Caroline Junker
Post traumatic stress disorder (PTSD) is well known for its potentially crippling effects, often impacting individuals who have sustained intensely stressful or traumatic experiences over their entire lifetimes. These trauma-inducing situations can be prevalent in military settings, particularly during active deployment and combat, characterizing returning veterans as vulnerable candidates for experiencing PTSD. A new literature review upcoming at The Journal of Young Investigators, “The Relationship Between PTSD and Peer Support Among Returning War Veterans,” investigated how peer support services may aid in improving the transition back to civilian life for returning veterans, ultimately finding that pairing treatment with support groups consisting of fellow veterans can help mitigate PTSD symptoms and produce positive social feelings.
PTSD, as defined in the current edition of the American Psychiatric Association’s The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is characterized by an individual reliving or replaying a traumatic event, practicing avoidance, experiencing negative changes in cognition and emotions, and experiencing hyperarousal. All of these symptoms can cause significant distress and anguish, obviously posing difficulties to the social and interpersonal functioning that is fundamental to reintegrating into society. Veterans are highly vulnerable to PTSD; data shows that of veterans returning from Operations Iraqi Freedom and Enduring Freedom programs, about 13 percent were affected by PTSD. Assimilating back into civilian culture can already be a challenging process, with veterans trading a highly regimented military structure and routine for the more independent lifestyle of normal civilians. With the added obstacle of PTSD and its impairment of social ability and cognition, this transition can be extremely difficult.
The two most highly effective and widely acknowledged treatments for PTSD are Prolonged Exposure (PE) Therapy and Cognitive Processing Therapy (CPT). PE Therapy involves stages of different levels of exposure, as the subject gradually processes their emotional memory internally and outside the context of therapy. CPT requires the subject to examine their beliefs relating to their traumatic experience. Both forms of therapy have been demonstrated to reduce PTSD symptoms, but studies show that enrollment in these programs could potentially be bolstered if supplemented with peer support. Peer support involves the presence of a person who shares a diagnosis with the individual undergoing treatment, and who is willing to share about their experiences with their mental health condition to promote social or personal growth. Importantly, this peer is not trained to provide mental health services, but offers support through the commonality of their condition. Peer support groups have been used to good results, demonstrating positive growth in the parameters of connecting individuals with mental health services and fighting the stigma of mental health conditions.
The use of peer support services for veterans may be particularly effective given the close relationships that often arise between veterans in intense combat situations or other deployment experiences. Peer support may help improve PTSD symptoms through promoting social bonds between veterans, aiding in the wellbeing and recovery of these veterans, and increasing their general knowledge about the healthcare system. The presence of fellow peers with shared experiences can foster environments that encourage communication, support, and trust, all which help improve social functioning. Future research should focus on defining exact metrics to assess these impacts of peer support groups on individuals, but reviewing trends in past studies suggests that veterans have everything to gain from these supportive environments.
References:
American Psychiatric Association, & American Psychiatric Association. (2013) ‘Diagnostic and statistical manual of mental disorders: DSM-5.’
Brown, C., Besterman-Dahan, K., Chavez, M., Njoh, E., & Smith, W. (2016) ‘It gave me an excuse to get out into society again: decreasing veteran isolation through a community agricultural peer support model’, Journal of Veterans Studies 1(1), 163. https://doi.org/10.21061/jvs.42
Drebing, C. E., Reilly, E., Henze, K. T., Kelly, M., Russo, A., Smolinsky, J., Gorman, J., & Walter E. Penk. (2018) ‘Using peer support groups to enhance community integration of veterans in transition’, Psychological Services 15(2),135–45. https://doi.org/10.1037/ser0000178
Jain, S., McLean, C., Adler, E., Lindley, S., & Rosen, C. (2013) ‘Does the integration of peers into the treatment of adults with posttraumatic stress disorder improve access to mental health care? A literature review and conceptual model’, Journal of Traumatic Stress Disorders & Treatment, 2(3), 1-9. https://doi.org/10.4172/2324-8947.1000109
Luchsinger, Alex. (2016) "Veterans seeking veterans through interpersonal communication." International Journal of Communication 8(2016): 1-9.
Odom, K., Shuwen, L., Zambrano-Vazquez, L., & Bakan, J. (2023) ‘The Relationship Between PTSD and Peer Support Among Returning War Veterans’, The Journal of Young Investigators.
Solomon, P. (2004) ‘Peer support/peer provided services underlying processes, benefits, and critical ingredients’, Psychiatric Rehabilitation Journal, 27(4), 392–401. https://doi.org/10.2975/27.2004.392.401