, immigrants are substantially underrepresented in federal, state, and local governments. To understand why, we use logit analysis for federal and for state and local government employment in each time period to test whether immigrants’ weaker educational attainment and English proficiency, lower probabilities of being citizens and military veterans, and different age, gender, and race/ethnicity distributions can explain that underrepresentation. Disparities in education and preferential government treatment of veterans are factors, but citizenship requirements appear to be the major obstacle to immigrant employment in the public sector.     

Posttraumatic Stress Disorder and Vietnam Veterans

Many unemployed Vietnam veterans may be sufferers of posttraumatic stress disorder (PTSD). Symptoms and behaviors of PTSD are reviewed to assist employment counselors in identifying such individuals, and suggestions for referral are made.     

Anhedonia, Emotional Numbing, and Symptom Overreporting in Male Veterans with PTSD

We used measures of positive affect and emotional expression to distinguish and better understand veterans with PTSD with symptom overreporting presentation styles. Based on prior research, symptom overreporting was defined as scores greater than eight on the F(p) (Infrequency-Psychopathology) scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Data were drawn from an archival dataset of 227 combat veteran outpatients. Results were consistent with theory and research on the distinction between negative and positive affect. Major findings indicated that (a) veterans endorsing greater anhedonia had a greater likelihood of being classified as a symptom overreporter (controlling for PTSD symptoms), and (b) compared to non-symptom overreporting veterans, overreporters showed greater congruency in their presentation of diminished positive affect and their expression across self- and clinician-ratings. Our data suggest that diminished positive emotions and their behavioral expression are uniquely associated with veterans' psychological experiences, providing insight into the nature of symptom overreporters.     

Counseling— A Friend to Placement

The policy declaring placement as top priority, accompanied by a responsive focus of staff and budget resources, has decreased the availability of counseling services to applicants contacting the employment service. Many people, if they are to be assisted in finding and keeping jobs, need the help given by professional employment service counselors. Management and program planners need an accountability rate of the importance of counseling services in the accomplishment of the placement priority. A study, covering two years of employment activities, was conducted in the Utah agency to gain insight into the question. The statistical material studied concerned available applicants, number placed, number counseled, and counseled applicants placed. The data indicated that counseled applicants have better than twice the chance of being placed on a job than uncounseled applicants. Thus, in Utah, counseling services have a positive influence in the job placement of an applicant.     

MMPI identification of nonrehabilitants among disabled veterans.

Utilized the Minnesota Multiphasic Personality Inventory (MMPI) with IQ scores and selected biographic data to identify drop-outs in a Veterans Administration vocational rehabilitation program. Subjects were 61 male disabled veterans. Data were collected at VA Hospital Richmond, Virginia, between September 1973 and September 1974. Follow-up six months after entrance into training utilized persistence in training or employment as success criteria. Multivariate analysis identified 32 of 33 successful and 25 of 28 unsuccessful subjects with p less than .001. Factor analysis of the best predictors identified MMPI Psychopathic deviate (Pd) Hypomania (Ma), and Lie (L) scales which was interpreted to be a social adjustment factor. Four other factors were identified. Results indicated the MMPI was a useful instrument in the identification of disabled veterans who were likely to experience difficulty in post-hospital vocational rehabilitation.     

JOB DEVELOPMENT FOR THE MENTALLY RESTORED PSYCHIATRIC PATIENT1

The experiences of the placement department of the Mental Health and Manpower Project have demonstrated that an effective team can be created to develop job opportunities for the mentally restored psychiatric patient. Composed of a vocational counselor and a placement counselor, the team is effective in securing meaningful employment and developing re-education programs in the community. While the vocational counselor provides the clinical information concerning the restored patient-client, the placement counselor serves as a more personnel oriented individual in finding the appropriate kind of employment position. The team points to the potential that the mental health center possesses in involving the general community in its programs.     

EFFECT OF SUPPORTED EMPLOYMENT ON THE VOCATIONAL OUTCOMES OF PERSONS WITH TRAUMATIC BRAIN INJURY

This paper reports the job placement of 5 males with severe traumatic brain injury. An individual placement model of supported employment was used. All individuals were placed in competitive employment and received staggered intervention over time by trained employment specialists. A multiple baseline design across persons was used to evaluate results. All individuals had been unable to work consistently or at all in competitive work environments. The range of wages was $4.25 to $5.00 per hour with an average of 339 hours of employment specialist intervention time required per case. The major problems experienced by employment specialists were insubordinate and disruptive behaviors as well as other inappropriate social behaviors displayed at the job site.